口服等回声造影剂超声和超声内镜对胃间质瘤临床诊断的对比分析

摘要

目的 探讨口服等回声造影剂超声和超声内镜检查对胃间质瘤诊断与病变性质鉴别中的应用价值.方法 38例获得病理确诊的胃间质瘤患者均进行了口服等回声造影剂超声检查及超声内镜(EUS)检查,以病理结果 为金标准,评估口服等回声造影剂超声和超声内镜对胃间质瘤的诊断价值,并对2种检查方法的一致性进行评价.结果EUS与口服等回声造影剂超声显像差异不大,表现出较高的一致性,其中尤其在病变大小、病变部位、病变边缘、有无周围组织浸润、淋巴结转移方面显示一致性很高(kappa>0.80).术后病理结果为标准,口服造影剂超声和EUS的诊断符合率分别为78.94%、73.68%.经一致性检验发现2种检查方法的一致性较好(Kappa=0.757).结果显示2种检查均具有较好的病灶性质的鉴别能力,与病理结果相比较,2种检查方法的一致性较好,Kappa值分别为0.687、0.691.结论 EUS和回声造影剂超声对于胃间质瘤均具有较高的诊断能力,各有特点,是有效的辅助检查方式,在临床上具有广泛的应用价值.%Objective To study the diagnostic value and the identification of the nature of the lesion in the gastric stro-mal tumor between ultrasound with oral equal echo contrast medium and ultrasound endoscopy (EUS)through the comparative a-nalysis.Methods 38 cases of gastric stromal tumor patients with pathological diagnosis were conducted ultrasound with oral e -qual echo contrast medium and EUS .With the gold standard of pathology result ,evaluated the value of contrast medium ultrasound and EUS in the diagnosis of gastric stromal tumor ,and evaluated the consistency between them .Results The imaging of EUS and equal echo contrast medium ultrasound showed high consistence ,especially on the lesion size,lesion area,the edge of lesion,sur-rounding tissue invasion,lymph node metastasis(kappa>0.80).According to the standard of postoperative pathological results , the diagnostic accordance rate of equal echo contrast medium ultrasound and EUS examination were 78.94% and 73.68% re-spectively,and showed good consistency between 2 ways by the consistency check(Kappa=0.757).The 2 kinds of examination showed good identification ability on characteristics of lesions compared with pathological biopsy results ,and the Kappa value were 0.687 and 0.691 respectively which showed good consistency .Conclusion EUS and equal echo contrast medium ultrasound have high diagnosed capacity for gastric stromal tumors with each characteristics .Both are effective auxiliary examination way with extensive clinic application value .