Research Of Oral Ultrasonic Contrast Agent In The Diagnosis Of Upper Gastrointestinal Diseases

Objective: This study discusses the value of oral ultrasonic contrast agent on diagnostic of gastrointestinal common disease by drinking an oral ultrasonic contrast agent to diagnose common diseases of the upper digestive tract, and then comparing with gastroscopy and pathological examination result.Methods: The case group 60 people drink about 600 ml ultrasound contrast agents which has been washed well cooled as gastrointestinal diseases inspection, choose convex array probe frequency of 3.5-5.0MHz from Xiaro-660 or IE33 made by GE company America, do longitudinal、transverse and oblique plane scanning to obtain the ultrasonographic section of each parts of the stomach according to the stomach in the body surface projection. First, the patient is asked to keep standing position to observe the situation of contrast agents into the stomach cavity, on the left of the abdominal aorta in the left lobe of the liver as a good acoustic window to observe the contrast agent through the lower esophagus and cardia whether smooth or not and the cardiac wall whether thickening or narrow. Turn to the left lateral decubitus position, make probe placed in the left 9-10 intercostal do intercostal oblique plane scanning to observed the bottom of the stomach and surrounding organs(liver and kidney), which position can obtain the bottom section of the full stomach.then, turn to the right lateral decubitus positionuse, use the probe do vertical and horizontal scaning in the upper abdomen to observe the gastric body、the gastric antrum、big bend、small bend、pylorus、duodenal and surrounding organs(liver、gallbladder and pancreas). According to the need, sometimes the patients also desirable seat check, when the air in the stomach is moved upward and the liquid is sinking, help to show the greater curvature of the stomach, the posterior wall of the stomach and the pylorus whether narrow or thickening.Let the patients do gastroscopy(gastroscopy has been done to hide the results), then do the pathological biopsy to diagnosis, comparison and analysis the results between ultrasound examination of gastrointestinal、gastroscope examination and pathological examination.Results:1. 60 cases of patients with pathologically diagnosed, the ultrasound contrast and endoscopy for lesion detection rate are shown in table-2, table-3. contrast-enhanced ultrasound can detect out 49 cases and 5 cases respectively in 53 cases of gastric diseases and 7 cases of duodenal diseases, the detection rates of gastric and duodenal disease is 92.45% and 71.43%. Gastroscopy can detect out 51 cases and 7 cases of gastric and duodenal diseases, the detection rates are 96.22% and 100%. 2. With pathological findings for gold standard, compare the coincidence rate of diagnostic between contrast-enhanced ultrasound and endoscopy in 53 cases of common gastric diseases, show in table-4. Among them, gastric ulcer 9 cases, gastric cancer 8 cases, one case of gastric leiomyoma and gastritis 35 cases, the results showed there is no significant difference in the two methods for diagnose four common stomach diseases(p﹥0.05). 3. With pathological findings for gold standard, use contrast-enhanced ultrasound and gastroscopy in 7 cases of patients with duodenal ulcer, compare the coincidence rate of diagnostic between contrast-enhanced ultrasound and endoscopy in duodenal ulcer, show in table-5. The results showed that P>0.05, Indicate the coincidence rate has no significant difference between them to diagnose the duodenal ulcer.Conclusions: 1. Fill up the stomach and duodenum through oral ultrasonic contrast agent to observe the gastrointestinal tract wall hierarchy、 peristalsis、 tension、 shape、continuity and gastric emptying function. 2. Observe structure of the organ’s which around the gastrointestinal, such as the liver、gallbladder、 pancreas、 ampulla of vater area and the peripheral lymph nodes. It has an important guiding significance to assessment before operation and choice the operation mode. This method is economic and simple for the postoperative patients who need to check repeatedly and well find the foreign body in the stomach. 3. Because the contrast agent emptying slowly, a long time stay in the gastrointestinal lumen, so the patients have plenty of time to change position to be checked, improve the detection rate of disease and the accurate rate of diagnosis. Studies has shown that through oral ultrasonic contrast agent to fill the stomach and duodenum cavity, which exhaust gas in the stomach and duodenum, can improve the display rate of gastrointestinal diseases, and have a higher diagnosis rate for common diseases of the gastrointestinal tract. This method is simple and easy, no side effects and adverse reaction, which can be as a way of follow-up inspection of gastrointestinal disease.