BACKGROUND The value of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for T-staging in patients with extrahepatic bile duct cancer was evaluated. METHODS This single-center, retrospective study included consecutive patients with extrahepatic bile duct cancer who underwent surgical resection after preoperative EUS, CH-EUS, and contrast-enhanced CT (CE-CT) examinations between June 2014 and August 2017. The capacity of these modalities for T-staging of extrahepatic bile duct cancer was evaluated by assessing invasion beyond the biliary wall into the surrounding tissue, gallbladder, liver, pancreas, duodenum, portal vein system (portal vein and/or superior mesenteric vein), inferior vena cava, and hepatic arteries (proper hepatic artery, right. and/or left. hepatic artery). Blind reading of EUS, CH-EUS, and CE-CT images was performed by two expert reviewers each. RESULTS 38 patients were eligible for analysis, of which eight had perihilar bile duct cancer and 30 had distal bile duct cancer. Postoperative T-staging was T1 in 6, T2 in 16, and T3 in 16 cases. CH-EUS was superior to CE-CT for diagnosing invasion beyond the biliary wall into surrounding tissue (92.1% vs. 45.9%, P = 0.0002); the ability to detect invasion to other organs did not differ significantly between the two modalities. The accuracy of CH-EUS for T-staging of tumors was better than that of CE-CT (73.7% vs. 39.5%, P = 0.0059). CH-EUS tended to have a better accuracy than EUS for the diagnosis of invasion beyond the biliary wall into the surrounding tissue (92.1% vs. 78.9%, P = 0.074) and T-staging (73.7% vs. 60.5%, P = 0.074). CONCLUSION CH-EUS is useful for T-staging of extra hepatic bile duct cancer, especially in terms of invasion beyond the biliary wall into the surrounding tissue.

中文翻译：

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对比增强谐波内镜超声在肝外胆管癌患者 T 分期中的应用。

背景 评估了对比增强谐波内镜超声 (CH-EUS) 对肝外胆管癌患者 T 分期的价值。方法 这项单中心、回顾性研究包括 2014 年 6 月至 2017 年 8 月期间在术前 EUS、CH-EUS 和增强 CT (CE-CT) 检查后接受手术切除的肝外胆管癌患者。评估肝外胆管癌 T 分期的方式是通过评估胆管壁以外侵入周围组织、胆囊、肝脏、胰腺、十二指肠、门静脉系统（门静脉和/或肠系膜上静脉）、下腔静脉、和肝动脉（右肝动脉和/或左肝动脉）。盲读 EUS、CH-EUS、CE-CT 图像由两名专家评审员进行。结果 38 例患者符合分析条件，其中 8 例为肺门周围胆管癌，30 例为远端胆管癌。术后T分期为T1 6例，T2 16例，T3 16例。CH-EUS 在诊断胆管壁外侵犯周围组织方面优于 CE-CT（92.1% 对 45.9%，P = 0.0002）；两种方式检测入侵其他器官的能力没有显着差异。CH-EUS 对肿瘤 T 分期的准确性优于 CE-CT（73.7% vs. 39.5%，P = 0.0059）。CH-EUS 在诊断胆管壁外侵犯到周围组织（92.1% vs. 78.9%，P = 0.074）和 T 分期（73.7% vs. 60.5%，P = 0.074)。