胃肠充盈超声造影检查补充诊断胃黏膜下微小占位病灶1例  

Gastrointestinal filling ultrasonography for complementary diagnosis of microscopic submucosal space-occupying lesions in the stomach:A case report

作　　者：吕明月 张新华 Ming-Yue Lv;Xin-Hua Zhang(Department of Ultrasound Medicine,Gansu University of Chinese Medicine,Gansu Provincial People’s Hospital,Lanzhou 730000,Gansu Province,China)

机构地区：[1]甘肃中医药大学,甘肃省人民医院超声医学科,甘肃省兰州市730000

出　　处：《世界华人消化杂志》2024年第1期88-92,共5页World Chinese Journal of Digestology

基　　金：甘肃省科技厅自然科学基金,No.20JR5RA148.

摘　　要：背景胃壁黏膜下病变体积过小或突出于胃腔外时,胃镜检查不易发现且易造成漏诊.病例简介本例患者胃镜首诊提示胃底黏膜下隆起型肿物,电子计算机断层扫描检查提示胃底黏膜下隆起型肿物为胃底间质瘤伴出血,该患者术前行胃肠充盈超声造影检查术前定位并补充诊断,明确了胃底间质瘤大小、内部回声及位置后,另于胃体小弯侧垂直部检出一大小5 mm×6 mm实性结节,患者行胃部病灶切除术,验证了胃底及胃体小弯侧垂直部2个病灶.结论术后病理及免疫组化证实胃底肿物为中危型胃间质瘤,胃体小弯侧垂直部为胃平滑肌瘤.胃肠充盈超声造影检查互补检出了前述两项检查未提示的胃体黏膜下小的占位性病灶.该项检查对胃黏膜下微小病变及向腔外突出的病灶,因其简便快捷精准有独特优势,可作为胃肠疾病首选的影像学互补检查手段.BACKGROUND When submucosal lesions of the gastric wall are too small or protrude outside the gastric lumen,they are not easily detected by gastroscopy and may be missed.CASE SUMMARY In this case,gastroscopy showed an elevated submucosal mass in the gastric fundus,and computed tomography examination suggested that the elevated submucosal mass was a gastric fundus mesenchymal tumor with hemorrhage.The patient underwent gastrointestinal filling ultrasonography to localize and diagnose this tumor before the operation,and the size,internal echogenicity,and location of the fundus mesenchymal tumor were clarified.Another solid nodule with a size of 5 mm×6 mm was detected at the vertical portion of the gastric body on the side of the lesser curvature.The patient underwent gastric resection of the lesions to confirm the diagnoses for the two lesions.CONCLUSION Postoperative pathology and immunohistochemistry confirmed a medium-risk gastric mesenchymal tumor in the fundus and a gastric smooth muscle tumor in the lateral vertical portion of the lesser curvature of the gastric body.Gastrointestinal filling ultrasonography played a complementary role in detecting small submucosal space-occupying lesions in the gastric body that were not diagnosed by previous examinations.Thus,gastrointestinal filling ultrasonography is a complementary imaging tool for gastric diseases because of its simplicity,rapidity,and accuracy in detecting small submucosal lesions and lesions protruding out of the lumen.

关 键 词：胃间质瘤 胃平滑肌瘤 胃肠充盈超声造影 补充诊断 病理诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R57[医药卫生—诊断学]