探讨口服造影剂胃超声检查在胃息肉诊断中的应用价值。

回顾性选取2016年1月至2019年12月于湖州市南浔区人民医院就诊、经口服造影剂胃超声检查诊断的胃息肉患者67例。所有患者均经胃镜和病理诊断确诊为胃息肉。对患者的超声表现、分型及诊断符合率等进行分析。

本组67例患者超声检查共发现胃息肉69个，息肉最大径5~34 mm，平均（15.6±4.8）mm。经病理诊断腺瘤性息肉34个、增生性息肉23个、炎性息肉9个、脂肪瘤1个、腺瘤恶变2个，超声诊断与胃镜和病理诊断符合率为95.65%（66/69）。胃息肉超声表现为起自黏膜层凸向胃腔的丘状、球状、乳头状、杆状及不规则形结构，边界多清晰；形态上无蒂28个（Ⅰ型12个、Ⅱ型16个），有蒂41个（Ⅲ型18个、Ⅳ型23个）；肿块内回声表现为低回声58个、高回声10个、混合回声1个；彩色多普勒显示14个有内部血流信号。本组胃息肉分为肿瘤性（包括腺瘤性、脂肪瘤和恶变者）37个和非肿瘤性（包括增生性和炎性）32个，2组在息肉大小、回声分布均匀性、内部有无血流信号、基底有无蒂方面，差异均有统计学意义（P=0.009、0.036、0.036、0.000）。

胃息肉具有特征性的超声声像图表现，超声诊断符合率较高，体积较大、内部有血流信号、回声欠均匀的有蒂息肉需警惕存在恶变可能。口服造影剂胃超声检查方法便捷、患者依从性好，具有一定的临床应用价值。

To assess the value of oral contrast-enhanced gastric ultrasonography in the diagnosis of gastric polyps.

A retrospective study was performed on 67 patients with gastric polyps diagnosed by oral contrast-enhanced ultrasound at the People's Hospital of Nanxun District, Huzhou City from January 2016 to December 2019. All patients were diagnosed with gastric polyps by gastroscopy and pathology. Ultrasound manifestations, classification, and diagnostic coincidence rate were analyzed.

A total of 69 gastric polyps were found on ultrasound examination of 67 patients in this group. The maximum diameter of polyps was 5 to 34 mm, with an average value of (15.6±4.8) mm. According to pathological diagnosis, there were 34 adenomatous polyps, 23 hyperplastic polyps, 9 inflammatory polyps, 1 lipoma, and 2 adenomas. The coincidence rate of ultrasound diagnosis with gastroscopic and pathological diagnosis was 95.65% (66/69). Ultrasound manifestations of gastric polyps included round-shaped, spherical, papillary, rod-shaped, or irregular structures protruding from the mucosal layer to the gastric cavity, with clear boundaries. Twenty-eight polyps had pedicles (12 type Ⅰ and 16 type Ⅱ) and 41 had no pedicles (18 type Ⅲ and 23 type Ⅳ). There were 58 hypoechoic masses and 10 hyperechoic masses, and 1 had mixed echo. Color Doppler showed that 14 polyps had internal blood flow signal. We then divided these gastric polyps into two groups: 37 tumors (including adenomatous polyps, lipomas, and malignant transformations) and 32 non-neoplastic (including proliferative and inflammatory) polyps. The two groups differed significantly with regard to polyp size, uniformity of echo distribution, presence of blood flow, and presence of pedicles (P=0.009, 0.036, 0.036, 0.000).

Gastric polyps have characteristic sonographic manifestations. The ultrasound diagnosis has a high coincidence rate with gastroscopic and pathological diagnosis. Clinicians should be vigilant for the possibility of malignant transformation of pedicled polyps with a large volume, internal blood flow signals, and uneven echo. Oral contrast-enhanced ultrasound is convenient and has good patient compliance.