Quiroz Moreno Rocío, Morales Guzmán Margarita Isabel, Cervantes Monroy Juan A, Rueda Torre Guillermo, Díaz Caldelas Leticia
Departamento de Radiología e Imagen, Hospital de Especialidades No. 14 del Centro Médico Nacional Adolfo Ruiz Cortines, Instituto Mexicano del Seguro Social, 91980 Veracruz, Ver.
Rev Gastroenterol Mex. 2003 Jul-Sep;68(3):245-52.
Our objective was to determine sensitivity, especificity and predictive values of transcutaneous sonography for detecting gastric wall lesions.
This prospective study was performed from March 1999 to April 2000 on 150 patients referred for transcutaneous sonography by the Endoscopic Service Unit. Sonographic examinations were performed using RT 4000 General Electric equipment with 5 Mhz transducer and replenishment of stomach with fluid. All scanning was done by the same sonographer, who was unaware of endoscopic, tomographic, or upper gastrointestinal series features. Results from sonography were compared with gastrointestinal tract endoscopy. Sensitivity, specificity, and predictive values were determined using contingency statistical procedure. Sonographic examination accuracy was calculated evaluating sensitivity and specificity confidence intervals (CI). Kappa index was calculated. Diagnostic accuracy differences observed between tumoral and non-tumoral lesions by sonography were evaluated by chi 2 probe.
Sensitivity of 85% (95% CI, from 75.2 to 94.8%) and specificity of 90% (95% CI, from 86 to 93.9%) were obtained. Positive predictability was 78% and negative predictability was 94%. Diagnostic accuracy was 87%. Kappa index was 0.717. There were 35 no false-positive results (19 tumoral lesions and 16 non-tumoral lesions), seven false-negative results (one tumoral lesion and six non-tumoral lesions) and 10 false-positive results (two tumoral lesions and eight non-tumoral lesions). Only one of 20 tumoral lesions were diagnosed by ultrasound whereas from 22 non-tumoral lesions were not diagnosed 6 (chi 2 = 3.74, p > 0.05).
Transcutaneous sonography is a rapid, low cost and non-invasive method that may be useful to establish clinic diagnosis and in the first steps of gastric wall lesions evaluation, it is valuable in assessment of diagnostic orientation for the referring clinic.
我们的目的是确定经皮超声检查对检测胃壁病变的敏感性、特异性和预测价值。
这项前瞻性研究于1999年3月至2000年4月对150例由内镜服务单元转诊进行经皮超声检查的患者进行。使用配备5MHz探头的通用电气RT 4000设备进行超声检查，并向胃内注入液体。所有扫描均由同一位超声检查医师完成，该医师对内镜、断层扫描或上消化道造影特征不知情。将超声检查结果与胃肠道内镜检查结果进行比较。使用列联统计程序确定敏感性、特异性和预测价值。通过评估敏感性和特异性置信区间（CI）计算超声检查准确性。计算kappa指数。通过卡方检验评估超声检查在肿瘤性和非肿瘤性病变之间观察到的诊断准确性差异。
获得了85%（95%CI，75.2%至94.8%）的敏感性和90%（95%CI，86%至93.9%）的特异性。阳性预测值为78%，阴性预测值为94%。诊断准确性为87%。kappa指数为0.717。有35例假阳性结果（19例肿瘤性病变和16例非肿瘤性病变），7例假阴性结果（l例肿瘤性病变和6例非肿瘤性病变）和10例假阳性结果（2例肿瘤性病变和8例非肿瘤性病变）。20例肿瘤性病变中只有1例通过超声诊断，而22例非肿瘤性病变中有6例未被诊断（卡方=3.74，p>0.05）。
经皮超声检查是一种快速、低成本且无创的方法，可能有助于临床诊断以及在胃壁病变评估的第一步，对转诊诊所的诊断方向评估具有重要价值。
