| [Objective]:Diseases of stomach and duodenum are common and frequently occurring diseases in china.With the change of lifestyle and environment,the incidence is increasing.Once data show that in 1 billion 300 million of the population in our country,there are 120 million patients with digestive tract disease,peptic ulcer incidence accounted for 10%.The incidence of chronic gastritis was 30%,400 thousand newly discovered gastric cancer in our country every year,accounting for the world cancer incidence number 42%[1].In addition to functional abnormalities,gastroduodenal diseases are often associated with morphological changes.In order to clarify the location and nature of the lesion,various examinations are often used to assist the diagnosis.The examination of the stomach and duodenum included:upper gastrointestinal barium meal,gastroscopy,gastric CT,MRI,etc.In recent years,with the popularization of new ultrasound contrast agents and the improvement of ultrasonic equipment and techniques,the gastroduodenal ultrasonography has been applied in clinical practice.Each inspection method has its advantages and disadvantages,and sometimes requires several different methods of inspection,complement each other,perfect,and finally get accurate inspection results.This study through the ultrasound examination on gastric and duodenal diseases were observed,and compared with the results of gastroscopy and pathological examination,to explore the value of contrast-enhanced ultrasound in the diagnosis of gastric and duodenal diseases,clinical diagnosis and follow-up of gastric and duodenal diseases detection of relative economic,safe,noninvasive,easy to accept,repeat good.[method]:According to inclusion criteria and exclusion criteria were collected in our hospital during January 2016-2017 March outpatient and hospitalized patients in 134 cases,there were 74 males and 60 females,the minimum age of 36 years,the maximum age of 85 years old,the average age(1.61 years 60+).Gastroscopy and contrast-enhanced ultrasonography were performed,and the interval between the two examinations was not more than 72 hours.Of which 119 cases of gastroscopy were performed biopsy.In the 134 patients,the same disease was diagnosed by two methods,and the data were analyzed by SPSS 19.0.Classification and enumeration data were compared by x2 test.The inspection level was P<0.05,which was statistically significant.Objective To observe the coincidence rate of ultrasonography and gastroscopy,and the accuracy of two different examination methods and pathological examination results.[Results]:1?In 134 patients,the number of cases by gastric ultrasonography in the diagnosis of gastric disease in 130 cases,including 4 cases of intestinal gas interference,the number of cases that showed poor;in the diagnosis of duodenal diseases in 129 cases,including 5 cases of intestinal gas interference,poor display.2?Comparison of the diagnostic accuracy of ultrasonography and gastroscopy in the same patient with the same disease:In 134 cases,the gastric ultrasound only report 56 cases of gastritis,the gastroscop only report gastritis in 53 cases,diagnostic gastric ultrasound radiography and gastroscopy rate of 94.6%;the of 38 cases of gastric ulcer,gastric ulcer 41 cases,diagnostic ultrasound angiography and endoscopy for gastric ulcer with the rate is 92.7%;the contrast-enhanced ultrasonography of 17 cases of gastric cancer,18 cases of gastric cancer by gastroscopy,the rate of 94.4%;the contrast-enhanced ultrasonography of 7 cases of gastric polyps,gastric polyps in 9 cases,the rate of 77.8%according to the diagnostic angiography and endoscopic gastric ultrasound;ultrasound angiography under duodenal stomach 12 cases of reflux,endoscopic bile reflux gastritis in 13 cases,he rate of 92.3%of gastro-duodenal reflux diagnosis;in 134 cases,combined with gastro-duodenal diseases,the ultrasonography of duodenal ulcer in 27 cases,30 cases of duodenal ulcer in endoscopy,diagnosis of ultrasound contrast and endoscopy for duodenal ulcer with the rate of 90%;the ultrasonography of duodenal inflammation in 32 cases,endoscopic duodenal inflammation in 34 cases,the diagnosis rate of 94.1%;the ultrasonography of duodenal polyps in 7 cases,9 cases of endoscopic diagnosis,the rate of 77.8%.Two groups of different diagnostic methods were tested by x2,and the P values were above 0.05,indicating that there were no significant differences in the gastroduodenal diseases between the two different diagnostic methods.3?Of the 134 confirmed cases,there were 119 cases of stomach diseases,pathological examination,71 cases of duodenal diseases,and pathological examination.4?The result of 119 pathological examinations was the gold standard.In 51 cases of gastritis diagnosed by contrast-enhanced ultrasonography,48 cases of gastritis,endoscopic gastritis in 49 cases,the same disease by ultrasonography and gastroscopy and pathological examination of the coincidence rate were 94.1/96.1,two kinds of inspection methods and pathological coincidence rate by x2 test,the results of x2=0.667,P= 0.414,0.05 that shows two kinds of inspection methods to pathologic examination as the gold standard,the diagnosis of gastritis with no statistically significant differences in rates.In the same way for pathological diagnosis of 41 cases of gastric ulcer,18 cases of gastric cancer,9 cases of gastric polyps,30 cases of duodenal ulcer,32 cases of duodenitis,9 cases of duodenal polyps were compared.The two methods of inspection and inspection with the rate of disease by x2 test,P values were greater than>0.05,two methods by biopsy as the gold standard,the diagnosis of gastric and duodenal diseases with no statistically significant differences in rates.Two kinds of examination methods for gastric and duodenal diseases and pathological examination of the total coincidence rate compared by x2 test,x2=3.505,P=0.173,0.05,two groups of diagnosis of gastric and duodenal diseases total coincidence rate no significant difference.[conclusion]:1?This study shows that:129/134 subjects with oral ultrasonic contrast agent,removal of the gastrointestinal tract mucosa and mucus gas interference on display,contrast agent in the stomach and duodenum stay within sufficient time,success was observed in gastric and duodenal wall level,structure,size,motility,adjacent organs and lymph node and so on.2?This study by ultrasonography and gastroscopy comparing gastric and duodenal diseases,the same disease with ultrasound.and endoscopy of gastritis,gastric ulcer,gastric,duodenal and gastric reflux,gastric polyps,duodenal ulcer,duodenitis,twelve refers to the comparison of 8 kinds of diseases(intestinal polyps P>0.05)was not statistically significant.3?The pathological examination results as the gold standard,respectively.Comparison of contrast-enhanced ultrasound and gastroscopy of gastritis,gastric ulcer,gastric cancer,gastric polyps,duodenal ulcer,duodenitis,coincidence rate of disease and pathological examination of duodenal polyps of the same disease with no significant difference with the rate of two kinds of different inspection methods and disease detection(P>0.05).Ultrasonography and gastroscopy results have high accuracy and accuracy.4?Gastroscopy can directly open gastroduodenal mucosa,take pathological lesion characters,both endoscopic therapy;ultrasonography can show the gastric wall thickness and gastric peristalsis,surrounding organs and lymph nodes,gastric cavity to compensate for the lack of gastroscope examination to a certain extent.5?The ultrasonic examination equipment for the general ultrasonic examination,feasible bedside examination,for patients with critical illness and mobility of patients,the feasibility of bedside examination in time to understand the progress of the disease and efficacy evaluation6?Ultrasound equipment widely,and the inspection method is rapid,economic,safe,noninvasive.For undeveloped gastroscopy hospital gastroscopy patients with contraindications,refused to accept patients with gastroscopy,feasible ultrasonography is helpful in diagnosis.7?The results of this study show that the findings of ultrasonography are affected by obesity,flatulence,constipation,etc.,and the lesions are not good enough to be solved. |
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