摘要
目的研究超声内镜及CT诊断食管黏膜下肿物的应用价值。方法选取2019年1月至2020年12月南京医科大学附属淮安第一医院经胃镜检查显示食管黏膜下肿物的103例患者为研究对象,所有患者均行超声内镜及CT检查,均接受手术治疗并经病理确诊。分析所有患者病理结果、超声内镜及CT表现,比较这两种方法在判断食管黏膜下不同大小肿物良恶性方面与病理检查的一致性。结果所有患者病理结果显示,8.74%为恶性肿瘤,均为恶性间质瘤;91.26%为良性肿瘤。超声内镜显示良性肿块边界清晰,表面光滑,可见均匀或欠均匀低回声团块;恶性肿块边界模糊,可见混合回声团块。CT显示良性肿块形态规则,可见椭圆形实性肿块,边界清晰;恶性肿块密度欠均匀,边界模糊,强化不均匀。超声内镜与病理检查一致性较好(Kappa=0.797,P<0.05),CT与病理检查一致性一般(Kappa=0.415,P<0.05)。超声内镜诊断符合率高于CT,差异有统计学意义(P<0.05)。>2 cm肿物中,超声内镜、CT与病理检查的一致性较好(Kappa=1.000、0.800,P<0.05);1~2 cm肿物中,超声内镜与病理检查一致性一般(Kappa=0.470,P<0.05),CT与病理检查一致性较差(Kappa=0.356,P<0.05);<1 cm肿物中,超声内镜与病理检查一致性一般(Kappa=0.642,P<0.05),CT与病理检查不存在一致性(P>0.05)。结论超声内镜和CT对食管黏膜下>2 cm肿物诊断结果与病理结果具有较高的一致性,值得推广。
Objective To study the application value of endoscopic ultrasonography and CT in the diagnosis of esophageal submucosal masses.Methods A total of 103 patients with esophageal submucosal masses detected by gastroscopy from January 2019 to December 2020 in the Affiliated Huaian NO.1 People’s Hospital of Nanjing Medical University were selected as the study subjects.All patients underwent endoscopic ultrasonography and CT examination,and were treated by surgery and diagnosed by pathology.The pathological results,endoscopic ultrasonography and CT findings of all patients were analyzed.The consistency between these two methods and pathological examination in judging benign and malignant tumors of different sizes of esophageal submucosa was compared.Results Pathological results of all patients showed that 8.74%were malignant tumors,all of which were malignant stromal tumors,and 91.26%were benign tumors.Endoscopic ultrasonography showed that the benign mass had clear boundary,smooth surface,and homogeneous or less homogeneous hypoechoic mass.The malignant mass was indistinct with mixed echogenic masses.CT showed that the benign mass had regular shape,oval solid mass,and clear boundary.The malignant mass had uneven density,fuzzy boundary,and uneven enhancement.Endoscopic ultrasonography was consistent with pathological examination(Kappa=0.797,P<0.05),while CT was consistent with pathological examination(Kappa=0.415,P<0.05).The diagnostic coincidence rate of endoscopic ultrasound was higher than that of CT,and the difference was statistically significant(P<0.05).Endoscopic ultrasonography and CT had good consistency with pathological examination in>2 cm masses(Kappa=1.000,0.800,P<0.05).In 1-2 cm masses,endoscopic ultrasonography had a general consistency with pathological examination(Kappa=0.470,P<0.05),while CT had a poor consistency with pathological examination(Kappa=0.356,P<0.05).In<1 cm masses,endoscopic ultrasonography had a general consistency with pathological examination(Kappa=0.642,P<0.05),while CT had no cons
作者
李祥玉
顾雪香
葛倩文
LI Xiangyu;GU Xuexiang;GE Qianwen(Department of Gastroenterology,the Affiliated Huaian NO.1 People’s Hospital of Nanjing Medical University,Jiangsu Province,Huaian223300,China)
出处
《中国医药导报》
CAS
2021年第34期139-142,147,共5页
China Medical Herald
基金
江苏省中医药局科技重点项目(ZD201805)。
关键词
超声内镜
CT
食管黏膜
肿物
病理结果
Endoscopic ultrasonography
CT
Esophageal mucosa
Tumor
Pathological examination
