微探头内镜超声对上消化道囊性病变的诊断价值

目的探讨微探头内镜超声对上消化道粘膜下囊性病变的诊断价值。方法对191例普通胃镜检查怀疑囊性病变的患者行微探头内镜超声检查。34例患者接受了Endo-dop检查。探及到血流信号后,适当调整探头位置,并调整探测深度,记录多普勒图形。结果 191例囊性病变中,囊肿139例（72.8%）,血管瘤51例（26.7%）,淋巴管扩张症1例（0.5%）。34例患者接受了Endo-dop检查,26例血管瘤均测及血流信号,8例囊肿未测及血流信号。9例囊肿行细针穿刺抽吸治疗,均抽出淡黄色囊液后隆起消失,1例淋巴管扩张症行内镜粘膜切除（EMR）活检,病理证实。结论内镜超声微探头检查能准确诊断上消化道粘膜下无回声占位病变,仅根据声像表现对囊肿和血管瘤的鉴别诊断有困难,结合内镜表现可对食管血管瘤作出诊断,内镜多谱勒对囊肿和血管瘤的鉴别诊断可能有较大意义。

Diagnostic value of miniprobe endoscopic ui trasonography for cystic lesions in upper gastrointestinal tract

Objective To evaluate the diagnostic value of the miniprobe endoscopic ultrasonography（mEUS）for cystic lesions in upper gastrointestinal trace.Methods 191 patients with protruding lesions revealed by routine gastroscopy underwent mEUS.34 of them received Endo-dop examination,in which position and depth of the probe was adjusted once signals of blood flow was detected.The image of Endo-dop was recorded.Results 191 cystic lesions comprised of 139 cyst,51 angioma and 1 lymphangiectasis.Endo-dop examination was performed on 34 patients,among which blood flow signal was detected in 26 patients with angioma,but not in the 8 with cyst.Fine needle aspiration was performedon 9 cystic lesions that showed disappearance of protrusion after retrieval of light yellow cystic fluid.1 lymphangiectasis was biopsied by means of EMR and then pathologically confirmed.Conclusion mEUS is an ideal diagnostic modality for none-echo mass in upper gastrointestinal tract.But it is difficult in distinguishing cyst from angioma according to ultraphonic image.It is valuable for Endo-dop in distinguishing cyst from angioma.