小探头内镜超声在消化道隆起性病变中的诊断价值

目的探讨小探头内镜超声扫查消化道黏膜下病变在管壁的分布特点以及对消化道黏膜下隆起性病变的诊断价值。方法回顾性分析2017年1月—2018年10月在武汉协和医院行小探头内镜超声检查消化道隆起性病变316例，患者均行内镜下治疗切除，组织送病理检查，通过超声检查结果结合病理诊断明确病变的层次和性质。结果316例消化道隆起性病变中黏膜下病变198例，其中平滑肌瘤118例，间质瘤27例，脂肪瘤、囊肿各15例，乳头状瘤4例，神经内分泌瘤7例，异位胰腺9例，颗粒细胞瘤、神经鞘瘤和布氏腺瘤各1例。病变分布在整个消化道管壁，以起源于黏膜肌层最常见，有7例病变在小探头内镜超声下未明确层次。结论小探头内镜超声可以明确黏膜下病变在消化道中的分布，并对病变大小、层次起源提供高准确率的判断，对治疗方案的选择亦有重要指导意义。

The role of miniature probe endoscopic ultrasonography on the gastrointestinal lesions

Objective To summarize the distribution characteristics of submucosal lesions and explore the clinical value of miniature probe endoscopic ultrasonography(mEUS) in gastrointestinal tract. Method We retrospective analyzed 316 cases of patients with gastronintestinal tract lesion were examined by mEUS from January 2017 to October 2018. All patients were subjected to endoscopic therapy for pathology examination. The origin and property of lesions were determined by ultrasound examination results combined with pathological diagnosis. Result In the 316 cases, there were 198 cases of submucosal tumors(SMT), 118 cases of leiomyomas, 27 cases of stromal tumors, 15 cases of lipomas, 15 cases of cysts, 4 cases of papillomas, 7 cases of neuroendocrine tumors, 9 cases of heterotopic pancreas, 1 case of granulosa cell tumor, 1 case of schwannoma and 1 case of burnner adenoma. Submucosal tumors could be located in the whole gastrointestinal tract wall which most origin from muscularis mucosae . the origin of 7 cases cannot have positive diagnosis. Conclusion The mEUS could provide origin characteristics of SMT and evidences for clinical diagnose. The results could guide the selection of different treatments.