A prospective study comparing endoscopy and EUS in the evaluation of GI subepithelial masses
A prospective study comparing endoscopy and EUS in the evaluation of GI subepithelial masses
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DOI：
10.1016/s0016-5107(05)01567-1
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发表时间：
2005-08-01
影响因子：
7.7
通讯作者：
Kimmey, MB
中科院分区：
文献类型：
--
作者：
Hwang, JH;Saunders, MD;Kimmey, MB
背景：本研究的目的是前瞻性评价胃肠道上皮下肿块的内窥镜和超声检查的表现特征。方法：对100例怀疑胃肠道上皮下病变的患者进行前瞻性研究。在内窥镜检查时记录大小、颜色、流动性、位置(壁内或壁外)、一致性(实性、囊性或血管)和推定诊断，然后进行超声造影，确定大小、回声、位置和推定诊断。结果：总共评估了100个上皮下病变。胃镜检查对确定肠壁内病变的敏感性为98%，特异性为%。内窥镜测量的大小与EUS测量的大小相关(r=0.88)。23例获得组织学检查，EUS诊断正确率仅为48%，大多数EUS误诊为低回声3级和层状肿块。结论：胃镜对上皮下病变的定位(壁内或壁外)敏感性高，但特异性低。此外，EUS单独成像不足以准确诊断第3层和第4层低回声肿块，应尽可能获得组织学证实。
Background: The purpose of this study is to prospectively evaluate the performance characteristics of endoscopy and EUS in the diagnosis of GI subepithelial masses.Methods: A total of 100 consecutive patients referred for the evaluation of a suspected of GI subepithelial lesion were prospectively studied with endoscopy followed by EUS. Size, color, mobility, location (intramural or extramural), consistency (solid, cystic, or vascular), and presumptive diagnosis were recorded at the time of endoscopy, EUS then was performed, and size, echogenicity, location, and presumptive diagnosis were determined.Results: A total of 100 subepithelial lesions were evaluated. Endoscopy had 98% sensitivity and 64% spesificity in identifying intramural lesions. Size measurement by endoscopy correlated with size measurement by EUS (r = 0.88). Histology was obtained in 23 cases, with the presumptive EUS diagnosis correct in only 48% of cases, Most incorrect EUS diagnoses occurred with hypoechoic 3rd and with layer massesConclusions: Endoscopy has high sensitivity but low specififcity in identifying the location (intramural or extramural) of subepithelial lesions. In addition, EUS imaging alone is insufficient to accurately diagnose 3(rd) and 4th layer hypoechoic masses, and histologic confirmation should be obtained whenever possible.