A Preliminary Study On The Use Of Intestinal Endo-luminal Ultrasound In The Diagnosis Of Intestinal Diseases

Objective Study the imaging features of the normal small intestine under the intestinal endo-luminal ultrasound and its application in diagnosing disease of small intestine.Methods The existing endoscopic ultrasonography (EUS) cannot detect the small intestine directly for the limited length of its probe. But it can do this on the patients whose digestive tracts have been shortened after operations on esophageal, stomach, duodenum, large intestine or laparotomy. Thus the patients should be screened.50patients were chosen out of the patients who stayed in Shanxi Coal Center Hospital Digestive Endoscopy Center, and who have been checked with capsule intestine, gastroscope, colonoscopy and double-balloon enteroscopy, as well as the patients who stayed in General Surgery and Digestive Surgery and who had intestinal checking during the operation. All the50patients have intestinal endo-luminal ultrasound, observe the imaging features of the normal small intestine and those with diseases, and take down the thickness of every small intestine wall layer and the characteristics. If any disease is found, the patient should have US and SCT, so as to decide the value of intestinal endo-luminal ultrasound in getting the imaging features of the normal small intestine and its application in diagnosing disease of small intestine.Results Of the50patients,47had ISUS, of whom10have diseases. The normal small intestine wall has six layers while the jejunum and ileal has totally different imaging features and their separate characteristics. The jejunum wall and ileal wall which have tapetum is high-level echo-high-level ech---low-level echo high-level echo---low-level echo---high-level echo from inside to outside. Those without tapetum is high-level echo---low-level echo---high-level echo---ow-level echo---high-level echo from inside to outside. The layer thickness of jejunum is measured to be about1.5-2.Omm, ileal1.8-2.2mm, tapetum in jejunum0.4mm, tapetum in ileal0.2mm. The diseases include submucosal tumor (Gastrointestinal stromal tumors and Lipoma), polyp, ulcer lesions (benign), Crohn’s disease and elevated malignancy. Take the biopsy and the postoperative pathological results as standards; compare the US, SCT and diagnosis. The ten which have diseases were diagnosed with biopsy and the postoperative pathological. The diagnostic accuracy of ISUS is70%, US10%, and SCT30%. As can be seen in the result, ISUS has a higher accuracy. But it’s not enough to do statistical analysis for there are very few diseases in the small intestine. More cases are being observed.Conclusion ISUS can provide high resolution photography of every small intestine laver, and also a clear observation of the cause of the disease as well as the internal echo. It can become a new kind of diagnostic method of small intestine disease, and has guiding significance for treatment.