【作者】 刘军；

【导师】 王正滨；

【作者基本信息】 青岛大学 ， 影像医学与核医学， 2008， 硕士

【摘要】 目的:通过与二维超声对胃隆起性病变的诊断及其对胃癌术前分期的结果对比分析,探索三维及四维超声对胃隆起性病变的诊断及其对胃癌术前分期的临床应用研究。材料与方法:2005年3月至2007年2月期问87例胃隆起性疾病患者,年龄26～77岁,平均50岁。所用仪器:GE VOLUSON730型三维彩色多普勒超声显像仪,LOGIQ9三维彩色多普勒超声成像仪,探头频率3.5MH_z～5.5MH_z,10MH_z。先对患者行空腹二维检查,大体观察病变,然后瞩患者饮用脱气水500～600ml,再行二维超声检查、三维及四维超声检查,观察病变的位置,大小形态及与周围组织的关系,拟诊胃隆起病变的性质,对拟诊胃癌患者进行术前分期。最后将三维及四维超声检查结果与二维检查结果分别与病理结果对照,计算诊断符合率,然后就两者进行统计学分析。结果:1.本组87例胃隆起性疾病患者,57例胃癌,9例息肉,1例平滑肌瘤,9例疣状胃炎,11例良性胃溃疡。三维超声显像对本组病例疾病类型诊断与病理诊断符合率:82.3%,二维超声显像为67.8%,经统计学分析,二者存在显著性差异(P＜0.05),即三维及四维超声显像对胃隆起性病变性质的诊断符合率要明显高出二维超声显像。2.本组患者57例胃癌,三维及四维超声检出51例,检出率89%,二维超声检出42例,检出率73.7%,经统计学分析,两者存在显著性差异(P＜0.05),既三维及四维超声对胃癌的检出率明显高出二维超声。三维及四维超声对胃癌术前分期准确率为82.4%,二维超声对胃癌术前分期准确率为71.4%,经统计学分析,两者无显著性差异(P＞0.05),既三维及四维超声对胃癌术前分期准确率与二维超声比较没有显著差别。结论:胃腔适当充盈适合进行超声检查,利用三维超声重建病变形成立体结构,可显示有关结构的立体形态、内部结构,能对胃隆起性疾病较二维超声作出正确的诊断与鉴别诊断,结合二维超声能对胃癌较准确地进行术前分期。更多还原

【Abstract】 OBJECTIVE: An analysis was made about the diagnosis of gastric eminence lesions and the results of the preoperative TNM staging of gastric cancer by two-dimensional ultrasonography in contrast with three or four-dimensional ultrasonography to explore The study of Clinical Application on gastric eminence lesions & the preoperative TNM staging of gastric cancer by means of three-dimensional &four-dimensional ultrasonography.MATERIAL&METHODS: During March 2005 to February 2007, there were 87 cases of patients aged 26-77 with the average age 50 ,who suffered from gastric eminence lesions. The apparatuses used were GE Voluson730 three-dimensional color Doppler ultrasonography, 3.5HZ and LOGIQ 9 three-dimensional color Doppler ultrasonography, 3.5MH_z～5.5MH_z, 10MH_z . Firstly examined the patients on empty stomachs by two-dimensional ultrasonography, roughly observing their pathological changes, then told them to drink 500-600ml water without air to examine again by two, three, or four dimensional ultrasonography; when examining, observed the relationship among their pathological positions, shapes and surrounding tissues, preliminarily diagnosed the quality of gastric eminence lesions and performed the preoperative staging. Finally made a respective contrast between pathological results and check-up results by two, three, four dimensional ultrasonography, then figured out diagnostic accordance rates and made a statistic analysis of them.RESULT: 1.There were 87 cases of patients with gastric eminence lesions, of which 57 cases were stomach cancer, 9 cases polypus, 1 case leiomyoma,9 cases gastritis verrucosa, 11 cases benign gastric ulcer. Compared with the diagnosis by three-dimensional ultrasonography, the pathological diagnostic accuracy rate was 82.3%, the diagnostic accuracy rate being 67.8% by two-dimensional ultrasonography. According to statistic analysis, there existed significance difference (p<0.05), which meant the diagnostic accuracy rateby three,four-dimensional ultrasonography was obviously superior to that by two-dimensional ultrasonography. 2. There were 57cases of patients with stomach cancer, of which 51 cases were examined by three, four-dimensional ultrasonography, with check-up rate being 89%, and 42 cases were examined by two-dimensional ultrasonography, with check-up rate being 73.7%. Based on statistic analysis, there existed significance difference(p<0.05), which meant the check-up rate by three,four-dimensional ultrasonography was obviously superior to that by two-dimensional ultrasonography. By three, four-dimensional ultrasonography, the accuracy rate of the preoperative staging of stomach cancer was 82.4%, while by two-dimensional ultrasonography, the accuracy rate was 71.4%. According to statistic analysis, there was no significance difference (p>0.05), which meant by three, four-dimensional ultrasonography, the accuracy rate of the preoperative staging of stomach cancer had no obvious difference from that by two-dimensional ultrasonography.CONCLUSION: The examination was performed by ultrasonography after gastric cavity was appropriately full, and three-dimensional ultrasonography was used to rebuild pathological changes to shape three-dimensional structure, which was able to show related structures’ three-dimensional shapes, interior structure, to make a more accurate analysis of Gastric Eminence Lesions than two-dimensional ultrasonography and to perform more correctly the preoperative staging of stomach cancer combined with two-dimensional ultrasonography.更多还原