Gastrointestinal contrast-enhanced ultrasonography for diagnosis and treatment of peptic ulcer in children

BACKGROUND The detection rate of peptic ulcer in children is improving,with development of diagnostic procedures.Gastroscopy is the gold standard for the diagnosis of peptic ulcer,but it is an invasive procedure.Gastrointestinal contrast-enhanced ultrasonography(CEUS)has the advantages of being painless,noninvasive,nonradioactive,easy to use,and safe.AIM To investigate the clinical value of CEUS for diagnosis and treatment of peptic ulcer in children.METHODS We investigated 43 children with digestive tract symptoms in our hospital from January 2021 to June 2022.All children were examined by routine ultrasound,gastrointestinal CEUS,and gastroscopy.The pathological results of gastroscopy were taken as the gold standard.Routine ultrasonography was performed before gastrointestinal CEUS.Conventional ultrasound showed the thickness of the gastroduodenal wall,gastric peristalsis,and the adjacent organs and tissues around the abdominal cavity.Gastrointestinal CEUS recorded the thickness of the gastroduodenal wall;the size,location and shape of the ulcer;gastric peristalsis;and adjacent organs and tissues around the abdominal cavity.The results of routine ultrasound and gastrointestinal ultrasound were compared with those of gastroscopy to evaluate the diagnostic results and coincidence rate of routine ultrasound and gastrointestinal CEUS.All children received informed consent from their guardians for CEUS.This study was reviewed and approved by the hospital medical ethics committee.RESULTS Among the 43 children,17(15 male,2 female)were diagnosed with peptic ulcer by gastroscopy.There were 26 children with nonpeptic ulcer.There were eight cases of peptic ulcer and 35 of nonpeptic ulcer diagnosed by conventional ultrasound.The diagnostic coincidence rate of peptic ulcer in children diagnosed by conventional ultrasound was 79.1%(34/43),which was significantly different from that of gastroscopy(P=0.033).It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is low.Fifteen cases of peptic ulcer and 28 of nonpeptic ulcer were diagnosed by CEUS.The diagnostic coincidence rate of peptic ulcer in children was 95.3%(41/43).There was no significant difference between CEUS and gastroscopy(P=0.655).It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is high.CONCLUSION Gastrointestinal CEUS has a high coincidence rate in the diagnosis of peptic ulcer in children,and can be used as a preliminary examination method.

Contrast-enhanced ultrasound using SonoVue mixed with oral gastrointestinal contrast agent to evaluate esophageal hiatal hernia: Report of three cases and a literature review

BACKGROUND Due to a thicker abdominal wall in some patients,ultrasound artifacts from gastrointestinal gas and surrounding tissues can interfere with routine ultrasound examination,precluding its ability to display or clearly show the structure of a hernial sac(HS)and thereby diminishing diagnostic performance for esophageal hiatal hernia(EHH).Contrast-enhanced ultrasound(CEUS)imaging using an oral agent mixture allows for clear and intuitive identification of an EHH sac and dynamic observation of esophageal reflux.CASE SUMMARY In this case series,we report three patients with clinically-suspected EHH,including two females and one male with an average age of 67.3±16.4 years.CEUS was administered with an oral agent mixture(microbubble-based SonoVue and gastrointestinal contrast agent)and identified a direct sign of supradiaphragmatic HS(containing the hyperechoic agent)and indirect signs[e.g.,widening of esophageal hiatus,hyperechoic mixture agent continuously or intermittently reflux flowing back and forth from the stomach into the supradiaphragmatic HS,and esophagus-gastric echo ring(i.e.,the“EG”ring)seen above the diaphragm].All three cases received a definitive diagnosis of EHH by esophageal manometry and gastroscopy.Two lesions resolved upon drug treatment and one required surgery.The recurrence rate in follow-up was 0%.The data from these cases suggest that the new non-invasive examination method may greatly improve the diagnosis of EHH.CONCLUSION CEUS with the oral agent mixture can facilitate clear and intuitive identification of HS and dynamic observation of esophageal reflux.

High-frame-rate contrast-enhanced ultrasound findings of liver metastasis of duodenal gastrointestinal stromal tumor:A case report and literature review

BACKGROUND Liver metastasis of duodenal gastrointestinal stromal tumor(GIST)is rare.Most reports mainly focus on its treatment and approaches to surgical resection,while details on its contrast-enhanced ultrasound(CEUS)findings are lacking.The diagnosis and imaging modalities for this condition remain challenging.CASE SUMMARY A 53-year-old Chinese man presented with mild signs and symptoms of the digestive tract.He underwent routine examinations after GIST surgery.Magnetic resonance imaging showed a 2.3 cm hepatic space-occupying lesion.All the laboratory test results were within normal limits.For further diagnostic confirmation,we conducted high frame rate CEUS(H-CEUS)and found a malignant perfusion pattern.Heterogeneous concentric hyper-enhancement,earlier wash-in than the liver parenchyma,and two irregular vessel columns could be observed at the periphery of the lesion during the arterial phase.Ultrasound-guided puncture biopsy was used to confirm the diagnosis of the lesion as liver metastasis of duodenal GIST.Imatinib was prescribed after biopsy,and the patient’s clinical course was monitored.CONCLUSION H-CEUS is useful for detecting microcirculation differences,wash-in patterns,and vascular morphogenesis and diagnosing liver metastasis of duodenal GIST.

Diagnosis of upper gastrointestinal perforation complicated with fistula formation and subphrenic abscess by contrast-enhanced ultrasound:A case report

BACKGROUND Gastrointestinal perforation complicated by subphrenic abscess is a surgical emergency.Its diagnosis relies mainly on X-ray or computed tomography(CT),while the value of ultrasound,especially contrast-enhanced ultrasound(CEUS),has been underestimated.CASE SUMMARY A 37-year-old man presented with fever and edema of the lower extremities for 10 d.He had a history of laparoscopic repair of gastroduodenal perforation 6 mo prior.His first-time intravenous CEUS indicated a diagnosis of subphrenic abscess.He received antibiotic therapy and ultrasound-guided percutaneous drainage of the abscess.However,second-time intravenous CEUS revealed an unsatisfactory therapeutic effect.Intracavitary CEUS was proposed,and this examination detected communication between the abscess and the stomach.Upper gastrointestinal perforation complicated by fistula formation and subphrenic abscess was diagnosed with the help of CEUS.Abdominal CT and esophagogastroduodenoscopy confirmed the diagnosis.The patient recovered after the perforation was repaired by surgery.CONCLUSION Intravenous and intracavitary CEUS provides helpful information for the diagnosis of upper gastrointestinal perforation complicated by fistula formation and subphrenic abscess.

胃肠充盈超声造影技术对胃癌的检查和诊断探讨

目的 探讨胃肠充盈超声造影检查对胃癌的临床诊断价值。方法 选取甘肃省人民医院2017年7月至2022年7月行胃肠充盈超声造影诊断胃癌107例,排除非胃癌或未手术16例,最终入组91例,分析胃肠充盈超声造影术前T分期预评估,与术后病理结果进行对照研究。结果 入组91例,胃癌T分期的准确率为75.82%,T1期为66.66%,T2期为64.29%,T3期为71.42%,T4期为85.00%;结论 胃肠充盈超声造影检查对胃癌术前T分期预评估的准确率较高,具有较高的临床互补应用价值,尤其适用于对胃癌高危人群进行筛查和健康人群胃肠体检。

胃肠道充盈超声检查

胃肠超声检查已经被认为是多种胃肠疾病的简捷有效的检查工具。使用充盈剂来填充胃肠道从而实现对肠道的详细评估同时排除肠道气体的干扰,是目前胃肠道超声检查的主要研究方向。大量的研究显示,在肠道超声检查中使用充盈剂会改善检查结果,但应根据临床情况和超声医师的经验,依照具体情况来选择使用。本文主要对胃肠道充盈超声检查的实施方法以及其益处和局限性做一综述。

胃间质瘤超声造影表现及良恶性的相关性分析

目的:采用胃肠充盈超声检查法分析胃间质瘤的超声表现与良恶性的关系。方法:回顾性分析2019年1月—2022年6月陆良县中医医院收治的64例胃间质瘤患者资料,患者术前均接受口服胃肠超声助显剂后的腹部超声检查,并经手术病理证实为胃间质瘤。分析恶性胃间质瘤的独立预测指标及各项预测指标的预测准确性。结果:64例胃间质瘤患者中,良性27例,恶性37例。恶性组的肿瘤内径较良性组更大,不规则形态、不均匀回声以及边界欠清的比例高于良性组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析发现,肿瘤内径、形态不规则、内部回声不均匀,边界欠清是恶性胃间质瘤的独立预测指标(P<0.05)。ROC曲线显示,肿瘤内径、形态、回声以及边界单独预测恶性胃间质瘤的准确率均较低,但综合四项指标的联合预测能够准确预测胃间质瘤(AUC:0.878),其准确性显著高于各项指标单独预测(P<0.05)。结论:肿瘤内径、形态、回声及边界四个独立预测因子对恶性胃间质瘤的诊断具有较高准确性,胃肠充盈超声检查法在诊断胃间质瘤方面具有显著优势。

胃肠超声充盈法对十二指肠疾病诊断的应用价值

目的探讨胃肠超声充盈法对十二指肠疾病诊断的应用价值。方法选择我院收治的十二指肠疾病患者92例,所有患者皆口服胃肠超声造影剂,进行胃肠超声充盈检查,同时以胃镜下病理组织诊断作为诊断的标准,对比分析胃肠超声充盈检查检出率。结果其中十二指肠梗阻表现为梗阻近端肠管明显扩张,幽门管保持持续开放状态、胃潴留。十二指肠溃疡时,十二指肠充盈时间受到限制,时间明显被延长,球部发生变形。。胃肠超声充盈及胃镜检查对十二指肠溃疡、十二指肠炎症及十二肠梗阻的检出率分别为36.96%、33.70%、16.30%,33.70%、33.70%、18.48%,两种检查方法在对十二指肠溃疡、十二指肠炎症及十二肠梗阻的检出率差异不显著(P>0.05)。胃肠超声充盈及胃镜检查对十二指肠球部恶性肿瘤及十二指肠降部恶性肿瘤检出率对比差异不显著(P>0.05)。胃肠超声充盈检查和病理组织检查对十二指肠疾病的检出率对比差异不显著。结论胃肠超声充盈法检查有利于降低消化道内气体及内容物的影响,对十二指肠疾病具有较高的检出率。

胃肠超声充盈法对胃十二指肠疾病的诊断效果分析

目的:研究胃肠超声充盈法对胃十二指肠疾病诊断效果.方法:选取胃十二指肠患者56例用胃肠超声充盈法进行检查,并对比和纤维胃镜检测结果有无不同.结果:胃肠超声充盈法对胃十二指肠疾病的诊断和纤维胃镜检查结果无统计学差异,P>0.05.结论:利用胃肠超声充盈法胃十二指肠疾病诊断效果准确率较高,值得推广.

Diagnosis of bowel diseases:The role of imaging and ultrasonography

Examinations with a visualisation of the anatomy and pathology of the gastrointestinal(GI) tract are often necessary for the diagnosis of GI diseases.Traditional radiology played a crucial role for many years.Endoscopy,despite some limitations,remains the main technique in the differential diagnosis and treatment of GI diseases.In the last decades,the introduction of,and advances in,non-invasive cross-sectional imaging modalities,including ultrasound(US),computed tomography(CT),positron-emission tomography(PET),and magnetic resonance imaging,as well as improvements in the resolution of imaging data,the acquisition of 3D images,and the introduction of contrast-enhancement,have modified the approach to the examination of the GI tract.Moreover,additional co-registration techniques,such as PET-CT and PET-MRI,allow multimodal data acquisition with better sensitivity and specificity in the study of tissue pathology.US has had a growing role in the development and application of the techniques for diagnosis and management of GI diseases because it is inexpensive,non-invasive,and more comfortable for the patient,and it has sufficient diagnostic accuracy toprovide the clinician with image data of high temporal and spatial resolution.Moreover,Doppler and contrastenhanced ultrasound(CEUS) add important information about blood flow.This article provides a general review of the current literature regarding imaging modalities used for the evaluation of bowel diseases,highlighting the role of US and recent developments in CEUS.

超声胃肠充盈造影检查在诊断胃癌TNM分期的价值探讨

目的:探讨超声胃肠充盈造影检查在诊断胃癌TNM分期的价值。方法:选取73例经胃镜病理诊断为胃癌并行手术治疗的患者。以术后病理结果为金标准,术前行超声胃肠充盈造影检查,并以2010年国际抗癌联盟和(或)美国癌症联合委员会(UICC/AJCC)中制定的诊断标准进行恶性肿瘤原发灶,淋巴结转移和远处转移综合分期(TNM)进行分期,比较超声胃镜充盈造影检查对胃癌T分期、N分期及M分期与病理结果的差异。结果:超声胃镜充盈造影检查对胃癌T分期的总准确率为72.6%,对N分期的总准确率为84.9%,对M分期的总准确率为100%。超声胃癌T分期、N分期结果与病理分期结果无统计学差异(x^2=2.193,x^2=0.922;P>0.05)。结论:超声胃肠充盈造影在诊断胃癌TNM分期具有较高诊断价值,尤其对N分期和M分期的诊断准确率较高,可用于胃癌的临床初步筛查。

胃肠充盈超声造影在胃肠道疾病诊断中的应用价值

目的:探讨胃肠充盈超声造影在胃肠道疾病诊断中的应用价值。方法:选取龙川县人民医院2021年5-10月收治的80例疑似胃肠道疾病患者作为研究对象。所有患者均进行胃肠充盈超声造影、胃肠镜检查,对疑似存在胃肠道疾病者行取材病理检查。分析胃肠充盈超声造影结果与胃肠镜结果的符合率,以病理结果作为金标准,分析胃肠充盈超声造影结果与病理结果的符合率,比较胃肠充盈超声造影和胃肠镜的诊断价值。结果:经胃肠充盈超声造影诊断为胃溃疡6例,胃息肉3例,MT 3例,胃间质瘤1例;经胃肠镜检查,胃溃疡6例,胃息肉4例,MT 3例,胃间质瘤2例,诊断符合率为86.67%。胃肠充盈超声造影与病理相比较,MT符合率为75.00%,胃间质瘤符合率为100%,总符合率为80.00%(4/5)。胃肠充盈超声造影诊断的敏感性为68.75%,特异性为96.88%,准确性为91.25%,阳性预测值为84.62%,阴性预测值为92.54%。胃肠镜诊断的敏感性为68.75%,特异性为93.75%,准确性为88.75%,阳性预测值为73.33%,阴性预测值为92.31%,两种检测方法敏感性、特异性、准确性、阳性预测值、阴性预测值比较差异均无统计学意义(P>0.05)。结论:胃肠道疾病患者应用胃肠充盈超声造影检测的诊断价值好,操作简便,且符合率与胃肠镜相似。

胃肠充盈超声造影与CT强化扫描在进展期胃癌术前肿瘤分期的诊断价值比较

目的 比较胃肠充盈超声造影与CT强化扫描在进展期胃癌(GC)术前肿瘤分期中的应用价值.方法 对85例进展期GC患者分别行术前胃肠充盈超声造影和螺旋CT强化扫描,由至少2位经验丰富的主任医师进行阅片,以术后组织病理检查结果为金标准,比较胃肠充盈超声造影与CT强化扫描在进展期GC患者肿瘤分期中的诊断价值.结果?CT强化扫描对肿瘤浸润深度T1、T?2分期诊断的准确度明显高于胃肠充盈超声造影准确度,差异有统计学意义(P<0.05);二者对T3、T4分期诊断的准确度比较,差异无统计学意义(P>0.05).胃肠充盈超声造影与CT强化扫描对肿瘤N0、N1、N2、N3分期诊断的准确度比较,差异无统计学意义(P>0.05).胃肠充盈超声造影与CT强化扫描对肿瘤M0、M1分期诊断的准确度比较,差异无统计学意义(P>0.05).结论CT强化扫描对肿瘤T1、T2分期诊断效能明显优于胃肠充盈超声造影,对T3、T4、N分期及M分期的诊断效能相差不大,表明CT强化扫描可能对GC患者术前肿瘤分期的诊断价值更高.

胃肠超声充盈检查联合超声造影诊断胃十二指肠肿瘤的应用价值分析

目的通过对胃十二指肠肿瘤疾病采取胃肠超声充盈检查方式联合超声造影检查方式进行诊断,探究分析此两种诊断方式对胃十二指肠肿瘤疾病的临床应用价值。方法随机选取乌海市人民医院疑似胃十二指肠肿瘤疾病患者共计324例,将其视为本次研究对象且对其进行临床回顾分析。结果疑似胃十二指肠肿瘤疾病324例患者分别采取单一超声造影检查方式与胃肠超声充盈检查方式联合超声造影检查方式进行检查,且病理学检查结果可知其中阳性245例,就两种临床检查方式准确率之比可知,观察组明显高于对照组,组间对比存在统计学差异(P<0.05)。结论通过对胃十二指肠肿瘤疾病采取胃肠超声充盈检查方式联合超声造影检查方式进行诊断,所取得的临床应用效果比较理想,此种联合检查方式可以明显提高患者疾病的临床诊断准确率,且为临床医生对患者疾病制定适宜的治疗方案提供参考依据,具有临床推荐实施的价值与意义。

胃肠充盈超声造影检查在反酸、嗳气患者临床诊断中的应用

目的探讨胃肠充盈超声造影在具有反酸、嗳气患者的临床诊断中的应用价值。方法回顾性分析2020年12月至2022年12月期间具有反酸、嗳气症状的患者120例,利用胃镜、CT等常规检查手段和病理检查确诊胃食管反流病(反流组)43例、消化性溃疡44例、胃肿瘤33例,同时选取40例健康志愿者作为对照组,并对两组患者行胃肠充盈超声造影技术进行复检;采用SPSS20.0进行统计学分析,胃肠超声造影检测与常规胃部检测手段计数资料比较以[例(%)]表示,采用χ^(2)检验。P<0.05为差异有统计学意义。结果胃肠充盈超声检查与常规筛查符合率:胃食管反流病为88.4%(38/43);消化性溃疡(胃溃疡23例、十二指肠溃疡17例)为90.9%(40/44);胃肿瘤(22例恶性肿瘤,9例良性肿瘤)为93.9%(31/33)。胃肠充盈超声检查与胃镜、CT等其他临床确诊手段和病理检查相比差异无统计学意义(P>0.05);反流组与对照组患者的胃肠充盈超声检查结果在5min内反流次数和5min内反流时间上差异有统计学意义(P<0.05);超声检查患者服从率为91.7%,而胃镜检查患者服从率仅为18.3%(P<0.05)。结论胃肠充盈超声造影技术对反酸、嗳气患者在临床中的疾病诊断具有很高的应用价值,可大幅度提升胃部疾病诊断的准确性,有助于胃癌患者的早期筛查。