超声内镜在胃黏膜下隆起性病变诊断中的应用分析  

Analysis on the application of endoscopic ultrasonography in diagnosis of gastric submucosal lesions

作　　者：苏燕波 冯洁 唐建光 苏艺群 周芸 SU Yan-bo;FENG Jie;TANG Jian-guang;SU Yi-qun;ZHOU Yun(Department of Gastroenterology,Guilin People's Hospital,Guilin,Guangxi 541002,China.)

机构地区：[1]桂林市人民医院消化内科,广西桂林541002

出　　处：《临床消化病杂志》2024年第1期53-57,共5页Chinese Journal of Clinical Gastroenterology

摘　　要：[目的]探讨超声内镜检查术(endoscopic ultrasonography,EUS)在胃黏膜下隆起性病变临床诊断中的应用价值。[方法]回顾性分析经EUS诊断,并接受内镜微创或外科手术治疗后病理确诊为胃黏膜下隆起性病变的95例患者临床资料,分析病变的部位、病理结果、EUS特征及比较术前EUS诊断与术后病理诊断的符合情况。[结果]95例中病变部位以胃底(58.95%,56/95)、胃窦(22.11%,21/95)常见。最常见的病理类型为间质瘤(56.84%,54/95),其次为平滑肌瘤(22.11%,21/95)。95例中,EUS诊断起源于黏膜肌层28例、黏膜下层23例、固有肌层42例,层次不清2例,EUS对病变起源层次的诊断符合率为88.42%(84/95)。EUS诊断与术后病理诊断的符合率为90.53%(86/95)。[结论]EUS可较好地对胃黏膜下隆起性病变的层次起源、回声特点及病变性质作出准确判断,但对起源于黏膜下层、固有肌层的低回声病变的误诊率较高,对纤维瘤、脓肿等少见病变的诊断存在一定局限性。[Objective]To explore the clinical diagnestic value of endoscopic ultrasonography(EUS)in gastric submucosal lesions.[Methods]Date of 95patients gastric submucosal lesions evaluated by EUS were retrospectively analyzed.All the patients received endoscopic minimally invasive surgery or surgery and were diagnosed by pathology.The location,pathological types,EUS characteristics,the coincidence rate of EUS diagnosis before surgery and pathological diagnosis after surgery were compared.[Results]Gastric submucosal lesions were common in the gastric fundus(58.95%,56/95)and gastic antrum(22.11%,21/95).The most common pathological type was stromal tumors(56.84%,54/95),followed by Leiomyoma(22.11%,21/95).Under EUS and among the 95cases,28cases were detected in muscularis mucosa,23cases in submucosa,42cases in muscularis propria and 2cases in no hierarchy.As to the lesions origin diagnosesed by EUS,the coincidence rate was 88.42%(84/95).The consistency in pathological types of EUS was 90.53%(86/95).[Conclusion]EUS is an effective and reliable diagnostic method for the origin,echogenicity and nature of gastric submucosal lesions.For gastric submucosal lesions originating from the mucosa in third or fourth layers are diagnosed by EUS,the misdiagnosis rate is high.EUS has some limitations in the diagnosis of rare lesions such as fibroma and abscess.

关 键 词：胃黏膜下隆起性病变 超声内镜 诊断 

分 类 号：R322.4[医药卫生—人体解剖和组织胚胎学]