微探头超声对下消化道疾病的诊断价值

The value of ultrasonic mini probe in the diagnosis of lesions of lower digestive tract

目的 探讨微探头超声检查对下消化道疾病的诊断价值。方法 应用微探头超声对115例下消化道病灶进行内镜超声检查（EUS）。结果 结直肠癌81例,EUS下表现为低回声肿块,微探头超声检查对肿瘤侵犯深度诊断总的准确率为82.7％（67/81）,肠壁周围淋巴结转移的敏感性55.4％（36/65）和特异性68.8％（11/16）;粘膜下肿瘤15例,除1例平滑肌瘤误诊为平滑肌肉瘤外其余全部得到正确诊断;溃疡性结肠炎10例;克罗恩氏病9例。结论 微探头超声对结直肠癌侵犯深度和粘膜下肿瘤的诊断有很高的准确率,术前微探头超声检查可以为结直肠癌和粘膜下肿瘤选择合适的治疗方案提供指导。

Objective To evaluate the value of ultrasonic mini probe(UMP) in the diagnosis of lower digestive tract lesions . Methods one hundred and fifteen patients with lesions of lower digestive tract were undergone EUS with UMP (Olympus UM-3R, 20MHz; UM-2R, 12MHz). Results Eighty one cases with colorectal carcinoma appeared as a hypoechoic mass under UMP. UMP had an overall accuracy rate of 82. 7% (67/81) in the diagnosis of depth of infiltrative colorectal carcinoma. The sensitivity and specificity of UMP in the diagnosis of lymph node metastasis were 55. 4% and 68. 8% respectively. All 15 cases with submucosal tumors were diagnosed correctly under EUS except one leiomyoma misdiagnosed as leiomyosarcoma and other 10 and 9 cases were ulcerative colitis and Crohn's diseases respectively. Conclusions UMP has a high accuracy in determining the invasive depth of colorectal carcinoma and submucosal tumors. The preoperative UMP may provide much information and influence on the choice of therapy for colorectal carcinoma and submucosal tumors.