十二指肠隆起性病变超声内镜频率选择的临床研究

Frequency of endoscopic ultrasonography for diagnosis of duodenal submucosal lesions

目的探讨超声内镜扫查不同大小十二指肠隆起性病变时频率的选择。方法对常规胃镜发现的201例患者210个十二指肠隆起性病灶，根据病灶特征和超声图像清晰度，选择不同扫查频率进行超声胃镜或者微型探头扫查。在征得患者同意后，对病灶进行相应的病理检查，并将病理检查结果与EUS诊断结果进行对比分析。结果EUS与病理诊断结果的符合率为81．4％（22／27）。低频扫描易于显示病灶全貌，对扫查直径≥1．5cm的病灶及高回声病灶具有优势，而高频扫描易于显示微细层次结构，扫查直径〈1．5cm病灶更为有利，联合使用多种频率扫描较大病灶能够提供更多影像信息。结论对于不同大小的隆起性病灶，选择合适的超声扫查频率或联合使用多种扫查频率有助于EUS对十二指肠隆起性病变的诊断。

Objective To investigate the effect of different frequencies of endoscopic uhrasonography （EUS） on diagnosis of duodenal submucosal lesions. Methods A total of 210 elevated duodenal lesions detected by routine endoscopy in 201 patients were examined by EUS at different frequencies according to lesion features and image clarity. Endoscopic resection was applied in 27 lesions with informed consents, and pathological findings were compared with the results of EUS. Results The accuracy of EUS was 81.4% （22/27）. Ultrasound of low frequency was superior in displaying overview of lesion and was more suitable for lesions larger than 1.5 cm in diameter or lesions of hyperecho. On the other hand, ultrasound of high frequency was more reliable to reveal minute structures and could be employed in scanning lesions smaller than 1.5 cm in diameter. Combination of different frequencies of ultrasound could provide more details in larger lesions. Conclusion Application of appropriate frequency or combined frequencies of ultrasound in examination of elevated duodenal lesions is beneficial to achieve more accurate diagnosis.