内镜超声对皮革胃的诊断价值  

Endoscopic ultrasonography in diagnosis of linitis plastica

作　　者：彭燕[1] 邹晓平[2] 许国铭[2] 金震东[2] 李昌平[1] 李云[1] 

机构地区：[1]四川泸州医学院附属医院消化科,646000 [2]第二军医大学附属长海医院消化科

出　　处：《中华消化内镜杂志》2004年第2期114-116,共3页Chinese Journal of Digestive Endoscopy

摘　　要：目的　探讨内镜超声检查 (EUS)对皮革胃的诊断价值。方法　对 2 1例皮革胃患者行EUS检查 ,并将其结果与内镜、胃肠道钡餐、CT检查及术后病理结果进行对照研究。结果　皮革胃的EUS声像图表现为 (1 )病灶处胃壁第 2、3、4层明显增厚 ,所侵犯胃壁层次结构消失 ,胃壁增厚处平均 (1 6 8± 0 37)cm ;(2 )大多数 (95 2 4 % )呈低回声改变 ;(3)EUS下病灶范围超过内镜所见异常区域 ;(4 ) 85 7%的患者病变沿胃的横轴生长呈连续性分布 ;(5 )病灶边界较容易分辨 ,但图像放大观察交界处模糊 ,是皮革胃浸润生长的标志。EUS对皮革胃的诊断符合率为 90 4 8% ,显著高于常规内镜检查的 5 2 38% (P =0 0 0 95 )、胃肠道钡餐的 6 1 1 1 % (P =0 0 396 )及CT检查的 35 2 9% (P =0 0 0 5 9)。术前EUS对皮革胃的T、N分期诊断的准确性分别为 80 95 %、85 71 % ,EUS对皮革胃可切除性判断的准确率为 71 4 3%。Objective To evaluate the significance of endoscopic ultrasonography (EUS) in the diagnosis of linitis plastica.Methods Twenty one cases of linitis plastica were examined by EUS; the results were compared with those of conventional gastroscopy with biopsies, gastrointestinal X ray, CT, and the postoperative pathological findings.Results The ultrasonography of lanitis plastica manifested as 1. The second, third and fourth layers of stomach wall thickened at the lesion site, and disappearance of the layered structure of the invaded stomach wall, the thickened stomach wall have the thickness of (1 68±0 37) cm in average; 2. 95 24% of the lesion shows hypo echoic patterns; 3. The confines of lesion in EUS are beyond those of the conventional endoscopies. 4. 85 7% of the lesion tends to grow along the transverse axis of stomach in continuous distribution; 5.The border of lesion is readily distinguished, but in enlarged picture blurred boundary is the evidence of infiltrative growth of the lesion. The coincidence rate of ESU in diagnosing linitis plastica is 90 48%, that is evidently higher than that of conventional endoscopy 52 38% ( P =0 0095), gastrointestinal X ray 61 11% ( P =0 0396) and CT 35 29% ( P =0 0059). Compared with the postoperative pathological diagnosis, the diagnostic accuracy of T, N staging by ESU are 80 95% and 85 71% respectively. The accuracy of predicting resectability by ESU was 71 43% (15/21).Conclusion ESU has the superiority of raising the diagnostic accuracy and is helpful in predicting the border of lesion and the resectability.

关 键 词：内镜超声检查 皮革胃 诊断 胃癌 

分 类 号：R735.2[医药卫生—肿瘤]