胃窗超声造影对胃壁占位性病变的诊断价值研究

Objective To investigate the diagnostic value of gastric window contrast-enhanced ultrasonography in gastric wall occupying lesions. Methods A retrospective analysis was conducted on 51 patients with gastric wall occupying lesions who underwent trans-abdominal sonography, gastric window contrast-enhanced ultrasonography, and endoscopic biopsy sequentially. Using pathological diagnosis as the gold standard, the lesion detection rate and positioning accuracy of trans-abdominal sonography and gastric window contrast-enhanced ultrasonography were compared. Additionally, the diagnostic sensitivity, specificity, accuracy, and area under the receiver operating characteristic(ROC) curve(AUC) of trans-abdominal sonography and gastric window contrast-enhanced ultrasonography for benign and malignant lesions were compared. Results Pathological examination of gastric wall occupying lesions identified 21 malignant and 30 benign cases. The lesion detection rate and positioning accuracy of trans-abdominal sonography were 84.31% and 79.07%, respectively, with low consistency with pathological diagnosis(Kappa=0.276) and a diagnostic accuracy of 66.67%. The lesion detection rate and positioning accuracy of gastric window contrast-enhanced ultrasonography were 98.04% and 96.00%, respectively, both superior to those of trans-abdominal sonography(P<0.05), with good consistency with pathological diagnosis(Kappa=0.671) and a diagnostic accuracy of 84.31%. In the differential diagnosis of benign and malignant lesions, the AUC of trans-abdominal sonography was 0.610(P=0.228, 95% CI: 0.432-0.787), with a sensitivity of 42.86% and specificity of 83.33%. The AUC of gastric window contrast-enhanced ultrasonography was 0.883(P<0.001, 95% CI: 0.769～0.998), with a sensitivity of 76.19% and specificity of 90.00%, which was superior to that of trans-abdominal sonography. Conclusion Gastric window contrast-enhanced ultrasonography can improve the lesion detection rate and positioning accuracy of gastric wall occupying lesions, and has high diagnostic efficacy in differentiating benign and malignant lesions. It can serve as an important non-invasive supplementary tool to endoscopy.