胃三维容积超声造影与上消化道碘水造影评价经口内镜下幽门肌切开术疗效的价值  

Value of three-dimensional volume contrast-enhanced ultrasonography of stomach and iodinated water contrast-enhanced radiography of upper digestive tract in evaluation of the effect of gastric peroralendoscopic pyloromyotomy

作　　者：卢延嘉 黄岩[1] 夏丛燕 史进军[3] 高启[3] 卢瞳[4] Sachin Mulmi Shrestha 顾建平[2] LU Yanjia;HUANG Yan;XIA Congyan;SHI Jinjun;GAO Qi;LU Tong;Sachin Mulmi Shrestha;GU Jianping(Department of Ultrasound,Nanjing First Hospital,Nanjing Hospital Affiliated to Nanjing Medical University,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院南京市第一医院超声医学科,南京市210006 [2]南京医科大学附属南京医院南京市第一医院介入科,南京市210006 [3]东南大学附属中大医院超声科 [4]东南大学附属中大医院放射科 [5]东南大学附属中大医院消化科

出　　处：《临床超声医学杂志》2020年第4期262-265,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨胃三维容积超声造影与上消化道碘水造影在经口内镜下幽门肌切开术(G-POEM)疗效评估中的价值。方法选取确诊为胃轻瘫且需行G-POEM的患者94例,随机分为胃三维容积超声检查组48例(A组)和X线碘水造影检查组46例(B组),A组口服超声造影剂后5 min、15 min、30 min、60 min及90 min分别行超声检查,B组口服碘水造影剂后于上述相同时间点行上腹部平片检查,于G-POEM前后各测量一次,获得三维容积超声造影和X线碘水造影估测的胃容积,分析手术前后胃排空时间和胃排空率的差异,评估G-POEM后的胃排空改善情况。结果①A组胃三维容积超声造影检查的成功率97.9%(47/48),B组上消化道碘水造影检查的成功率97.8%(45/46),两组比较差异无统计学意义;②A、B组分别有31例患者的术后胃排空时间较术前明显减少(均P<0.05);③A组16例患者术前及术后胃排空时间均为90 min,90 min时间点测得胃排空率较术前明显改善者8例,差异均有统计学意义(均P<0.05),胃排空率无明显改善者8例,与术前比较差异均无统计学意义。B组14例患者术前及术后胃排空时间均为90 min,90 min时间点测得胃排空率较术前明显改善者5例,差异均有统计学意义(均P<0.05),胃排空率无明显改善者9例,与术前比较差异均无统计学意义;④A组47例超声造影患者中,31例胃排空情况较术前显著改善,8例有一定改善,余8例患者无明显改善;B组45例碘水造影患者中,31例胃排空情况较术前显著改善,5例有一定改善,余9例无明显改善。两组胃排空改善率比较差异无统计学意义(83%vs.80%)。结论胃三维容积超声造影和上消化道碘水造影均可有效评估G-POEM前后的胃排空情况,临床可首选胃三维容积超声造影评估G-POEM前后的胃排空情况和术后胃排空功能的改善效果,上消化道碘水造影可作为补充方法,为临床提供客观的影像学信息。Objective To explore the value of three-dimensional(3D)volume contrast-enhanced ultrasonography of stomach and iodinated water contrast-enhanced radiography of upper digestive tract in the evaluation of the effect of gastric peroralendoscopic pyloromyotomy(G-POEM).Methods Ninety-four patients with gastroparesis who were indicative of G-POEM were divided into group A treated by 3D ultrasound(n=48)and group B treated by iodinated water contrast X-ray examination(n=46).In group A,3D ultrasonography was proceeded at 5,15,30,60 and 90 min after oral administration of ultrasound contrast agent.In group B,the upper abdomen plain film was taken at the same time points as group A after taking iodized water contrast agent.The gastric volume after oral intake of contrast medium was estimated by 3D ultrasound and X-ray before and after G-POEM,respectively.The improvement of gastric emptying after G-POEM was evaluated and the results were compared and analyzed.Results①The success rate of 3D ultrasonography was 97.9%(47/48)in group A,and success rate of iodinated water contrast-enhanced radiography was 97.8%(45/46)in group B,there was no significant difference.②The gastric emptying time of 31 patients in each of group A and B were reduced compared with those before operation(all P<0.05).③The gastric emptying time of 16 patients in group A was 90 min before and after operation.The gastric emptying rate of 8 patients were significantly improved in 90 min compared with that before operation and had statistical difference(all P<0.05).The gastric emptying rate of 8 patients had no changes compared with that before operation with no statistical difference.The gastric emptying time of 14 patients in group B was 90 min before and after operation.The gastric emptying rate of 5 patients were significantly improved in 90 min compared with that before operation(all P<0.05).The gastric emptying rate of 9 patients were not significantly improved compared with that before operation with no statistical difference.④In group A,31 of 47

关 键 词：超声检查 三维 造影剂 碘水造影 经口内镜下幽门肌切开术 胃排空 

分 类 号：R445.1[医药卫生—影像医学与核医学]