Songür Y, Okai T, Watanabe H, Motoo Y, Sawabu N
Department of Internal Medicine, University of Kanazawa, Japan.
Gastrointest Endosc. 1995 May;41(5):468-74. doi: 10.1016/s0016-5107(05)80005-7.
Giant gastric folds develop in several benign and malignant diseases. We used endoscopic ultrasonography to evaluate giant gastric folds in 15 patients with Borrmann type IV scirrhous carcinoma, 8 patients with gastric lymphoma, 5 patients with anisakiasis, 1 patient with Menetrier's disease, and 6 normal subjects with simple gastric hyperrugosity. With a 7.5 MHz transducer, a five-layered gastric wall structure was imaged. The thickness of the gastric wall and each layer was measured and compared with the endosonographic findings of 16 healthy subjects. Endoscopic ultrasonography findings revealed that the second layer alone was thickened in Menetrier's disease, and the third layer alone enlarged in anisakiasis. Most of the patients with scirrhous carcinoma showed an abnormally enlarged third and fourth layer. The second layer together with the third layer was thickened in healthy subjects with simple hyperrugosity and also in patients with gastric lymphoma. However, the fourth ultrasound layer corresponding to the muscularis propria was significantly thickened only in malignant conditions. It is concluded that endoscopic ultrasonography can visualize the structure of giant gastric folds and may facilitate the differentiation of benign from malignant etiologies.
巨大胃皱襞在多种良性和恶性疾病中出现。我们使用内镜超声检查评估了15例Borrmann IV型硬癌患者、8例胃淋巴瘤患者、5例异尖线虫病患者、1例门脉高压性胃病患者以及6例单纯胃皱襞增多的正常受试者的巨大胃皱襞。使用7.5MHz探头对胃壁的五层结构进行成像。测量胃壁及其各层的厚度，并与16例健康受试者的内镜超声检查结果进行比较。内镜超声检查结果显示，门脉高压性胃病仅第二层增厚，异尖线虫病仅第三层增厚。大多数硬癌患者显示第三层和第四层异常增厚。单纯皱襞增多的健康受试者以及胃淋巴瘤患者的第二层和第三层均增厚。然而，仅在恶性病变中，对应固有肌层的第四超声层显著增厚。结论是，内镜超声检查可以显示巨大胃皱襞的结构，可能有助于鉴别良性和恶性病因。
