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Kolanjiokarsinomun Endosonografik Özellikleri ve Bilgisayarlı Tomografi ve Endoskopik Retrograd Kolanjiyografi Bulguları ile Karşılaştırılması

Yıl 2019, Cilt: 5 Sayı: 2, 317 - 323, 01.01.2019

Öz

Amaç: Literatürde kolanjiokarsinomun CC endosonografik EUS özellikleri açık bir şekilde tanımlanmamıştır. Çalışmamızın amacı, CC'nin EUS özelliklerini belirlemek ve bunları bilgisayarlı tomografi BT ve endoskopik retrograd kolanjiyografi ERCP bulgularıyla karşılaştırmaktır.Gereç ve Yöntemler: Çalışmaya Ocak 2008-Ocak 2011 tarihleri arasında KK tanısı konan 35 hasta alındı. EUS, BT ve ERCP bulguları retrospektif olarak değerlendirildi.Bulgular: EUS, 33 % 95 hastada hipoekoik kitle lezyonu gösterdi. BT ve ERCP bulguları, tümörün lokalizasyonu açısından EUS bulguları ile uyumluydu. Kitle lezyonlarının kenar ve konturları 15 hastada düzenli ve iyi tanımlanmış, ancak 20 hastada düzensiz ve kötü tanımlanmıştır. Bu özellikleri göz önünde bulundurarak, EUS üzerinde 2 adet CC paterni belirledik: 1 safra kanalları ile net bir ilişkisi olmayan, düzensiz ve kötü sınır ile tanımlı hipoekoik bir lezyon 2 safra kanalları ile ilişkisi açıkça görülen, düzenli ve iyi bir sınır ile tanımlı hipoekoik bir lezyon.Sonuç: Bu retrospektif çalışmada EUS, CC'li tüm hastalarda kitle lezyonlarını ortaya koydu. CC, EUS üzerinde iki ayrı paten sergileyebilir

Kaynakça

  • 1. Ustundag Y, Bayraktar Y. Cholangiocarcinoma: A compact review litarature. World J Gastroenterol 2008; 14:6458-66.
  • 2. Weber A, Schmid RM, Prinz C. Diagnostic approaches for cholangiocarcinoma. World J Gastroenterol 2008; 14:4131-6.
  • 3. Mohamadnejad M, DeWitt JM, Sherman S, LeBlanc JK. Role of EUS for preoperative evaluation of cholangiocarcinoma: A large single-center experience. Gastrointest Endosc 2011; 73:71-8.
  • 4. Fritscher-Ravens A, Broering DC, Sriram PV. EUSguided fine-needle aspiration cytodiagnosis of hilar cholangiocarcinoma: A case series. Gastrointest Endosc 2000; 53:534-40.
  • 5. Varghese JC, Farrell MA, Courtney G, Osborne H, Murray FE, Lee MJ. A prospective comparison of magnetic resonance cholangiopancreatography with endoscopic retrograde cholangiopancreatography in the evaluation of patients with suspected biliary tract disease. Clin Radiol 1999; 54:513-20.
  • 6. Garrow D, Miller S, Sinha D, Conway J, Hoffman BJ, Hawes RH, Romagnuolo J. Endoscopic Ultrasound: A meta analysis of test performance in suspected biliary obstruction. Clin Gastroenterol Hepatol 2007; 5:616-23.
  • 7. Aljiffry M, Walsh MJ, Molinari M. Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990- 2009. World J Gastroenterol 2009; 15:4240-62.
  • 8. Patel T. Cholangiocarcinoma. Nat Clin Pract Gastroenterol Hepatol 2006; 3:33-42.
  • 9. Ishak KG, Anthony PP, Sobin LH. In: Histological typing of tumours of the liver. WHO International Histological Classification of Tumours. 2nd ed. Berlin: Springer Verlag, 1994:5-7.
  • 10. Eloubeidi MA, Chen VK, Jhala NC, Eltoum IE, Jhala D, Chhieng DC, Syed SA, Vickers SM, Mel Wilcox C. Endoscopic ultrasound-guided fine needle aspiration biopsy of suspected cholangiocarcinoma. Clin Gastroenterol Hepatol 2004; 2:209-13.
  • 11. Strongin A, Singh H, Eloubeidi MA, Siddiqui AA. Role of endoscopic ultrasonography in the evaluation of extrahepatic cholangiocarcinoma. Endosc Ultrasound. 2013; 2(2):71-6.
  • 12. Hara K, Bhatia V, Hijioka S, Mizuno N, Yamao K. A convex EUS is useful to diagnose vascular invasion of cancer, especially hepatic hilus cancer. Dig Endosc 2011; 23 Suppl 1:26-8.
  • 13. DeWitt J, Misra V, LeBlanc J, Sherman S, McHenry L. EUS-guided FNA of proximal biliary strictures after negative ERCP brush cytology results. Gastrointest Endosc 2006; 64:325-33.
  • 14. Alper E, Arabul M, Buyrac Z, Baydar B, Ustundag Y, Celik M. The use of radial endosonography findings in the prediction of cholangiocarcinoma in cases with distal bile duct obstructions. Hepatogastroenterology 2013; 60:678- 83.
  • 15. Khashab MA, Fockens P, Al-Haddad MA. Utility of EUS in patients with indeterminate biliary strictures and suspected extrahepatic cholangiocarcinoma (with videos). Gastrointest Endosc 2012; 76(5):1024-33.
  • 16. Weilert F, Bhat YM, Binmoeller KF, Kane S, Jaffee IM, Shaw RE, Cameron R, Hashimoto Y, Shah JN. EUS-FNA is superior to ERCP-based tissue sampling in suspected malignant biliary obstruction: Results of a prospective, single-blind, comparative study. Gastrointest Endosc 2014; 80(19):97-104.
  • 17. Sadeghi A, Mohammadnejad M, Islami F, Keshtkar A, Biglari M, Malekzadeh R, Eloubedidi MA. Diagnostic yield of EUS- guided FNA for malignant biliary stricture: A systematic review and meta-analysis. Gastrointest Endosc 2016; 83(2): 290-8.
  • 18. Han JK, Choi BI, Kim AY, An SK, Lee JW, Kim TK, Kim SW. Cholangiocarcinoma: pictorial essay of CT and cholangiographic findings. Radiographics 2002; 22:173- 87.
  • 19. Kim TK, Choi BI, Han JK, Jang HJ, Cho SG, Han MC. Peripheral cholangiocarcinoma of the liver: 2-phase spiral CT findings. Radiology 1997; 204:539-43.
  • 20. Watadani T, Akahane M, Yoshikawa T, Ohtomo K. Preoperative assessment of hilar cholangiocarcinoma using multidetector-row CT: Correlation with histopathological findings. Radiat Med 2008; 26:402-7.
  • 21. Feydy A, Vilgrain V, Denys A, Sibert A, Belghiti J, Vullierme MP, Menu Y. Helical CT assessment in hilar cholangiocarcinoma: Correlation with surgical and pathologic findings. Am J Roentgenol 1999; 172:73-7.
  • 22. Zhang Y, Uchida M, Abe T, Nishimura H, Hayabuchi N, Nakashima Y. Intrahepatic peripheral cholangiocarcinoma: Comparison of dynamic CT and dynamic MRI. J Comput Assist Tomogr 1999; 23:670-7.
  • 23. Tillich M, Mischinger HJ, Preisegger KH, Rabl H, Szolar DH. Multiphasic helical CT in diagnosis and staging of hilar cholangiocarcinoma. Am J Roentgenol 1998; 171:651-8.
  • 24. Okumoto T, Sato A, Yamada T, Takase K, Matsuhashi T, Tsuda M, Seiji K, Ishibashi T, Higano S, Katayose Y, Unno M, Takahashi S. Correct diagnosis of vascular encasement and longitudinal extension of hilar cholangiocarcinoma by four channel multidetector-row computed tomography. Tohoku J Exp Med 2009; 217:1-8.
  • 25. Park MS, Kim TK, Kim KW, Park SW, Lee JK, Kim JS, Lee JH, Kim KA, Kim AY, Kim PN, Lee MG, Ha HK. Differentiation of extrahepatic bile duct cholangiocarcinoma from benign stricture: Findings at MRCP versus ERCP. Radiology 2004; 233:234-40.
  • 26. Rösch T, Meining A, Frühmorgen S, Zillinger C, Schusdziarra V, Hellerhoff K, Classen M, Helmberger H. A prospective comparison of the diagnostic accuracy of ERCP, MRCP, CT, and EUS in biliary strictures. Gastrointest Endosc 2002; 55:870-6.

Endosonographic Features of Cholangiocarcinoma and Comparison with Computed Tomography and Endoscopic Retrograde Cholangiography Findings

Yıl 2019, Cilt: 5 Sayı: 2, 317 - 323, 01.01.2019

Öz

Objective: Endosonographic EUS features of cholangiocarcinoma CC have not been clearly described in the literature. The aim of our study was to determine the EUS features of CC and to compare them to computed tomography CT and endoscopic retrograde cholangiography ERCP findings.Material and Methods: Thirty-five patients who were diagnosed with CC between January 2008 and January 2011 were recruited in the study. Their EUS, CT, and ERCP findings were retrospectively evaluated. Results: EUS showed a hypoechoic mass lesion in 33 95% patients. CT and ERCP findings were concordant with EUS findings in terms of localization of the tumor. The margin and contour of the mass lesions were regular and well defined in 15 patients; however, they were irregular and ill defined in 20. Considering these features, we identified 2 patterns of CC on EUS: 1 a hypoechoic lesion with an irregular and ill-defined border without a clear relationship with the bile ducts and 2 a hypoechoic lesion with a regular and well-defined border, with the relationship to the bile ducts clearly demonstrated.Conclusion: In this retrospective study, EUS revealed mass lesions in all the patients with CC. CC may exhibit two distinct patterns on EUS

Kaynakça

  • 1. Ustundag Y, Bayraktar Y. Cholangiocarcinoma: A compact review litarature. World J Gastroenterol 2008; 14:6458-66.
  • 2. Weber A, Schmid RM, Prinz C. Diagnostic approaches for cholangiocarcinoma. World J Gastroenterol 2008; 14:4131-6.
  • 3. Mohamadnejad M, DeWitt JM, Sherman S, LeBlanc JK. Role of EUS for preoperative evaluation of cholangiocarcinoma: A large single-center experience. Gastrointest Endosc 2011; 73:71-8.
  • 4. Fritscher-Ravens A, Broering DC, Sriram PV. EUSguided fine-needle aspiration cytodiagnosis of hilar cholangiocarcinoma: A case series. Gastrointest Endosc 2000; 53:534-40.
  • 5. Varghese JC, Farrell MA, Courtney G, Osborne H, Murray FE, Lee MJ. A prospective comparison of magnetic resonance cholangiopancreatography with endoscopic retrograde cholangiopancreatography in the evaluation of patients with suspected biliary tract disease. Clin Radiol 1999; 54:513-20.
  • 6. Garrow D, Miller S, Sinha D, Conway J, Hoffman BJ, Hawes RH, Romagnuolo J. Endoscopic Ultrasound: A meta analysis of test performance in suspected biliary obstruction. Clin Gastroenterol Hepatol 2007; 5:616-23.
  • 7. Aljiffry M, Walsh MJ, Molinari M. Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990- 2009. World J Gastroenterol 2009; 15:4240-62.
  • 8. Patel T. Cholangiocarcinoma. Nat Clin Pract Gastroenterol Hepatol 2006; 3:33-42.
  • 9. Ishak KG, Anthony PP, Sobin LH. In: Histological typing of tumours of the liver. WHO International Histological Classification of Tumours. 2nd ed. Berlin: Springer Verlag, 1994:5-7.
  • 10. Eloubeidi MA, Chen VK, Jhala NC, Eltoum IE, Jhala D, Chhieng DC, Syed SA, Vickers SM, Mel Wilcox C. Endoscopic ultrasound-guided fine needle aspiration biopsy of suspected cholangiocarcinoma. Clin Gastroenterol Hepatol 2004; 2:209-13.
  • 11. Strongin A, Singh H, Eloubeidi MA, Siddiqui AA. Role of endoscopic ultrasonography in the evaluation of extrahepatic cholangiocarcinoma. Endosc Ultrasound. 2013; 2(2):71-6.
  • 12. Hara K, Bhatia V, Hijioka S, Mizuno N, Yamao K. A convex EUS is useful to diagnose vascular invasion of cancer, especially hepatic hilus cancer. Dig Endosc 2011; 23 Suppl 1:26-8.
  • 13. DeWitt J, Misra V, LeBlanc J, Sherman S, McHenry L. EUS-guided FNA of proximal biliary strictures after negative ERCP brush cytology results. Gastrointest Endosc 2006; 64:325-33.
  • 14. Alper E, Arabul M, Buyrac Z, Baydar B, Ustundag Y, Celik M. The use of radial endosonography findings in the prediction of cholangiocarcinoma in cases with distal bile duct obstructions. Hepatogastroenterology 2013; 60:678- 83.
  • 15. Khashab MA, Fockens P, Al-Haddad MA. Utility of EUS in patients with indeterminate biliary strictures and suspected extrahepatic cholangiocarcinoma (with videos). Gastrointest Endosc 2012; 76(5):1024-33.
  • 16. Weilert F, Bhat YM, Binmoeller KF, Kane S, Jaffee IM, Shaw RE, Cameron R, Hashimoto Y, Shah JN. EUS-FNA is superior to ERCP-based tissue sampling in suspected malignant biliary obstruction: Results of a prospective, single-blind, comparative study. Gastrointest Endosc 2014; 80(19):97-104.
  • 17. Sadeghi A, Mohammadnejad M, Islami F, Keshtkar A, Biglari M, Malekzadeh R, Eloubedidi MA. Diagnostic yield of EUS- guided FNA for malignant biliary stricture: A systematic review and meta-analysis. Gastrointest Endosc 2016; 83(2): 290-8.
  • 18. Han JK, Choi BI, Kim AY, An SK, Lee JW, Kim TK, Kim SW. Cholangiocarcinoma: pictorial essay of CT and cholangiographic findings. Radiographics 2002; 22:173- 87.
  • 19. Kim TK, Choi BI, Han JK, Jang HJ, Cho SG, Han MC. Peripheral cholangiocarcinoma of the liver: 2-phase spiral CT findings. Radiology 1997; 204:539-43.
  • 20. Watadani T, Akahane M, Yoshikawa T, Ohtomo K. Preoperative assessment of hilar cholangiocarcinoma using multidetector-row CT: Correlation with histopathological findings. Radiat Med 2008; 26:402-7.
  • 21. Feydy A, Vilgrain V, Denys A, Sibert A, Belghiti J, Vullierme MP, Menu Y. Helical CT assessment in hilar cholangiocarcinoma: Correlation with surgical and pathologic findings. Am J Roentgenol 1999; 172:73-7.
  • 22. Zhang Y, Uchida M, Abe T, Nishimura H, Hayabuchi N, Nakashima Y. Intrahepatic peripheral cholangiocarcinoma: Comparison of dynamic CT and dynamic MRI. J Comput Assist Tomogr 1999; 23:670-7.
  • 23. Tillich M, Mischinger HJ, Preisegger KH, Rabl H, Szolar DH. Multiphasic helical CT in diagnosis and staging of hilar cholangiocarcinoma. Am J Roentgenol 1998; 171:651-8.
  • 24. Okumoto T, Sato A, Yamada T, Takase K, Matsuhashi T, Tsuda M, Seiji K, Ishibashi T, Higano S, Katayose Y, Unno M, Takahashi S. Correct diagnosis of vascular encasement and longitudinal extension of hilar cholangiocarcinoma by four channel multidetector-row computed tomography. Tohoku J Exp Med 2009; 217:1-8.
  • 25. Park MS, Kim TK, Kim KW, Park SW, Lee JK, Kim JS, Lee JH, Kim KA, Kim AY, Kim PN, Lee MG, Ha HK. Differentiation of extrahepatic bile duct cholangiocarcinoma from benign stricture: Findings at MRCP versus ERCP. Radiology 2004; 233:234-40.
  • 26. Rösch T, Meining A, Frühmorgen S, Zillinger C, Schusdziarra V, Hellerhoff K, Classen M, Helmberger H. A prospective comparison of the diagnostic accuracy of ERCP, MRCP, CT, and EUS in biliary strictures. Gastrointest Endosc 2002; 55:870-6.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Araştırma Makalesi
Yazarlar

Gökhan Aksakal Bu kişi benim

Mete Akın Bu kişi benim

Yıldıran Songür Bu kişi benim

Yayımlanma Tarihi 1 Ocak 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 5 Sayı: 2

Kaynak Göster

APA Aksakal, G., Akın, M., & Songür, Y. (2019). Endosonographic Features of Cholangiocarcinoma and Comparison with Computed Tomography and Endoscopic Retrograde Cholangiography Findings. Akdeniz Tıp Dergisi, 5(2), 317-323.