超声内镜与CT仿真内镜对上消化道隆起样病变的诊断价值

目的 研究超声内镜(EUS)与CT仿真内镜(CTVE)对上消化道隆起样病变的诊断价值。方法 48例经胃镜检查发现有上消化道隆起样病变的患者(食管癌、胃癌、息肉等病例除外)，行CTVE和EUS检查，除9例检查发现为正常脏器外压、2例食管静脉瘤而密切随访观察外，其余均经手术或活检获取病理确诊。将以上三种方法诊断结果与病理结果进行比较。结果 胃镜、EUS、CTVE对上消化道隆起样病变的诊断准确率分别为16．7％、89．6％、66．7％，EUS、CTVE与胃镜检查结果差异有显著性(P＜0．001)；EUS、CTVE两者之间比较差异有显著性(P＜0．05)，EUS优于CTVE；EUS、CTVE对上述疾病的诊断的敏感性、特异性分别为89．7％、88．9％和66．7％、66.7％。结论 EUS和CTVE作为新兴的检查手段在对上消化道隆起样病变的诊断中有较高的临床实用价值，且两者有较强的互补性，可作为胃镜较难诊断的上消化道隆起样病变的确诊方法之一。

Evaluation of endoscopic ultrasonography and computed tomographic virtual endoscopy in the diagnosis of protuberant lesions of upper gastrointestinal tract

Objective To investigate the diagnostic values of endoscopic ultrasonography (EUS) and computed tomographic virtual endoscopy( CTVE) in protuberant lesions of upper gastrointestinal tract. Methods EUS and CTVE were used to diagnosis the 48 patients with protuberant lesions of upper gastrointestinal tract which were diagnosised by gastroscopy. All of the results except 11 cases were compared with pathological diagnosis. Results The accuracy of electronic gastroscopy, EUS and CTVE on the diagnosis of the protuberant lesions of the upper gastrointestinal tract were 16.7% ,89. 6% ,66. 7% , respectively . There was a significantly difference among them (P < 0.01) and EUS was better than CTVE (P < 0.05). The diagnostic accuracy was 100. 0% when EUS combined with CTVE. The sensitivity and specificity of EUS and CTVE were respectively 89. 7% , 88. 9% and 66. 7% , 66. 7% , corresponded well with pathology and specimens in demonstrating the protuberant lesions. Conclusion EUS and CTVE are newly developed techniques in diagnosing protuberant lesion of upper gastrointestinal tract, the combined use of these two techniques will obtain a most efficient and accurate results.