体表超声对腹部食管病变及早期癌的诊断价值  

Evaluation of body surface ultrasonography in the diagnosis of diseases of abdominal segment esophagus and early stage carcinoma

作　　者：陈敏华[1,2,3] 朱强[1,2,3] 严昆[1,2,3] 廖盛日[1,2,3] 霍苓[1,2,3] 张晖[1,2,3] 小川肇[1,2,3] 岸本理和[1,2,3] 丁子清[1,2,3] 宫坂和男[1,2,3] 福田守道 

机构地区：[1]北京医科大学临床肿瘤学院超声科 [2]日本北海道大学医学部放射科 [3]日本札幌医科大学机器检查部

出　　处：《中华医学杂志》1998年第1期44-48,共5页National Medical Journal of China

摘　　要：目的了解超声对腹部食管病变及早期癌检出的可能性。方法日常常规超声检查观察７９７例腹部食管；以测量壁厚≥６ｍｍ，局部回声及内腔有异常改变为诊断食管病变的标准。结果７２９例（９２％）食管得以显示。其中７１６例壁厚≤４ｍｍ，诊断为正常，１３例诊断异常；最终证实１３例中食管癌５例（粘膜癌、粘膜肌层癌、粘膜下癌、肌层癌、全层癌各１例），转移癌２例，溃疡合并水肿２例，憩室合并息肉１例；另１例经内镜超声等诊断为平滑肌瘤，余２例为正常。结论超声不仅可显示食管壁增厚、壁内回声及内腔异常变化，并能发现早期癌，尤对粘膜下肿瘤的检出优于Ｘ线造影及内窥镜检查，其灵敏、简便、无创、无痛苦等优点，可成为高发区普查食管癌和临床常规检查筛选食管疾病的手段。本文还讨论了食管早期癌及其他病变的声像图表现。Objective To investigate the possibility of detecting esophageal carcinoma and other lesions by body surface ultrasound (BSUS). Methods BSUS examinations of the abdominal segment of the esophagus in 797 subjects were undertaken. Wall thickness more than or equal to 6 mm, wall echo abnormality, and lumen morphologic changes were referred as the criteria of the disease. Results A visualization rate of 92% ( n =729) was obtained. 716 subjects without any esophageal diseases had a wall thickness of 4 mm or less; Of other 13, one patient had a wall thickness of 5 mm, 11 had 6 mm or more, and one had luminal cystic dilatation without wall thickening. In the 13 cases, the final pathological examination showed 5 cases of esophageal carcinoma (intramucosal, mucosal muscle, submucosal, proper musculature, and serosal patterns, respectively), 2 of metastatic lesion, one of leimyoma, 2 of edematous benign ulcer, one of diverticulum with polyp, and 2 of normal result. Conclusion BSUS can not only detect the early stage carcinoma, but also further demonstrate wall echo and pathologic changes inside and outside the wall. In the visualization of the submucosal tumor, it is advantage ous to barium examination and endoscopy. With its high sensitivity, simplicity, and non intervention, BSUS can become a better screening method in everyday practice and in the area with high incidence of esophageal carcinoma.

关 键 词：食管疾病 食管肿瘤 超声波诊断 

分 类 号：R571.04[医药卫生—消化系统] R735.104[医药卫生—内科学]