Abstract:
Objective To assess the value of oral contrast-enhanced gastric ultrasonography in the diagnosis of gastric polyps.
Methods 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.
Results 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).
Conclusion 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.
Key words:
Oral,
Contrast medium,
Ultrasonography,
Stomach,
Polyps
Jiawen Dong, Jianqiang Mao, Weili Jin, Xufeng Xing. Value of oral contrast-enhanced ultrasonography in diagnosis of gastric polyps[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(10): 965-969.