端扫式直肠超声探头对直肠间质瘤的诊断价值

Diagnostic value of transrectal ultrasound in detecting rectal gastrointestinal stromal tumor with head scanning probe

目的探讨端扫式直肠超声探头对直肠间质瘤的诊断价值。方法采用端扫式直肠超声探头对12例经病理证实的直肠间质瘤患者术前行经直肠腔内超声检查,同时采用超声检查分析病变侵犯层次,并与病理结果对照。结果 12例直肠间质瘤患者中,中低度危险程度间质瘤3例,中度危险程度间质瘤6例,高度危险程度间质瘤3例,肠周均未发现淋巴结转移。端扫式经直肠腔内超声检查对直肠间质瘤的诊断准确率为75.0%(9/12),直肠间质瘤的超声表现均为境界清晰、形态较规则、呈膨胀性生长的低回声团块,CDFI均显示肿瘤内部血流丰富,超声分析直肠间质瘤病变侵犯层次与病理结果对照的准确性达83.3%(10/12)。结论端扫式经直肠腔内超声检查对直肠间质瘤术前明确诊断及病变侵犯层次分析有重要价值,对直肠间质瘤的术前手术方式选择有重要意义。利用直肠内水窗检查以及良好的检查手法是提高经直肠腔内超声检查成功率与准确性的关键。

Objective To explore the methods and clinical value of transrectal ultrasound （TRUS） in detecting rectal gastrointestinal stromal tumor（GIST） with head scanning probe. Methods A total of 12 patients had the ultrasonic examination through the rectum with the head scanning probe. Preoperative ultrasonic findings were compared with the pathological results. Results Of the 12 patients,the patients were divided into three groups,including 3 cases with low-degree severity,6 cases with moderate-degree severity and 6 cases with high-degree severity. The lymph node metastasis was not found near intestines. Rectal GIST appeared as a hypoechoic mass with clear limit、regular form and expanded growth under TRUS. The CDFI showed abundant flow in the tumor and TRUS had an overall accuracy rate of 75.0%（9/12）in the diagnosis of rectal GIST. The accuracy of TRUS in the staging diagnosis of rectal GIST was 83.3%（10/12）. Conclusion The TRUS with the head scanning probe is of great value for pre-operative diagnosis and staging of rectal GIST. Rectal water window and felicitous check-up technique can enhance the accuracy of TRUS.