Background: In most circumstances, subepithelial tumors lack distinct endoscopic and ultrasonographic features. Consequently, definitive diagnosis usually requires tissue acquisition and pathologic confirmation. Estab...Background: In most circumstances, subepithelial tumors lack distinct endoscopic and ultrasonographic features. Consequently, definitive diagnosis usually requires tissue acquisition and pathologic confirmation. Establishing a tissue diagnosis is difficult because the yield of forceps biopsies is low. However, prospective data evaluating tissue sampling techniques for subepithelial lesions are currently lacking. Objective: Our purpose was to prospectively determine the diagnostic yield of endoscopic submucosal-mucosal resection (ESMR) compared with forceps biopsy for lesions limited to the submucosa (third endosonographic layer) of the GI tract. Design: A prospective head-to-head comparison was performed. Setting: The study was performed in a tertiary care hospital. Patients: Study patients were 23 adults with subepithelial lesions limited to the submucosa. Intervention: All submucosal lesions underwent forceps biopsy followed by endoscopic submucosal resection. Biopsy speciments were obtained with large-capacity “jumbo" forceps. A total of 4 double passes (8 biopsy specimens) were collected from each lesion with use of the bite-on-bite technique. Endoscopic resection was then performed with an electrosurgical snare or cap-fitted endoscopic mucosal resection device. Main Outcome Measurement: The main outcome measurement was the diagnostic yield of biopsy forceps compared with endoscopic submucosal resection. Results: Twenty-three patients with lesions limited to the submucosa were identi-fied by endoscopic ultrasonography. All lesions underwent forceps biopsy followed by ESMR. The diagnostic yield of the jumbo forceps biopsy was 4 of 23 (17%), whereas the diagnostic yield of ESMR was 20 of 23 (87%) (P = .0001, McNemar test). Conclusion: In the evaluation of subepithelial lesions limited to the submucosa, ESMR has a significantly higher diagnostic yield than jumbo forceps biopsy with use of the bite-on-bite technique.展开更多
Background: Endoscopic color Doppler ultrasonography (ECDUS) is a method for detecting color flow images in blood vessels. We previously reported on the usefulness of ECDUS (convex-type scanning instruments with forwa...Background: Endoscopic color Doppler ultrasonography (ECDUS) is a method for detecting color flow images in blood vessels. We previously reported on the usefulness of ECDUS (convex-type scanning instruments with forward -Oblique viewing) for evaluating the hemodynamics of esophageal varices. In the present study, we report the usefulness of new electronic radial ECDUS in cases of esophageal varices by comparison with convex-type ECDUS. Methods: Twenty-six patients with esophageal varices were identified and studied. The underlying pathologies of portal hypertension included liver cirrhosis (15 patients) and cirrhosis associated with hepatocellular carcinoma (11 patients). Endoscopic findings of esopha-geal varices were as follows: Cb, F3, and Ls varices in four patients; Cb, F2, and Lm varices in 21 patients; and Cb, Lm, and F1 varices in one patient. RC1 was observed in the esophagus in 14 of the 26 patients. RC2 was noted in 11 cases, and RC0 was seen in one patient. ECDUS was performed using a Pentax EG- 3630UR (forward view) with a distal tip diameter of 12mm. The instrument (electronic radial array) has a curved array scanning transducer with variable frequency (5.0, 7.5, 10.0MHz). A Hitachi EUB 6500,8500 was used for the display, providing 270° images. We monitored the color flow images of esophageal varices, paraesophageal veins, palisade veins, perforating veins, and pulsatile waves using this technique. As a control, 110 patients were examined by convex-type ECDUS. Results: (1) Color flow images of esophageal varices and paraesophageal veins were obtained in 26 of the 26 patients, whereas color flow images of perforating veins were obtained in 18 of the 26 patients (69.2% ). Color flow images of palisade veins were obtained in 12 of the 26 patients (46.2% ). (2) Color flow images of pulsatile waves were obtained in 10 of the 26 patients (38.5% ). Color flow images of pulsatile waves were detected in zero (0% ) of the 4 F3 varices, in nine (42.9% ) of the 21 F2 varices, and in the 1 (100% ) case of F1 varices. Also, color flow images of pulsatile waves were detected in seven (50.0% of the 14 RC1 varices, in two (18.2% ) of the 11 RC2 varices, and in the 1 (100% ) case of RC0 varices. (3) As a control, 110 patients were examined by convex-type ECDUS. Color flow images of esophageal varices and paraesophageal veins were obtained in 110 of the 110 patients, whereas color flow images of perforating veins were obtained in 74 of 110 (67.3% ) with convex-type ECDUS. The detection rate of palisade veins with electronic radial ECDUS (12 of the 26 patients, 46.2% )was significantly higher than with convex-type ECDUS (28 of the 110 patients,25.5% ) (P < 0.05) . The detection rate of pulsatile waves with electronic radial ECDUS (10 of the 26 cases, 38.5% ) was significantly higher than with convex-type ECDUS (3 of the 110 cases, 2.7% ) (P < 0.0001). Conclusions: Electronic radial ECDUS provides clear color flow images of blood vessels in esophageal varices with the additional advantages of forward-view optics and extended 270° views. Electronic radial ECDUS was superior to convextype ECDUS in detecting palisade veins and pulsatile waves.展开更多
目的探讨乳腺影像报告与数据系统(breast imaging reporting and data system,BI-RADS)超声分级联合超声光散射成像技术(US—diffuse optical tomography,US-DOT)在乳腺肿块诊断中的应用。方法选取2019年1月—2021年12月期间高安市中医...目的探讨乳腺影像报告与数据系统(breast imaging reporting and data system,BI-RADS)超声分级联合超声光散射成像技术(US—diffuse optical tomography,US-DOT)在乳腺肿块诊断中的应用。方法选取2019年1月—2021年12月期间高安市中医院收治的因乳房肿块需行手术的67例患者,应用BI-RADS超声分级标准联合US-DOT检查,并与病理诊断比较,计算诊断效能。结果经病理诊断共有70个肿块。BI-RADS超声分级诊断与病理结果相符的有61个,诊断灵敏度、特异度、准确度分别为84.85%、89.19%、87.14%;US-DOT有58个,诊断灵敏度、特异度、准确度分别为81.82%、83.78%、82.86%;协同诊断有68个,灵敏度、特异度、准确度依次为96.97%、97.30%、97.14%。结论BI-RADS超声分级联合超声光散射成像在乳腺肿块诊断中具有一定意义。展开更多
文摘Background: In most circumstances, subepithelial tumors lack distinct endoscopic and ultrasonographic features. Consequently, definitive diagnosis usually requires tissue acquisition and pathologic confirmation. Establishing a tissue diagnosis is difficult because the yield of forceps biopsies is low. However, prospective data evaluating tissue sampling techniques for subepithelial lesions are currently lacking. Objective: Our purpose was to prospectively determine the diagnostic yield of endoscopic submucosal-mucosal resection (ESMR) compared with forceps biopsy for lesions limited to the submucosa (third endosonographic layer) of the GI tract. Design: A prospective head-to-head comparison was performed. Setting: The study was performed in a tertiary care hospital. Patients: Study patients were 23 adults with subepithelial lesions limited to the submucosa. Intervention: All submucosal lesions underwent forceps biopsy followed by endoscopic submucosal resection. Biopsy speciments were obtained with large-capacity “jumbo" forceps. A total of 4 double passes (8 biopsy specimens) were collected from each lesion with use of the bite-on-bite technique. Endoscopic resection was then performed with an electrosurgical snare or cap-fitted endoscopic mucosal resection device. Main Outcome Measurement: The main outcome measurement was the diagnostic yield of biopsy forceps compared with endoscopic submucosal resection. Results: Twenty-three patients with lesions limited to the submucosa were identi-fied by endoscopic ultrasonography. All lesions underwent forceps biopsy followed by ESMR. The diagnostic yield of the jumbo forceps biopsy was 4 of 23 (17%), whereas the diagnostic yield of ESMR was 20 of 23 (87%) (P = .0001, McNemar test). Conclusion: In the evaluation of subepithelial lesions limited to the submucosa, ESMR has a significantly higher diagnostic yield than jumbo forceps biopsy with use of the bite-on-bite technique.
文摘Background: Endoscopic color Doppler ultrasonography (ECDUS) is a method for detecting color flow images in blood vessels. We previously reported on the usefulness of ECDUS (convex-type scanning instruments with forward -Oblique viewing) for evaluating the hemodynamics of esophageal varices. In the present study, we report the usefulness of new electronic radial ECDUS in cases of esophageal varices by comparison with convex-type ECDUS. Methods: Twenty-six patients with esophageal varices were identified and studied. The underlying pathologies of portal hypertension included liver cirrhosis (15 patients) and cirrhosis associated with hepatocellular carcinoma (11 patients). Endoscopic findings of esopha-geal varices were as follows: Cb, F3, and Ls varices in four patients; Cb, F2, and Lm varices in 21 patients; and Cb, Lm, and F1 varices in one patient. RC1 was observed in the esophagus in 14 of the 26 patients. RC2 was noted in 11 cases, and RC0 was seen in one patient. ECDUS was performed using a Pentax EG- 3630UR (forward view) with a distal tip diameter of 12mm. The instrument (electronic radial array) has a curved array scanning transducer with variable frequency (5.0, 7.5, 10.0MHz). A Hitachi EUB 6500,8500 was used for the display, providing 270° images. We monitored the color flow images of esophageal varices, paraesophageal veins, palisade veins, perforating veins, and pulsatile waves using this technique. As a control, 110 patients were examined by convex-type ECDUS. Results: (1) Color flow images of esophageal varices and paraesophageal veins were obtained in 26 of the 26 patients, whereas color flow images of perforating veins were obtained in 18 of the 26 patients (69.2% ). Color flow images of palisade veins were obtained in 12 of the 26 patients (46.2% ). (2) Color flow images of pulsatile waves were obtained in 10 of the 26 patients (38.5% ). Color flow images of pulsatile waves were detected in zero (0% ) of the 4 F3 varices, in nine (42.9% ) of the 21 F2 varices, and in the 1 (100% ) case of F1 varices. Also, color flow images of pulsatile waves were detected in seven (50.0% of the 14 RC1 varices, in two (18.2% ) of the 11 RC2 varices, and in the 1 (100% ) case of RC0 varices. (3) As a control, 110 patients were examined by convex-type ECDUS. Color flow images of esophageal varices and paraesophageal veins were obtained in 110 of the 110 patients, whereas color flow images of perforating veins were obtained in 74 of 110 (67.3% ) with convex-type ECDUS. The detection rate of palisade veins with electronic radial ECDUS (12 of the 26 patients, 46.2% )was significantly higher than with convex-type ECDUS (28 of the 110 patients,25.5% ) (P < 0.05) . The detection rate of pulsatile waves with electronic radial ECDUS (10 of the 26 cases, 38.5% ) was significantly higher than with convex-type ECDUS (3 of the 110 cases, 2.7% ) (P < 0.0001). Conclusions: Electronic radial ECDUS provides clear color flow images of blood vessels in esophageal varices with the additional advantages of forward-view optics and extended 270° views. Electronic radial ECDUS was superior to convextype ECDUS in detecting palisade veins and pulsatile waves.
文摘目的探讨乳腺影像报告与数据系统(breast imaging reporting and data system,BI-RADS)超声分级联合超声光散射成像技术(US—diffuse optical tomography,US-DOT)在乳腺肿块诊断中的应用。方法选取2019年1月—2021年12月期间高安市中医院收治的因乳房肿块需行手术的67例患者,应用BI-RADS超声分级标准联合US-DOT检查,并与病理诊断比较,计算诊断效能。结果经病理诊断共有70个肿块。BI-RADS超声分级诊断与病理结果相符的有61个,诊断灵敏度、特异度、准确度分别为84.85%、89.19%、87.14%;US-DOT有58个,诊断灵敏度、特异度、准确度分别为81.82%、83.78%、82.86%;协同诊断有68个,灵敏度、特异度、准确度依次为96.97%、97.30%、97.14%。结论BI-RADS超声分级联合超声光散射成像在乳腺肿块诊断中具有一定意义。
