超声内镜在食管微小平滑肌瘤诊断和治疗中的应用价值

Diagnostic and Therapeutic Value of Endoscopic Ultrasonography for Small Leiomyoma of Esophagus

目的 :探讨超声内镜在食管微小平滑肌瘤诊断和治疗中的应用价值。方法 :对 2 4例临床诊断微小食管平滑肌瘤患者 ,行超声胃镜检查后分别予高频电切除或外科手术切除 ,切除组织送组织病理检查 ,最后对比分析相关资料。结果 :2 4例行超声胃镜检查 ,显示超声声像以低回声、不均匀回声多见 ,境界较清楚。 12例病变位于黏膜肌层 ,9例病变位于固有肌层浅层 ,共2 1例予高频电切除治疗 ;3例病变位于固有肌层深层 ,予外科手术治疗。 2 4例病理检查示平滑肌瘤 2 3例 (瘤位于黏膜肌层 12例 ,固有肌层 11例 )。超声内镜检查诊断准确率 95 .8% (2 3/ 2 4 )。结论 :超声胃镜不仅能对食管微小平滑肌瘤作出准确诊断 ,而且由于其对肿瘤的起源、范围等探查准确 ,可为后续治疗的选择提供重要的借鉴。

Objective: To study the use of endoscopic ultrasonography (EUS) in the diagnosis of and treatment of small leiomyoma of esophagus. Methods: Twenty-four patients with suspected leiomyoma of esophagus were studied by endoscopic ultrasonography. In all patients, the results of EUS examination were compared with the histology of the resected specimens. Results: In twelve patient, the lesions were originating from the muscularis mucosa. Nine lesions were located in from the superficial proper muscle layer. Twenty-one cases were performed by endoscopic resection. In another three patients, the lesions were originating from the deeper proper muscle layer, and enucleation was carried out under surgery. Twenty-three with leiomyomas were confirmed by histology. Twelve lesions were located in the muscularis mucosa, and the other eleven lesions appeared to be in the proper muscle layer. The accurate rate of EUS was 95.8% in the diagnosis of leiomyoma of esophagus. Conclusion:EUS method is very effective in visualizing small leiomyoma of esophagus, and facilitates the choice of therapeutic method because of its capacity to clearly define the size, layer of the origin, and pattern of the mass.