小探头超声内镜对140例上消化道隆起性低回声病变的研究  

Study on Endoscopic Miniprobe Sonography in the Diagnosis of 140 Patients with Upper Gastrointestinal Protuberant Hypoechoic Lesions

作　　者：刘海霞[1] 杨诚[1] 马医安 王鸿轲 徐彩霞[1] 李继昌[1] 

机构地区：[1]宝鸡市中心医院消化内科,陕西宝鸡721008

出　　处：《医学综述》2015年第1期126-128,共3页Medical Recapitulate

摘　　要：目的 探讨小探头超声内镜（MPS）对上消化道隆起性低回声病变的诊断价值.方法 回顾性分析2009年4月至2012年6月宝鸡市中心医院收治的经MPS检查发现的140例上消化道隆起性、低回声病变患者的临床资料,了解病变的部位、大小、性质、来源及病理结果.结果 上消化道低回声隆起性病变的好发部位依次是胃（47.1％）、食管（45.7％）、十二指肠（7.2％）;食管病变以下段好发,中段次之,上段最少;胃部病变好发部位依次为：胃底、胃窦、胃体及胃体窦交界处;十二指肠病变相对较少.病交大小：大部分≤1 cm,占62.9％,以1～3 cm次之,占35.7％;≥3 cm占1.4％,最少.超声诊断结果,食管病变大部分为平滑肌瘤,而胃、十二指肠均为间质瘤;食管病变中起源于黏膜肌层的42例,起源于固有肌层的22例;胃部病变起源于固有肌层的62例,起源于黏膜肌层的4例;十二指肠病变均起源于固有肌层.从病理资料显示,食管病变中支持超声内镜平滑肌瘤诊断的18例;胃、十二指肠共16例患者中,支持超声内镜间质瘤诊断的为12例.结论 上消化道隆起性低回声病变中食管病变多＜1 cm,胃及十二指肠病变多＜3 cm,食管病变多起源于黏膜肌层,而胃及十二指肠病变多起源于固有肌层.MPS对间质瘤的诊断有重要临床价值,有助于指导进一步的治疗及判断预后.手术切除是此类病变最有效的治疗方法.Objective To explore the value of endoscopic miniprobe sonography （MPS） in the diagnosis of upper gastrointestinal protuberant hypoechoic lesions.Methods Clinical data of 140 patients with upper gastrointestinal protuberant hypoechoic lesions admitted in Baoji Central Hospital from Apr.2009 to Jun.2012 was retrospectively analyzed.All the cases were examined by MPS,the location,size,nature,source and pathological results of the lesions were studied.Results The predilection sites of upper gastrointestinal protuberant hypoechoic lesions were stomach （47.1%）,esophagus （45.7 %）,and duodenum （7.2%） successively.The predilection site of esophageal lesions was the lower part,followed by the middle part,and the upper part at least.The predilection sites of gastric lesions were fundus of stomach,gastric antrum,and the junction of gastric body and gastric antrum in order.Duodenal lesions were scarce.Most lesion size was less than 1 cm,accounting for 62.9% ;size between 1 cm and 3 cm,accounting for 35.7% ;size more than 3 cm,accounting for 1.4%,at least.Results of ultrasound diagnosis showed that esophageal lesions were leiomyoma usually,and gastric and duodenal lesions were stromal tumors.There were 42 cases of esophageal lesions derived from mucosal muscularis,and 22 cases derived from inherent muscularis; there were 62 cases of gastric lesions derived from muscularis propria,and 4 cases derived from mucosal muscularis; duodenal lesions all derived from inherent muscularis.Pathologic results showed,18 cases of esophageal lesions were leiomyoma,supporting the results of endoscopic sonography;and 12 cases of gastric and duodenal lesions were stromal tumors,supporting the results of endoscopic sonography.Conclnsion Among patients with upper gastrointestinal protuberant hypoechoic lesions,esophageal lesions are usually less than 1 cm,gastric and duodenal lesion are usually less than 3 cm,esophageal lesions mainly derive from mucosal muscularis,gastric and duodenal lesions mainly derive from inherent muscularis

关 键 词：小探头超声内镜 低回声隆起性病变 上消化道 诊断 

分 类 号：R571[医药卫生—消化系统] R573[医药卫生—内科学]