超声微探头检查在胃粘膜下病变临床诊断中应用.doc

超声微探头检查在胃粘膜下病变临床诊断中应用 　　摘要：目的 探讨超声微探头（MPS）在胃粘膜下病变中的诊断价值。方法 使用MPS对65例经电子胃镜检查发现的胃粘膜下病变患者进行MPS检查，对病变进行描述及诊断，影像检查结果均与病理进行对比。结果 发现间质瘤32例，平滑肌瘤20例，异位胰腺7例，脂肪瘤5例，恶性淋巴瘤1例；65例胃粘膜下病变超声诊断结果与术后病理比较后发现，诊断符合率为82.54%，其中小于1.0cm的胃黏膜下病变经MPS检查的诊断符合率为92.10%，而大于1.0cm的胃黏膜下病变经MPS检查的诊断符合率为66.67%，两者之间有显著性差异（P0.01）。结论 MPS能清晰的显示胃黏膜下病变的层次、结构及回声，尤其对于小于1.0cm的胃黏膜下病变，使用MPS检查，准确方便有效。 　　关键词：超声胃镜；超声微探头；胃；粘膜下病变 　　Abstract：Objective To assess the clinical value of micro-probe endscopic ultrasonography（MPS） in diagnosing gastric submucosal lesions. Methods The use of MPS was examined in our hospital in 2010 January ～2013 year in December 65 cases by electronic gastroscope gastric submucosal lesions， description and diagnosis of lesion， results were compared with the postoperative pathology. Results 32 cases of glioma was found， 20 cases of leiomyoma， 7 cases of ectopic pancreas， 5 cases of lipoma， 1 cases of malignant lymphoma； In 65 cases of gastric submucosal lesions Diagnosed by ultrasonography and postoperative pathology found after comparison， the diagnostic rate is 82.54%， in less than 1.0cm of gastric submucosal lesions by MPS examination， the coincidence rate is 92.10%， but in more than 1.0cm of gastric submucosal lesions by MPS examination， the coincidence rate is 66.67%， there was a significant difference（P0.01）. Conclusion MPS can display the level， structure and echo of gastric submucosal lesions clearly， clinically for less than 1.0cm of gastric submucosal lesions， by the MPS examination， accurare， effective and convenient， due to the limited range of MPS exploration， for larger gastric submucosal lesions （more than 1.0cm）， diagnosis still has certain difficulty. 　　Key words：Endoscopic ultrasonography； Micro-probe endscopic ultrasonography； Stomach； Submucosal lesions 　　随着内镜技术的发展，超声胃镜（endoscopic ultrasonography EUS ）越来越多地被应用于消化道粘膜下病变的临床诊断[1-3]。超声胃镜采用环扫、扇扫及小探头扫描能比较清楚地显示消化道粘膜下病变的回声、层次、形态、有无包膜及周围淋巴结等情况，已成为消化道粘膜下病变的首选检查手段[4，5]。但是有关不同型号超声胃镜在消化道粘膜下病变诊断中价值仍有待研究。我们对胃镜检查发现胃粘膜下病变患者采用MPS检查，并与活检组织或