窄带成像技术对十二指肠非壶腹部表浅隆起型病变诊断价值的研究 *

Narrow band imaging in nonampullary duodenal superfcial elevated lesions*

摘要:

目的 探讨窄带成像技术（NBI）在十二指肠非壶腹部表浅隆起型病变诊断中的应用价值。 方法 搜集胃镜诊断十二指肠非壶腹部表浅隆起型病变为研究对象，根据病理诊断分组，NBI 模式下观察 病变分布、融合、直径、血管结构（VP）和表面结构（SP），比较不同组间各项观察指标是否存在差异。 结果 共搜集表浅型隆起病变 72 例，35 例（48.61%）为炎症，17 例（23.61%）为胃黏膜异位，12 例（16.67%） 为胃上皮化生，8 例（11.11%）为腺瘤。4 种病变中，腺瘤易单发、直径更大，炎症病变 SP 多与周边黏膜一致， VP 及融合对部分病变的鉴别具有一定提示作用。 结论 应用 NBI 可以对十二指肠非壶腹部表浅隆起型病变 进行初步鉴别，从而引导靶向性活检，提高诊断准确性及阳性率。

Abstract:

Objective To investigate the diagnostic value of narrow?band imaging in patients with nonampullary duodenal superficial elevated lesions. Methods Analysis were limited to respondents diagnosed with nonampullary duodenal superfcial elevated lesions on endoscopic examination. The lesion distribution, fusion, diameter, vascular and surface pattern were evaluated and compared with NBI mode according to pathological group. Results 72 cases were collected, 35 (48.61%) cases were in?ammation, 17 (23.61%) cases were heterotopic gastric mucosa, 12 (16.67%) cases were gastric duodenal metaplasia and 8 (11.11%) cases were adenoma. Among the four types of duodenal lesion, solitary adenomatous lesions were observed more frequently and larger in diameter. Surface pattern of in?ammatory lesions were consistent with the surrounding mucosa. Vascular pattern and fusion may be helpful to differential some superficial elevated lesions. Conclusion Nonampullary duodenal superficial elevated lesions can be identified preliminarily by NBI. Meanwhile, diagnosis accuracy and positive rate can be improved by target biopsy.