Levine M S, Creteur V, Kressel H Y, Laufer I, Herlinger H
Radiology. 1987 Jul;164(1):9-13. doi: 10.1148/radiology.164.1.3588932.
Double-contrast upper gastrointestinal examinations revealed 108 gastric ulcers at the authors' hospital during a recent 1-year period. With use of current double-contrast examination criteria for differentiating benign and malignant ulcers, the radiographic appearance was unequivocally benign in 68 patients, probably benign in 25, probably malignant in 12, and unequivocally malignant in three. Fifty-six patients with benign, probably benign, or probably malignant ulcers underwent endoscopy and biopsy. All 56 had benign ulcers. Another three patients with unequivocally malignant ulcers had endoscopically proved carcinomas. Thus, most suspicious ulcers were benign, but no benign-appearing ulcers were malignant. Follow-up double-contrast studies for 87 ulcers revealed complete ulcer healing in 68 (78%). A residual ulcer scar was observed in 61 of those 68 cases (90%). This experience suggests that double-contrast radiography is a valuable technique for diagnosing benign gastric ulcers and that once diagnosed, typically benign ulcers can be followed up radiographically until completely healed, without need for endoscopic intervention.
在最近一年期间，作者所在医院通过双重对比上消化道检查发现了108例胃溃疡。根据目前用于鉴别良性和恶性溃疡的双重对比检查标准，68例患者的放射学表现明确为良性，25例可能为良性，12例可能为恶性，3例明确为恶性。56例患有良性、可能良性或可能恶性溃疡的患者接受了内镜检查和活检。所有56例均为良性溃疡。另外3例明确为恶性溃疡的患者经内镜证实为癌。因此，大多数可疑溃疡是良性的，但没有看似良性的溃疡是恶性的。对87例溃疡进行的随访双重对比研究显示，68例（78%）溃疡完全愈合。在这68例中的61例（90%）观察到残留的溃疡瘢痕。这一经验表明，双重对比造影是诊断良性胃溃疡的一种有价值的技术，而且一旦确诊，典型的良性溃疡可以通过放射学进行随访直至完全愈合，无需内镜干预。
