Endoscopic ultrasonography represents a crucial aspect of the diagnosis of pancreatic lesions. The echo-endoscopic features of pancreatic lesions, particularly their contrast behavior with the advent of Contrast-Enhanced EUS (CE-EUS) and Contrast Enhanced Harmonic-EUS (CH-EUS), can predict a lesion’s aggressiveness, depending on its nature. According to this, CH-EUS could be applied to structure an even more dedicated approach to patient care, for example, to ascertain eligibility for surgical intervention of a pancreatic ductal adenocarcinoma (PDAC) or the response to neoadjuvant chemotherapy in cases deemed borderline resectable. In addition to PDAC, other significant issues pertain to the management of small neuroendocrine tumors (NETs) and intraductal papillary mucinous neoplasms (IPMNs). In this context, CH-EUS can be crucial. The aim of this review is to underline the most recent evidence for EUS and CH-EUS applications in pancreatic lesion aggressiveness assessment and to focus on possible future research directions to further extend the application of CH-EUS in this field.
超声内镜在胰腺病变的诊断中占据关键地位。胰腺病变的超声内镜特征，特别是随着对比增强超声内镜（CE-EUS）和对比增强谐波超声内镜（CH-EUS）技术发展所呈现的造影特征，可根据病变性质预测其侵袭性。基于此，CH-EUS可构建更具针对性的诊疗策略，例如评估胰腺导管腺癌（PDAC）患者的手术适应症，或判断临界可切除病例新辅助化疗的疗效。除PDAC外，该技术在小型神经内分泌肿瘤（NETs）及导管内乳头状黏液性肿瘤（IPMNs）的诊疗中也具有重要意义。本文旨在综述EUS与CH-EUS在胰腺病变侵袭性评估中的最新循证依据，并聚焦未来研究方向，以拓展CH-EUS在该领域的应用前景。
肿瘤(癌症)患者之家