胰腺囊性病变包括炎症性的假性囊肿和肿瘤性病变；后者包括浆液性囊腺瘤、黏液性囊性瘤及导管内乳头状黏液性瘤，其中黏液性肿瘤具有一定恶变风险。影像学检查的普及使得胰腺囊性病变的发现率明显升高。多数病人没有明显的临床症状。对病变性质的判断主要依赖于CT、MRCP及超声内镜（EUS）等形态学特征。EUS通过高频扫描获取高分辨率的图像，可以观察胰腺病变的细微结构，以及病变与胰管的关系，对病变诊断具有重要作用；同时，EUS引导下穿刺获取的囊液化验分析对鉴别诊断也有提示作用。治疗上，具有恶变倾向的黏液性肿瘤往往需要手术切除，而对于手术风险高的病人需要权衡风险与获益。EUS引导下囊肿的局部治疗为胰腺囊性病变的治疗提供了新的选择。

Application of endoscopic ultrasenography in the diagnosis and treatment of pancreatic cystic neoplasms              WU Xi, YANG Ai-ming. Department of Gastroenterology,Peking Union Medical College Hospital, Peking Union Medical College, Beijing 100730,China
Corresponding author: YANG Ai-ming, E-mail：yangaiming@medmail.com.cn
Abstract    Pancreatic cystic lesions consist of inflammatory pseudoscysts and neoplastic lesions. Most pancreatic cystic lesions are asymptomatic and discovered incidentally through the routine use of crosssectional imaging tests. The differential diagnoses for cystic neoplasms include serous cystadenoma, mucinous cystic neoplasm and intraductal papillary mucinous neoplasm. The mucinous cystic lesions pose a risk of malignant degeneration. The imaging modalities, such as CT, MRCP or EUS, offer diagnostic strengths. EUS imaging play a vital role for pancreatic lesion diagnoses. The use of high frequencey imaging with EUS may provide detailed information regarding the morphology of cystic lesions, as well as the relation of the lesion and the pancreatic duct. EUS guided fine needle aspiration may improve the accuracy of EUS through the use of cystic fluid analysis. The major therapy for the mucinous neoplasms with high risk for malignancy has been surgical resection. Ethanol ablation therapy guided by EUS offers the alternative option.