内镜超声在慢性肠系膜缺血评估中的作用。

The role of endoscopic ultrasound in the evaluation of chronic mesenteric ischaemia.

机构信息

Division of Gastroenterology and Hepatology, Mayo Clinic Florida, Jacksonville, FL, USA.

出版信息

Dig Liver Dis. 2011 Jun;43(6):470-4. doi: 10.1016/j.dld.2011.01.003. Epub 2011 Feb 11.

DOI:10.1016/j.dld.2011.01.003

PMID:21316317

Abstract

INTRODUCTION

Doppler transabdominal ultrasound is a validated screening test for chronic mesenteric ischaemia, but gas and obesity are limitations. Endoscopic ultrasound has been proposed as a comprehensive test to evaluate chronic upper abdominal pain and is capable of Doppler measurement. We aim to evaluate the accuracy of Doppler endoscopic ultrasound (D-EUS) as a single screening test to rule out chronic mesenteric ischaemia in patients with abdominal pain and compare it with Doppler transabdominal ultrasound (D-TUS).

METHODS

We enrolled all patients ≥50 years with chronic upper abdominal pain and vascular risk referred for endoscopic ultrasound. All were scheduled for D-EUS and D-TUS plus a confirmatory test if one of the previous resulted positive. We estimated the accuracy of both techniques comparing them using McNemar test.

RESULTS

68 patients completed the study. Fifty-three (78%) underwent D-EUS, D-TUS, and a confirmatory test. Fifteen (38%) underwent follow-up after negative results. Three (4%) in the D-EUS group and 14 in the D-TUS (21%) were excluded due to artefacts. D-EUS presented a sensitivity of 63%, specificity of 84%, whilst D-TUS presented a sensitivity of 80% and a specificity of 78%. Specificity of D-EUS was not significantly different to D-TUS.

CONCLUSIONS

These results support the role of Doppler endoscopic ultrasound to exclude chronic mesenteric ischaemia as cause of chronic abdominal pain.

摘要

简介

经腹部多普勒超声是一种经过验证的慢性肠系膜缺血筛查试验，但气体和肥胖是其限制因素。内镜超声已被提议作为一种全面的测试方法，用于评估慢性上腹痛，并能够进行多普勒测量。我们旨在评估多普勒内镜超声（D-EUS）作为单一筛查试验排除腹痛患者慢性肠系膜缺血的准确性，并将其与经腹部多普勒超声（D-TUS）进行比较。

方法

我们招募了所有≥50 岁的、有慢性上腹痛和血管风险的患者，并将其转介进行内镜超声检查。所有患者均计划进行 D-EUS 和 D-TUS 检查，如果其中一项检查结果阳性，则进行确认性检查。我们使用 McNemar 检验比较两种技术的准确性。

结果

68 例患者完成了研究。53 例（78%）患者进行了 D-EUS、D-TUS 和确认性检查。15 例（38%）患者在阴性结果后进行了随访。D-EUS 组中有 3 例（4%）和 D-TUS 组中有 14 例（21%）因伪影而被排除。D-EUS 的敏感性为 63%，特异性为 84%，而 D-TUS 的敏感性为 80%，特异性为 78%。D-EUS 的特异性与 D-TUS 无显著差异。