Elastography in pancreatic solid tumours diagnoses.

INTRODUCTION: Pancreatic solid tumour diagnoses remain a challenge for modern medicine. However, using endosonography together with elastography helps to examine the elasticity of tissues and therefore may allow definition of the nature of pancreatic tumours. AIM: To evaluate the usefulness of elastography with the strain ratio method and quantitative evaluation of pancreatic solid tumours. MATERIAL AND METHODS: A total of 54 patients with pancreatic solid tumours were treated with ultrasound endosonography with fine-needle aspiration biopsy. The control group contained 26 patients with normal pancreas. Pancreatic solid tumours and normal pancreas were analysed with elastography and elasticity evaluation of the interest area (A), reference (B), and the strain ratio factor (B/A). Postoperative histopathological or cytological examinations were the final diagnoses. Both postoperative and cytological diagnoses were compared with average elasticity parameters (A) and strain ratio factors (B/A). RESULTS: Average elasticity parameters (A) and the strain ratio factors (B/A) were: 0.025% (0.01-0.05%) for malignant process, and (B/A) 33.93 (18.23-75.45); (A) - 0.26% (0.14-0.35%), and (B/A) 5.35 (3.47-7.8) for inflammatory process; (A) 0.54% (0.35-0.82%), and (B/A) 1.79 (1.02-2.05) for normal pancreatic tissue. CONCLUSIONS: Malignant tumours have higher tightness factor compared to inflammatory tumours and normal pancreatic tissue. Elasticity parameters reach the highest levels in normal pancreatic tissue, lower in inflammatory tumours, and the lowest in malignant tumours.

[Groove pancreatitis--case report]. / Zapalenie trzustki okolicy "bruzdy"--opis przypadku.

Groove pancreatitis is an uncommon type of chronic pancreatitis. Most patients with groove pancreatitis are middle-aged men, smokers with excessive alcohol consumption. The describing patient is male admitted to hospital for fourth time during last six months because of recurrent abdominal pain, vomiting and lost weight. He has abused an alcohol in the history. The preliminary diagnosis of chronic pancreatitis was made. During hospitalization it was ordinated spasmolitic and analgesic therapy, antibiotic and enteral nutrition. The result of the implemented conservative therapy was successful, but the symptoms recurrented in very short period of time. Due to lack of long term improvement, patient was treated by pancreatoduodenectomy (Whipple's operation). The postoperative material was assessed by the patologist, and it was described focal chronic inflammation of the head of pancreas with fibrosis involving the wall of the duodenum. To diagnose groove pancreatitis in this case many diagnostic test, including endoscopy, imaging were required, but the histopathology was crucial. The patients should be diagnosed very carefully, because of the risk of the overlook of the cancer, which can be very similar in symptoms. The operation is recommended therapy in situation when improvement is short-period, with frequent recurrences or additional examination are uncertain.

[New methods of identification and screening of Barrett's esophagus]. / Nowe mozliwosci rozpoznawania i monitorowania przelyku Barretta.

The increase of patients number suffering from neoplastic esophageal diseases bring about application of most modern technics aiming at the earliest possible detection of pathology and the possibility of its efficient screening. The new technics detecting pathology on the cellular level join with the well-known chromo- and magnifying endoscopy. These include the spectroscopy analysis, getting 3D view of magnifying esophageal mucosa. Nowadays, we observe the gradual come back of chromoendoscopy methods that can be enhanced by the picture magnification. High sensitivity and specificity feature the most modern technics though we notice restrictions associated with these methods. In the years to come we believe that some of these methods will become standard with regards to detection and screening of esophageal metaplasia.

[New possibilities for detection of adenomas of the colon]. / Nowe mozliwosci diagnostyczne w ocenie polipów gruczolakowych jelita grubego.

More and more modern diagnostic methods are utilised in detection of colon adenomatous lesions. This trend is associated with increased efficiency of new research techniques as well as the necessity of more accurate assessment of discovered lesions during endoscopic examinations. New techniques can be particularly utilised in detection of flat polypous lesions, whose localisation is especially difficult. Chromoendoscopy, magnifying endoscopy and high-resolution endoscopy are used in diagnostics on a daily basis. Currently developed new diagnostics methods can set new standards in detection of colon adenomatous lesions in the future. The study targets to present modern diagnostic methods and their utilisation in detection of various colon adenomatous lesions.