口服超声造影在胃疾病诊断中的应用分析

目的通过口服超声造影（OCUS）进行胃疾病筛查，探讨OCUS在胃疾病诊断中的应用价值。方法对上海崇明地区疑有胃疾病的2852患者进行OCUS筛查，以胃镜病理结果为对照，分析OCUS图像质量、病变位置、病变最大径、病变性质对胃疾病诊断符合率的影响。结果OCUS筛查胃疾病的检出率为12．9％（367，2852），诊断符合率、敏感性、特异性、阳性预测值和阴性预测值分别为93．8％（2676／2852）、69．1％（367／531）、99．5％（2309／2321）、96．8％（367／379）和93．4％（2309／2473）；图像质量、病变位置、病变最大径、病变性质均是OCUS诊断胃疾病诊断符合率的影响因素；根据Logistic回归方程：Logit P=-7．416＋0．842X1＋0．359X2＋1．728X3显示，影响胃疾病诊断的因素由大到小依次为病变最大径、图像质量和病变位置，其相对危险度分别为5．632、3．321和1．420；而病变性质对其无明显影响。结论OCUS筛查胃疾病准确率、特异性、阳性预测值及阴性预测值较高，可作为一种胃疾病选择性筛查的首选方法；其对胃疾病诊断符合率与图像质量、病变位置、病变最大径、病变性质有关，其中病变最大径影响最大，病变性质影响最小。

Application of oral contrast ultrasonography in diagnosis of gastric disease

Objective To investigate the value of oral contrast ultrasonography（OCUS） on selective screening of gastric diseases. Methods Two thousand eight hundred and fifty-two patients suspected of gastric diseases in Chongming district of Shanghai were examined with OCUS. The results of OUCS on screening of gastric diseases were analyzed and compared with those of pathology. The influence of image quality, the location, the maximum diameter and pathologic type of lesions on positive detection rate, diagnostic accuracy were analyzed, simultaneously. Results The detection rate of OCUS was 12.9%（367/2852）. The accuracy, sensitivity, specificity, positive and negative predictive value were 93.8% （2676/2852）, 69.1% （367/531 ）, 99.5% （2309/2321）, 96.8% （367/379） and 93.4% （2309/2473）, respectively. Factors that affected the results of OCUS on screening gastric diseases included image quality, location, maximum diameter and the type of the lesions. According to the Logistic regression equation： Logit P=-7.416 ＋0.842X1 ＋0.359X2＋l.728X3, the factors sorted in descending order were the maximum diameter of the lesion, image quality and location of the lesion, the relative risk was 5.632, 3.321 and 1.420 respectively. The type of the lesions had no significant influence on results of OCUS. Conclusion OCUS is suitable for gastric disease screening with high accuracy, specificity, positive and negative value. The lesion detection rate of OCUS is related to image quality, pathologic type, maximum size and location of the lesion. The maximum diameter of lesion is the major and the type of lesion is the minor factor.