超声胃镜对上消化道黏膜下隆起型病变的诊断价值

The Diagnostic Value of Ultrasonography in the Submucosal Raised Lesions of the Upper Gastrointestinal Tract

目的在上消化道黏膜下隆起型病变中,评估超声胃镜进行检查的应用价值。方法回顾性收集2019年6月至2020年6月在我院就诊的上消化道黏膜下隆起型病变患者120例。主要通过比较超声胃镜与病理检查的结果。观察上消化道黏膜下隆起型病变的种类以及部位分布情况,超声胃镜诊断120例上消化道黏膜下隆起型病变的敏感度、阳性预测值、准确度等,超声胃镜对黏膜下隆起病变黏膜层次比较及对黏膜下隆起低回声病变的长径以及宽径的差异性观察。结果120例上消化道黏膜下隆起型病变的总符合率为88.33%,病变类型中,对脂肪瘤的诊断准确率最高,且特异度及阳性预测值也均最高,均为100%。超声胃镜诊断黏膜下隆起病变黏膜层次总诊断符合率为87.50%(105/120),黏膜下隆起病变黏膜层次主要包括黏膜肌层、黏膜下层、固有肌层,其中超声胃镜对黏膜肌层的诊断价值更高,其次为固有肌层,最后黏膜下层,并且对黏膜下层、固有肌层存在误诊的情况。共109例低回声病变,包括中回声病变,超声胃镜检查与病理诊断相同的患者中,病变的长径为(1.82±0.55)cm,宽径为(1.27±0.52)cm;超声胃镜检查与病理诊断不相符的患者中,病变的长径为(1.13±0.42)cm,宽径为(0.86±0.36)cm。结论超声胃镜用于上消化道黏膜下隆起型病变,诊断价值较高。

Objective To evaluate the application value of ultrasound gastroscope in the submucosal raised lesions of the upper gastrointestinal tract.Methods A total of 120 patients with submucosal raised lesions of the upper gastrointestinal tract who were treated in our hospital from June 2019 to June 2020 were retrospectively collected.The results of ultrasonography and pathological examination were compared.Results The total coincidence rate of 120 cases of submucosal raised lesions in the upper gastrointestinal tract was 88.33%,and the diagnostic accuracy,specificity and positive predictive value of lipoma were all 100%.The total diagnostic coincidence rate of ultrasound gastroscope in the diagnosis of submucosal bulge lesions was 87.50%(105/120).The mucosal layers of submucosal bulge lesions mainly include muscularis mucosa,submucosa,and muscularis propria.Among them,the diagnosis of muscularis mucosa by ultrasound gastroscope higher value.Among 109 patients with hypoechoic lesions,including mid-echoic lesions,the long diameter of the lesions was(1.82±0.55)cm and the wide diameter was(1.27±0.52)cm in the patients with the same diagnosis by ultrasound gastroscopy and pathological diagnosis.Ultrasound gastroscopy and pathological diagnosis In the patients who did not match,the long diameter of the lesions was(1.13±0.42)cm and the wide diameter was(0.86±0.36)cm.Conclusion Ultrasound gastroscope is of high diagnostic value for the submucosal raised lesions of the upper gastrointestinal tract.