超声内镜检查对胃异位胰腺的诊断价值  

Value of endoscopic ultrasonography in diagnosing gastric heterotopic pancreas

作　　者：石进[1] 张杰[1] 张诗琪[1] 陈雪[1] 魏月明[1] 曹艳[1] 代静[1] 

机构地区：[1]首都医科大学附属北京安贞医院消化内科,100029

出　　处：《中国医药》2015年第11期1623-1625,共3页China Medicine

摘　　要：目的 探讨超声内镜检查对胃异位胰腺的诊断价值.方法 对2012年1月至2015年6月首都医科大学附属北京安贞医院及附属北京朝阳医院经超声内镜诊断为胃异位胰腺的51例患者的病历资料进行回顾性分析,记录电子胃镜表现（胃异位胰腺的大小、部位、有无黏膜桥、有无腺管开口或脐样凹陷）、超声内镜特点（起源层次、边界、内部回声特征）和病理结果等.结果 51例均为单发病灶,表面黏膜光滑,未见黏膜桥,最长径6 ～ 42 mm,平均（15±10） mm.42例（82.4％）病变位于胃窦,主要表现为盘状隆起;9例（17.6％）位于胃体,主要表现为半球形隆起.29例（56.9％）伴有典型的脐样凹陷或腺管开口.1例（2.0％）病变起源于黏膜固有层,44例（86.3％）病变起源于黏膜下层,4例（7.8％）位于固有肌层,1例（2.0％）位于浆膜下层,1例（2.0％）贯穿黏膜下层和固有肌层.49例（96.1％）病灶边界清晰;28例（54.9％）病灶为低回声中混有高回声,23例（45.1％）为不均匀中高回声.22例（43.1％）可见管腔样结构,2例（3.9％）可见无回声囊腔样结构.21例（41.2％）获得标本,经病理和免疫组织化学方法确诊为胃异位胰腺.结论 超声内镜能准确地显示病变的起源及内部回声特征,对胃异位胰腺的诊断有一定的价值。Objective To evaluate the value of endoscopic ultrasonography （EUS） in diagnosing gastric heterotopic pancreas.Methods Imaging data of 51 patients with gastric heterotopic pancreas diagnosed by EUS from January 2012 to June 2015 were retrospectively analyzed.The electrogastroscope manifestation （including size, location, mucosal bridge plica, pitpattern or umbilication）, the EUS features （including origin, border and echo） and the pathological findings were recorded.Results The lesion was single in all 51 patients;the mucosal surface was smooth;the mucous bridge was not found;the long diameter was （15 ± 10） mm （6-42 mm）.The lesion located at gastric antrum in 42 cases （82.4%） showing as disc bulge, at gastric body in 9 cases （17.6%） showing as hemispheric sticks;there was pitpattern or umbilication in 29 cases （56.9%）.EUS showed that the heterotopic pancreas originated from mucosa lamina propria in 1 cases （2.0%）, from submucosa in 44 cases （86.3%）, from muscularis propria in 4 cases （7.8%） , from subserosa in 1 cases （2.0%） and from submucosamuscularis propria in 1 cases （2.0%）;the boundary was clear in 49 lesions （96.1%）;28 lesions （54.9%）manifested as mixed echo, 23 lesions （45.1%） manifestaed as medium-high inhomogenous echo;tubularstructure was found in 22 lesions （43.1%）, cysts cavity structure was found in 2 lesions （3.9%）.Totally 21 cases （41.2%） were pathologically confirmed.Conclusion EUS can accurately reveal the origin and internal echo pattern of gastric heterotopic pancreas and is valuable in diagnosing gastric heterotopic pancreas.

关 键 词：胃异位胰腺 超声内镜 诊断 

分 类 号：R573[医药卫生—消化系统]