经肠镜微探头超声检查对结直肠黏膜下隆起病灶的诊断分析  

Value of ultrasonic probe in the diagnosis of submucosal tumor of colorectum

作　　者：张明黎[1] 李为慧 吴正祥[1] 张开光[1] 丁西平[1] 

机构地区：[1]安徽省立医院消化内科,合肥230001

出　　处：《中华消化内镜杂志》2013年第7期383-385,共3页Chinese Journal of Digestive Endoscopy

基　　金：安徽省卫生厅资助项目（09A007）

摘　　要：目的探讨经内镜微探头超声检查对结直肠黏膜下隆起病灶的诊断价值。方法应用微探头对68例70处结直肠黏膜下隆起性病灶进行肠镜下超声检查，总结内镜超声特点，并与最终诊断比较。结果发现类癌20例，表现为黏膜下层低回声；脂肪瘤12例，多位于右半结肠（11／12），表现为黏膜下层、边界清楚的强回声；囊肿12例，表现为黏膜下层的单房或多房性的无回声区，包膜完整；问质瘤或平滑肌瘤12例，多位于直肠9例，表现为黏膜肌层及以下各层次的均匀或不均匀低回声为主，外覆稍强回声包膜，两者在超声下很难区别；恶性淋巴瘤3例5个，表现为局部黏膜肌层和黏膜下层增厚，呈中低回声，不均匀，较少侵及固有肌层；血管性病变（血管瘤、静脉曲张）3个，表现为黏膜及黏膜下层的无回声，部分中、高回声，圆形或不规则形，散在或成族状分布，部分互相沟通；另外，还有子宫内膜异位2例，色素沉积1例，阑尾慢性脓肿1例，壁外压迫2例。超声与最终诊断结果均相符。结论经内镜微探头超声检查可以明确大肠黏膜下隆起的大小、肠壁起源和边界。根据超声特征对黏膜下良恶性判别有一定的价值，同时能与腔外压迫性病变相鉴别。Objective To assess the value of ultrasonic probe （USP） in the diagnosis of Submucous eminence of colorectume. Methods Sixty-eight patients with colorectal submucous eminence in 70 areas re-ceived USP under colonoscope. The accuracy of diagnosis was evaluated. Results Twenty carcinoid tumor were detected which manifested submucous hypoechoic; Lipoma 12,located in right half colon which manifes- ted submucous layer, clear boundaries byperechoic; Cyst 12 manifested single or muhi lattices no-echo on submucous which have integrated involucrum. Mesenchymoma or myoma levicellulare 12, most of them loca- ted inthe rectum manifested uniform or no-uniform hypoechoic on the muscularis mucosa or below and were difficult to discriminate. Malignant lymphoma,3 manifested muscularis mucosa and submucosa thickening, muscularis propria were seldom affected. Vascular diseases （hemangioma, varicosity） 3, manifested no-e- choic on mucosa or submucosa, some medium, high echoic, circular or irregular, and also endometriosis 2, pigment deposition 1, appendix abscess 1, extramural compression 2, ultrasonic test is marched with clinic diagnosis. Accuracy rate is 100%. Conclusion USP can diagnose colorectal submucous eminence with high accuracy, and even provide information about the size, layer of origin, border of the colorectal submu-cous eminence and can distinguish benign or malignant tumor according to ultrasonic check, at the same time provide differentiation with extramural compressive lesions.

关 键 词：结直肠肿瘤 内镜超声检查 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]