| Background and Objective:Different from the conventional endoscopic guidance, Endoscopicultrasonography is a means of ultrasound scan examination, which checks thedigestive tract and the adjacent organs under the guidance of endoscope from thedigestive cavity. The endoscopic ultrasonography examination methods are dividedinto two kinds,one method is equipped with micro endoscopic ultrasound probe todiagnosis and treat the related diseases,the other is inserted micro endoscopicultrasound probe through the scope, it can be used to diagnosis the related diseases.According to the scanning plane of the ultrasound probe,endoscopic ultrasonographycan be divided into two kinds.One is the circular scanning endoscopicultrasonography, its plane of scanning motion is perpendiculared to the long axis ofendoscope, it has high quality imaging because of its360-degree circular scanningfield of vision. The other is the longitudinal section, its plane of scanning motion isparalleled to the long axis of endoscope, it can monitor the puncture needle all theway when we give the fine needle puncture under the guidance of endoscopicultrasound. This kind of endoscopic ultrasonography can be used for variousinterventional techniques, for example, aspiratiion biopsy under the guidance ofendoscope, the internal drainage, needle injection technique, and so on. Through the characteristic of high resolution of endoscopic ultrasonography, we can be observedthe origin level and the enteral echo of gastrointestinal stromal tumor, to identify thegastrointestinal stromal tumor. In recent years, CT technology is developing veryquickly. The scanning speed of multi-sice computed tomography has been more fasterthan before, this can reduce the interference caused by abdominal motion artifacts,toimprove the temporal resolution greatly.Multi-slice spiral CT helps to the detection ofdisease at the same time, but also can monitor violations of gastrointestinal tract walland surrounding tissue by leisons in the differential diagnosis of gastric submucosaltumors, helps us to find distant metastases and provides assurance of reasonabletreatment for clinical doctors. Gastric submucosal tumor often has no clinicalmanifestation and is discovered accidentally in endoscopy. However submucosaltumor that is great and along with ulcer can cause abdominal pain, gastrointestinalbleeding and gastrointestinal tract obstruction. In our research, we try to compare thefunction of endoscopic ultrasound and multi-sice computed tomography for detectionand differentiation of gastric submucosal tumor.Objects and MethodsRetrospective analysis of45patients with gastric submucosal tumor of the thefirst Affiliated Hospital of Zhengzhou university from March2012to March2014who have the histopathological and had a history of MDCT and EUS. Analysis theresults of EUS by senior GI physician who had not see the results of MDCT andhistopathology. Analysis the EUS features of gastric submucosal tumor, inculded theorigin, internal echo and wether have the central dimpling. Analysis the results ofMDCT by senior radiologists who had not see the results of EUS and histopathology.Analysis the CT features of gastric submucosal tumor, inculded the size, location,outline, growth pattern, enhancement degree and wether have the central dimpling.Measuring the long diameter and short diameter of each gastric submucosal tumorand calculating the length to diameter ratio. The EUS and MDCT examination resultswere compared with histopathologic results. Compare the detection rate and correctdiagnosis rate of EUS and MDCT for gastric submucosal tumor. ResultsIn45patients diagnosed by histopathology, EUS detect gastric submucosaltumor44case, the detection is97.78%; MDCT detect gastric submucosal tumor33case, the detection is73.33%. The detection rate of EUS and MDCT has statisticallysignificant difference（χ2=7.69，p<0.05）. In35patients, EUS results consistent withthe pathological results, the correct diagnosis rate is77.78%; in32patients, MDCTresults consistent with the pathological results, the correct diagnosis rate is77.11%.The correct diagnosis rate of EUS and MDCT has not statistically significantdifference（χ2=0.8，p>0.05）. In19patients of gastric submucosal tumor of greaterthan or equal to2cm, EUS detect gastric submucosal tumor and consistent with thepathological results19case, the detection rate and correct diagnosis rate is100%;MDCT detect gastric submucosal tumor18case, consistent with the pathologicalresults18case，the detection rate and correct diagnosis rate is94.74%. For gastricsubmucosal tumor of greater than or equal to2cm, the detection rate and correctdiagnosis of EUS and MDCT has not statistically significant difference（χ2=0，p>0.05）. In26patients of gastric submucosal tumor of less than2cm, EUS detectgastric submucosal tumor25case, the detection rate is96.15%, correct diagnosis is50%; MDCT detect gastric submucosal tumor15case, consistent with thepathological results13case. the detection rate is57.69%, correct diagnosis rate is50%.For gastric stromal tumor of less than2cm, the detection rate of EUS and MDCT hasstatistically significant difference（χ2=4.35，p<0.05）, the correct diagnosis rate ofEUS and MDCT has not statistically significant difference（χ2=1.33，p>0.05）.ConclusionsAs with the EUS, MDCT is an effective method to distinguish gastricsubmucosal tumor, but the sensitivity of MDCT in gastric submucosal tumor maybelower than EUS. For gastric submucosal tumor of greater than or equal to2cmMDCT and EUS maybe has similar sensitivity. For gastric submucosal tumor of lessthan2cm, the sensitivity of MDCT maybe lower than EUS. For gastric submucosaltumor of less than2cm, greater than or equal to2cm, they maybe has similar correct diagnosis rate. |
PDF Full Text Request