超声内镜对上消化道黏膜下微小病灶的诊断价值

The Role of EUS in Diagnosing Small Submucosal Lesions of Upper Gastrointestinal Tract

目的回顾性分析超声内镜对上消化道黏膜下病灶的诊断价值。方法超声内镜扫查黏膜下病变,根据大小、回声、管壁层次等特点做超声诊断。小病灶定义为超声测量病灶的长径5≤10mm者。超声内镜诊断的准确率以病变切除后的组织学诊断为标准。结果共159例黏膜下小病灶,超声内镜可清晰扫查所有病变的管壁层次。病变位于食管和胃各75例,十二指肠9例。<5mm者71例(44.7%),5 mm^10 mm者88例(55.3%)。124例病灶接受内镜治疗,超声内镜诊断的准确率为75%(93/124)。结论超声内镜对上消化道管壁3 mm^10 mm的病灶的分层判断有重要价值,对于病变性质的诊断有重要价值,有助于选择内镜/微创治疗的方法。

Objective To evaluate the role of EUS in diagnosing small submucosal lesions of upper gastrointestinal tract retrospectively. Methods The size, echogenicity, the layer of origin, and presumptive diagnosis were determined by EUS. Small lesions was defined as major diameter ≤ 10mm. The diagnostic accuracy of EUS was determined by using histology as the criterion standard. Results：A total of 159 small lesions were detected by EUS, and the size and layer of origin of all lesions were well defined. 71 lesions （44.7%） ≥3 mm ≤ 5 mm,88（55.3% ） lesions 〉 5 mm ≤ 10 mm. 75 lesions located in esophagus, 75 in stomach,9 in duodenum. 124 lesions received endoscopic therapy. The accuracy of endoscopic ultrasound diagnostic was 75% （93/124）. Conclusion EUS is an accurate means of evaluating the size and layer of origin of small submucosal lesions in upper gastrointestinal tract, and is helpful for selecting procedure of minimally invasive endoscopic treatment.