金沢大学附属病院消化器内科金沢大学がん研究所We report usefulness of endoscopic ultrasonography (EUS) for the diagnoses of chronic pancreatitis (CP). We evaluated EUS features of hyperechoic foci, hyperechoic strand, lobular out gland margin, lobularity, cyst, stone, ductal dilatation, side branch dilatation, duct irregularity, hyperechoic duct margins, atrophy, localized swelling in cases with CP (30 definite and 6 probable) diagnosed by computed tomography (CT) or endoscopic retrograde cholangiopancreatography (ERCP). Hyperechoic foci, hyperechoic strand, lobularity, hyperechoic duct margins in definite or probable CP were recognized in more than 80 % cases. Lobular out gland margin was observed in 14 (47 %) of 30 cases with definite CP, although none with probable CP (P = 0.06). In conclusions, hyperechoic foci, hyperechoic strand, lobularity, hyperechoic duct margins are useful for screening of CP, and lobular out gland margin would be reliable finding in definite CP. 目的：慢性膵炎の診断における超音波内視鏡 (EUS) の有用性につき検討した。 対象と方法：対象は内視鏡的逆行性胆道膵管造影 (ERCP)、CTにて慢性膵炎と診断され、EUSを施行した36例 (確診30例、準確診6例) で、hyperechoic foci, hyperechoic strand, lobular out gland margin, lobularity, cyst, stone, ductal dilatation, side branch dilatation, duct irregularity, hyperechoic duct margins, atrophy, localized swellingの各種EUS所見について評価し、retrospectiveに検討した。 結果：慢性膵炎確診例、準確診例では、いずれもhyperechoic foci, hyperechoic strand, lobularity, hyperechoic duct marginsが、80％以上の症例でみられた。lobular out gland marginは確診例で47%に認めたが、準確診例ではみられず、確診例で多い傾向が見られた (p=0.06)。 結語：hyperechoic foci, hyperechoic strand, lobularity, hyperechoic duct marginsは慢性膵炎の拾い上げに有用であり、lobular out gland marginは慢性膵炎の確診所見になる可能性が示唆された
