| Objective:1.The value of endoscopic ultrasonography in the diagnosis of digestive tract protuberance lesions,focusing on the characteristics of stromal tumors,leiomyomas,lipomas,cysts,polyps,ectopic pancreas,hemangiomas and other diseases.2.The diagnostic accuracy of endoscopic ultrasonography was evaluated bypathological diagnosis as a gold standard,and the diagnostic accuracy of endoscopy,common endoscopy and CT was compared and analyzed.3.To evaluate the value of ultrasonic endoscope in diagnosis of early cancer and to judge the level of invasion,and to provide help for the treatment of early carcinoma of ESD.Methods:1.From April 2015 to January 2018 in Affiliated Hospital of Tai'an Medical College for ordinary gastroscopy found gastrointestinal lesions,clear lesions,and preliminary diagnosis in size to the family account and explanation of patients,428 cases underwent endoscopic ultrasound examination of patients,including 202 cases of male,female 226 cases,the lesions were 432,including 4 patients with two lesions.The age distribution in 18-83 years old,the average age is 53.4 years old,a retrospective analysis of the level distribution of lesions under endoscopic ultrasound,ultrasound echo features,size and other characteristics.The common diseases such as leiomyoma,lipoma Features of stromal tumors,cysts,polyps,Brinell adenoma,ectopic pancreas,hemangioma,external pressure and other diseases.2.Among 432 cases,132 cases with definite pathological results were analyzed and compared with pathological results.The total diagnostic rate of endoscopic ultrasonography and the coincidence rate of several common lesions were sum arized.Comparative analysis of the diagnostic accuracy of ultrasound endoscopy and conven-tional endoscopic CT.Results:1.Distribution of diseases: a total of 432 cases were collected,including 171 cases of esophagus and 190 cases of stomach,including 12 cases of cardia,85 cases of fundus,32 cases of body of stomach,61 cases of antrum,32 cases of duodenum,22 cases of colon and 17 cases of rectum.2.Characteristics of common diseases in endoscopic ultrasonography: among the protruding lesions of digestive tract,99 cases of stromal tumors were mainly from the mucosal myometrium and the inherent base,the median size was 1.11 cm.The echo characteristics of ultrasound were mainly hypoechoic and mixed echo.There were 115 cases of leiomyoma,mainly from the myometrium and the basal layer of the mucosa,the median size was 0.63 cm.The echo characteristics of ultrasound were mainly hypoechoic,and 16 cases of lipoma came from the submucous layer.The median size was 1.22 cm,and hyperechoic was the main characteristic of ultrasound echo,and 17 cases of ectopic pancreas came from submucous membrane.The median size is 0.67 cm,ultrasonic echo characteristics of diversity,high echo,low echo and mixed echo.Polyps in 61 cases,mainly from the mucous layer,the median size is 0.72 cm,ultrasonic echo characteristics of high;5 cases of Brandt adenoma,size median 0.3cm,endoscopic ultrasound mainly comes from 1-3 layers of low echo and mixed echo;cyst,hemangioma cystic lesions,42 cases,median size were 0.53 cm,0.5cm,mainly from the mucosa and submucosa,ultrasound characteristics of low echo and no echo,hemangioma by Doppler There were 35 cases of early cancer,the median size was 1.35 cm.The echo characteristics of ultrasound were mainly hypoechoic.3.There were 28 cases of external pressure changes,while 24 cases of stomach,mainly splenic external pressure.4.Comparison of endoscopic and pathological diagnosis: 143 cases were confirmed by pathology in 435 cases.The diagnostic coincidence rate of endoscopic ultrasonography was 81.066.In which,stromal tumor,lipoma,leiomyoma,polyp,ectopic pancreas,stromal tumor,lipoma,leiomyoma,polyp,ectopic pancreas,The diagnostic coincidence rate of early cancer was 72.73%,100%,93.54%,83.33%,60%,87.5% respectively.In the analysis of the factors of coincidence and nonconformity between endoscopic and pathological diagnosis,the size of the lesions of coincidence and nonconformity were 2.34±0.94 cm,1.3±0.72 cm,respectively,P < 0.05 after T test,and statistically intentional Righteousness.5.The diagnostic specificity of endoscopic ultrasonography for early cancer is 82.35%,sensitivity is 87.5%,positive predictive value is 82.35%,negative predictive value is 87.75%.Endoscopic ultrasonography is a diagnostic coincidence rate of ESD before invasion and ESD.The diagnostic accordance rate is 87%.6.Compared with the imaging examination,the diagnostic accuracy of endoscopic ultrasonography was 84.62%,the diagnostic accuracy rate of common endoscopy was 48.25%,the diagnostic accuracy of CT was 38.64%,and the diagnostic accuracy of Chi-square test was less than 0.05 with endoscopic ultrasonography(P < 0.05),which had statistical significance.Conclusion:1.Ultrasound endoscopy has a high diagnostic value in the diagnosis of digestive tract protuberance,especially in judging the origin,location and size of some common lesions,especially in judging the source of the change of external pressure.2.Endoscopic ultrasonography is superior to common endoscopy and CT in the diagnosis of upper gastrointestinal Carina disease.3.Endoscopic ultrasonography is of great significance in the diagnosis of early cancer and in judging the level of invasion.It is valuable for ESD in the treatment of early cancer. |
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