Zhou Ping-Hong, Yao Li-Qing, Zhong Yun-Shi, He Guo-Jie, Xu Mei-Dong, Qin Xin-Yu
Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
World J Gastroenterol. 2004 Aug 15;10(16):2444-6. doi: 10.3748/wjg.v10.i16.2444.
To evaluate the role of miniprobe ultrasonography under colonoscope in the diagnosis of submucosal tumor of the large intestine, and to determine its imaging characteristics.
Thirty-five patients with submucosal tumors of the large intestine underwent miniprobe ultrasonography under colonoscope. The diagnostic results of miniprobe ultrasonography were compared with pathological findings of specimens by biopsy and surgical resection.
Lipomas were visualized as hyperechoic homogeneous masses located in the submucosa with a distinct border. Leiomyomas were visualized as hypoechoic homogeneous mass originated from the muscularis propria. Leiomyosarcomas were shown with inhomogeneous echo and irregular border. Carcinoids were presented as submucosal hypoechoic masses with homogenous echo and distinct border. Lymphangiomas were shown as submocosal hypoechoic masses with cystic septal structures. Malignant lymphomas displayed as hypoechoic masses from mucosa to muscularis propria, while pneumatosis cystoids intestinalis originated from submucosa with a special sonic shadow. One large leiomyoma was misdiagnosed as leiomyosarcoma.
Endoscopic miniprobe ultrasonography can provide precise information about the size, layer of origin, border of submucosal tumor of the large intestine and has a high accuracy in the diagnosis of submucosal tumor of the large intestine. Pre-operative miniprobe ultrasonography under colonoscope may play an important role in the choice of therapy for submucosal tumor of the large intestine.
评估结肠镜下微探头超声检查在大肠黏膜下肿瘤诊断中的作用,并确定其影像学特征。
35例大肠黏膜下肿瘤患者接受了结肠镜下微探头超声检查。将微探头超声检查的诊断结果与活检及手术切除标本的病理结果进行比较。
脂肪瘤表现为位于黏膜下层的高回声均匀肿块,边界清晰。平滑肌瘤表现为起源于固有肌层的低回声均匀肿块。平滑肌肉瘤表现为回声不均匀、边界不规则。类癌表现为黏膜下低回声肿块,回声均匀,边界清晰。淋巴管瘤表现为黏膜下低回声肿块,有囊性分隔结构。恶性淋巴瘤表现为从黏膜到固有肌层的低回声肿块,而肠壁囊样积气症起源于黏膜下层,有特殊声影。1例大的平滑肌瘤被误诊为平滑肌肉瘤。
内镜下微探头超声检查可为大肠黏膜下肿瘤的大小、起源层次、边界提供精确信息,对大肠黏膜下肿瘤的诊断具有较高准确性。术前结肠镜下微探头超声检查在大肠黏膜下肿瘤治疗方案的选择中可能起重要作用。