不同类型超声内镜与螺旋CT在食管及胃黏膜下肿物诊断中的价值比较

发布时间：2018-12-09 09:41

【摘要】：目的:探讨超声内镜(endoscopic ultrasonography,EUS)对食管及胃黏膜下肿物的临床诊断价值。方法 :对105例经电子胃镜检查后发现食管及胃黏膜下肿物的患者分别选用小探头及大探头EUS、影像学检查,并与病理对比研究。结果 :105例中,食管和胃间质瘤48例,食管和胃平滑肌瘤37例,食管囊肿5例,食管脂肪瘤1例,食管恶性间质瘤1例,胃异位胰腺4例,胃脂肪瘤3例,胃囊肿1例,胃类癌1例,胃恶性间质瘤2例,食管和胃壁外压迫2例。EUS诊断与CT诊断符合率为72.38%,与病理诊断符合率为94.32%,CT诊断与病理诊断符合率为76.17%。1 cm的食管及胃黏膜下肿物,小探头EUS诊断和CT诊断符合率为46.23%,与病理诊断符合率为86.74%,CT诊断与病理诊断符合率为61.43%;1~2 cm的食管及胃黏膜下肿物,小探头EUS诊断和CT诊断符合率为77.31%,与病理诊断符合率为95.34%,CT诊断与病理诊断符合率为73.26%;2 cm的食管及胃黏膜下肿物,大探头EUS诊断和CT诊断符合率为83.52%,与病理诊断符合率为89.63%,CT诊断与病理诊断符合率为90.76%。结论 :EUS对食管及胃黏膜下肿物诊断准确有效。EUS诊断1 cm的食管及胃黏膜下肿物,准确性优于CT检查,EUS诊断1~2 cm的病变与病理符合率最高,EUS诊断2 cm的病变时与CT影像诊断无明显差异。
[Abstract]:Objective: to evaluate the value of endoscopic ultrasonography (endoscopic ultrasonography,EUS) in the diagnosis of esophageal and gastric submucosal masses. Methods: one hundred and five patients with esophageal and gastric submucosal masses were examined with small probe and large probe EUS, respectively, and compared with pathology. Results: there were 48 cases of esophageal and gastric stromal tumors, 37 cases of esophageal and gastric leiomyoma, 5 cases of esophageal cyst, 1 case of esophageal lipoma, 1 case of esophageal malignant stromal tumor, 4 cases of gastric ectopic pancreas, 3 cases of gastric lipoma and 1 case of gastric cyst. 1 case of gastric carcinoid, 2 cases of gastric malignant stromal tumor, 2 cases of esophageal and gastric extramural compression. The coincidence rate of EUS diagnosis with CT diagnosis was 72.38%, and the coincidence rate with pathological diagnosis was 94.32 2%. The coincidence rate between CT diagnosis and pathological diagnosis was 76.17.1 cm. The coincidence rate between small probe EUS and CT diagnosis was 46.233.The coincidence rate with pathological diagnosis was 86.74. The coincidence rate between CT diagnosis and pathological diagnosis was 61.43. 1the coincidence rate of small probe EUS and CT in diagnosing esophageal and gastric submucosal masses with cm was 77.31 and 95.3434 respectively. The coincidence rate between CT and pathological diagnosis was 73.26; 2the diagnostic coincidence rate of large probe EUS and CT was 83.52 for esophageal and gastric submucosal masses of cm, and 89.63 for CT and 90.76 for pathological diagnosis. Conclusion: EUS is accurate and effective in the diagnosis of esophageal and gastric submucosal masses. The accuracy of EUS in the diagnosis of 1 cm esophageal and gastric submucosal masses is better than that of CT. There was no significant difference between EUS and CT in the diagnosis of 2 cm lesions.
【作者单位】：南京医科大学第一附属医院消化内科;
【基金】：国家自然科学基金(30900666)
【分类号】：R735

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