CAJ | 학술논문

目的探讨超声内镜检查对胃异位胰腺的诊断价值.方法对2012年1月至2015年6月首都医科大学附属北京安贞医院及附属北京朝阳医院经超声内镜诊断为胃异位胰腺的51例患者的病历资料进行回顾性分析,记录电子胃镜表现(胃异位胰腺的大小、部位、有无黏膜桥、有无腺管开口或脐样凹陷)、超声内镜特点(起源层次、边界、内部回声特征)和病理结果等.结果 51例均为单发病灶,表面黏膜光滑,未见黏膜桥,最长径6 ～ 42 mm,平均(15±10) mm.42例(82.4％)病变位于胃窦,主要表现为盘状隆起;9例(17.6％)位于胃体,主要表现为半球形隆起.29例(56.9％)伴有典型的脐样凹陷或腺管开口.1例(2.0％)病变起源于黏膜固有层,44例(86.3％)病变起源于黏膜下层,4例(7.8％)位于固有肌层,1例(2.0％)位于浆膜下层,1例(2.0％)贯穿黏膜下层和固有肌层.49例(96.1％)病灶边界清晰;28例(54.9％)病灶为低回声中混有高回声,23例(45.1％)为不均匀中高回声.22例(43.1％)可见管腔样结构,2例(3.9％)可见无回声囊腔样结构.21例(41.2％)获得标本,经病理和免疫组织化学方法确诊为胃异位胰腺.结论超声内镜能准确地显示病变的起源及内部回声特征,对胃异位胰腺的诊断有一定的价值.
목적 탐토초성내경검사대위이위이선적진단개치.방법 대2012년1월지2015년6월수도의과대학부속북경안정의원급부속북경조양의원경초성내경진단위위이위이선적51례환자적병력자료진행회고성분석,기록전자위경표현(위이위이선적대소、부위、유무점막교、유무선관개구혹제양요함)、초성내경특점(기원층차、변계、내부회성특정)화병리결과등.결과 51례균위단발병조,표면점막광활,미견점막교,최장경6 ～ 42 mm,평균(15±10) mm.42례(82.4％)병변위우위두,주요표현위반상륭기;9례(17.6％)위우위체,주요표현위반구형륭기.29례(56.9％)반유전형적제양요함혹선관개구.1례(2.0％)병변기원우점막고유층,44례(86.3％)병변기원우점막하층,4례(7.8％)위우고유기층,1례(2.0％)위우장막하층,1례(2.0％)관천점막하층화고유기층.49례(96.1％)병조변계청석;28례(54.9％)병조위저회성중혼유고회성,23례(45.1％)위불균균중고회성.22례(43.1％)가견관강양결구,2례(3.9％)가견무회성낭강양결구.21례(41.2％)획득표본,경병리화면역조직화학방법학진위위이위이선.결론 초성내경능준학지현시병변적기원급내부회성특정,대위이위이선적진단유일정적개치.
Objective To evaluate the value of endoscopic ultrasonography (EUS) in diagnosing gastric heterotopic pancreas.Methods Imaging data of 51 patients with gastric heterotopic pancreas diagnosed by EUS from January 2012 to June 2015 were retrospectively analyzed.The electrogastroscope manifestation (including size, location, mucosal bridge plica, pitpattern or umbilication), the EUS features (including origin, border and echo) and the pathological findings were recorded.Results The lesion was single in all 51 patients;the mucosal surface was smooth;the mucous bridge was not found;the long diameter was (15 ± 10) mm (6-42 mm).The lesion located at gastric antrum in 42 cases (82.4％) showing as disc bulge, at gastric body in 9 cases (17.6％) showing as hemispheric sticks;there was pitpattern or umbilication in 29 cases (56.9％).EUS showed that the heterotopic pancreas originated from mucosa lamina propria in 1 cases (2.0％), from submucosa in 44 cases (86.3％), from muscularis propria in 4 cases (7.8％) , from subserosa in 1 cases (2.0％) and from submucosamuscularis propria in 1 cases (2.0％);the boundary was clear in 49 lesions (96.1％);28 lesions (54.9％)manifested as mixed echo, 23 lesions (45.1％) manifestaed as medium-high inhomogenous echo;tubularstructure was found in 22 lesions (43.1％), cysts cavity structure was found in 2 lesions (3.9％).Totally 21 cases (41.2％) were pathologically confirmed.Conclusion EUS can accurately reveal the origin and internal echo pattern of gastric heterotopic pancreas and is valuable in diagnosing gastric heterotopic pancreas.