Lee Yuk Tong, Lai Alex C W, Hui Yui, Wu Justin C Y, Leung Vincent K S, Chan Francis K l, Chung S C Sydney, Sung Joseph J Y
Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, China.
Gastrointest Endosc. 2002 Dec;56(6):842-8. doi: 10.1067/mge.2002.129611.
Management of dyspepsia often involves multiple diagnostic tests. By virtue of luminal and extraluminal imaging, EUS may be a satisfactory single test for the evaluation of patients with dyspepsia.
Patients with uninvestigated dyspepsia of more than 4 weeks duration were recruited. All underwent transabdominal US followed by EUS and EGD to look for both luminal and extraluminal lesions that could account for the dyspeptic symptoms. Each of these studies was performed by an independent operator blinded to the results of the other examinations. Patients were followed for 1 year to monitor clinical outcome.
Two hundred patients were recruited. Compared with EGD, EUS had accuracies of 92% to 100% for the diagnosis of different luminal lesions. All gastric ulcers and cancers were detected by EUS, but 3 duodenal ulcers were missed. EUS also identified 48 pancreaticobiliary lesions, 23 of which were detected by US, that could account for the dyspeptic symptoms. Other extraintestinal lesions including mediastinal malignant lymphadenopathy and a dissecting aortic aneurysm were also diagnosed by EUS. Through the identification of extraluminal lesions, staging of tumors, and exclusion of pancreaticobiliary diseases, EUS altered clinical management in 50 patients (25%).
EUS is a useful one-step investigation in patients with dyspepsia.
消化不良的管理通常涉及多项诊断测试。凭借腔内和腔外成像，超声内镜检查（EUS）可能是评估消化不良患者的一项令人满意的单一测试。
招募持续时间超过4周未经调查的消化不良患者。所有患者均接受经腹超声检查，随后进行超声内镜检查和上消化道内镜检查（EGD），以寻找可能导致消化不良症状的腔内和腔外病变。这些检查均由对其他检查结果不知情的独立操作人员进行。对患者进行为期1年的随访以监测临床结果。
招募了200名患者。与上消化道内镜检查相比，超声内镜检查对不同腔内病变的诊断准确率为92%至100%。所有胃溃疡和癌症均通过超声内镜检查检测到，但漏诊了3例十二指肠溃疡。超声内镜检查还发现了48例可解释消化不良症状的胰胆病变，其中23例通过超声检测到。超声内镜检查还诊断出其他肠外病变，包括纵隔恶性淋巴结病和主动脉夹层动脉瘤。通过识别腔外病变、肿瘤分期和排除胰胆疾病，超声内镜检查改变了50例患者（25%）的临床管理。
超声内镜检查对消化不良患者是一项有用的一站式检查。
