CAJ | 학술논문

目的探讨经内镜微探头超声检查对结直肠黏膜下隆起病灶的诊断价值.方法应用微探头对68例70处结直肠黏膜下隆起性病灶进行肠镜下超声检查,总结内镜超声特点,并与最终诊断比较.结果发现类癌20例,表现为黏膜下层低回声；脂肪瘤12例,多位于右半结肠(11/12),表现为黏膜下层、边界清楚的强回声；囊肿12例,表现为黏膜下层的单房或多房性的无回声区,包膜完整；间质瘤或平滑肌瘤12例,多位于直肠9例,表现为黏膜肌层及以下各层次的均匀或不均匀低回声为主,外覆稍强回声包膜,两者在超声下很难区别；恶性淋巴瘤3例5个,表现为局部黏膜肌层和黏膜下层增厚,呈中低回声,不均匀,较少侵及固有肌层；血管性病变(血管瘤、静脉曲张)3个,表现为黏膜及黏膜下层的无回声,部分中、高回声,圆形或不规则形,散在或成族状分布,部分互相沟通；另外,还有子宫内膜异位2例,色素沉积1例,阑尾慢性脓肿1例,壁外压迫2例.超声与最终诊断结果均相符.结论经内镜微探头超声检查可以明确大肠黏膜下隆起的大小、肠壁起源和边界.根据超声特征对黏膜下良恶性判别有一定的价值,同时能与腔外压迫性病变相鉴别.
목적 탐토경내경미탐두초성검사대결직장점막하륭기병조적진단개치.방법 응용미탐두대68례70처결직장점막하륭기성병조진행장경하초성검사,총결내경초성특점,병여최종진단비교.결과 발현유암20례,표현위점막하층저회성；지방류12례,다위우우반결장(11/12),표현위점막하층、변계청초적강회성；낭종12례,표현위점막하층적단방혹다방성적무회성구,포막완정；간질류혹평활기류12례,다위우직장9례,표현위점막기층급이하각층차적균균혹불균균저회성위주,외복초강회성포막,량자재초성하흔난구별；악성림파류3례5개,표현위국부점막기층화점막하층증후,정중저회성,불균균,교소침급고유기층；혈관성병변(혈관류、정맥곡장)3개,표현위점막급점막하층적무회성,부분중、고회성,원형혹불규칙형,산재혹성족상분포,부분호상구통；령외,환유자궁내막이위2례,색소침적1례,란미만성농종1례,벽외압박2례.초성여최종진단결과균상부.결론 경내경미탐두초성검사가이명학대장점막하륭기적대소、장벽기원화변계.근거초성특정대점막하량악성판별유일정적개치,동시능여강외압박성병변상감별.
Objective To assess the value of ultrasonic probe (USP) in the diagnosis of Submucous eminence of colorectume.Methods Sixty-eight patients with colorectal submucous eminence in 70 areas received USP under colonoscope.The accuracy of diagnosis was evaluated.Results Twenty carcinoid tumor were detected which manifested submucous hypoechoic ; Lipoma 12,located in right half colon which manifested submucous layer,clear boundaries hyperechoic; Cyst 12 manifested single or multi lattices no-echo on submucous which have integrated involucrum.Mesenchymoma or myoma levicellulare 12,most of them located inthe rectum manifested uniform or no-uniform hypoechoic on the muscularis mucosa or below and were difficult to discriminate.Malignant lymphoma,3 manifested muscularis mucosa and submucosa thickening,muscularis propria were seldom affected.Vascular diseases (hemangioma,varicosity) 3,manifested no-echoic on mucosa or submucosa,some medium,high echoic,circular or irregular,and also endometriosis 2,pigment deposition 1,appendix abscess 1,extramural compression 2,ultrasonic test is marched with clinic diagnosis.Accuracy rate is 100％.Conclusion USP can diagnose colorectal submucous eminence with high accuracy,and even provide information about the size,layer of origin,border of the colorectal submucous eminence and can distinguish benign or malignant tumor according to ultrasonic check,at the same time provide differentiation with extramural compressive lesions.