超声微探头联合环扫超声内镜对食管黏膜下病变与纵隔病变鉴别诊断的应用价值

The diagnostic value of radial echoendoscopy combined with micro-probe for differentiation of mediastinal disease and esophageal submucosal lesion

目的评价环扫超声内镜联合超声微探头对食管黏膜下病变与纵隔病变鉴别诊断的意义。方法回顾分析吉林大学中日联谊医院53例由于胃镜或CT等影像学检查发现不能明确来源的表现为食管隆起性病变患者，首先行超声微探头检查，明确大致起源后换用环扫超声内镜检查，综合两者结果做出诊断并与CT结果进行比较。结果超声内镜与CT诊断食管黏膜下病变的敏感度分别为90．9％（20／22）、50．0％（11／22），特异度分别为93．5％（29／31）、83．9％（26／31）；诊断非侵袭性纵隔病变的敏感度分别为91．7％（22／24）、70．8％（17／24），特异度分别为93．1％（27／29）、62．1％（18／29）；诊断侵袭性纵隔病变敏感度及特异度两者均为100．0％。结论超声微探头联合环扫超声内镜对食管黏膜下病变与纵隔病变的诊断与鉴别诊断有重要意义，尤其对食管黏膜下病变与非侵袭性纵隔病变其诊断的特异度与敏感度显著高于CT检查。

Objective To study the diagnostic value of radial echoendoscopy combined with ultrasonic micro-probe for differentiating mediastinal disease from esophageal submucosal lesion. Methods Data of 53 patients with esophageal eminence with unknown origin detected by gastroscopy or CT in China-Japan Union Hospital were reviewed. Ultrasonic micro-probe was performed first and followed with radial echoendoscopy. The diagnosis was compared with the results of CT. Results The diagnostic sensitivities of EUS and CT for esophageal submucosal lesion were 90. 9% （20/22） and 50.0% （11/22 ）, and the specificities were 93.5% （29/31 ）and 83.9% （26/31 ）. The sensitivities for the benign mediastinal disease were 91.7 % （22/24） and 70. 8% （17/24）, and the specificities for the benign disease were 93.1% （27/29）and 62. 1% （18/29）. The sensitivity and specificity for malignant mediastinal disease were both 100. 0%. Conclusion Radial echoendoscopy combined with ultrasonic micro-probe shows prominent advantage in the diagnosis of the esophageal submucosal lesion and mediastinal disease over CT, especially in the specificity and sensitivi- ty for esophageal submucosal lesion and benign mediastinal disease.