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英文誌(2004-)

Journal of Medical Ultrasonics

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1999 - Vol.26

Vol.26 No.12

Original Article(原著)

(1177 - 1183)

出血性消化性潰瘍に対する内視鏡術前超音波検査の有用性について

Pre-endoscopic Screening with Ultrasonography for Hemorrhagic Peptic Ulcer: Imaging Faculty by Location of Lesion

片岡 伸一1, 井出 満2, 黒原 進司2, 栄 則久2, 大地 宏昭1, 豊永 高史1, 土細工 工利夫1, 藤吉 朗1, 杉山 健1, 杉山 理恵子1, 許 泰志1, 湯浅 肇3, 廣岡 大司1

Shinichi KATAOKA1, Mituru IDE2, Shinji KUROHARA2, Norihisa SAKAE2, Hiroaki OOCHI1, Takashi TOYONAGA1, Toshio DOZAIKU1, Akira FUJIYOSHI1, Takeshi SUGIYAMA1, Rieko SUGIYAMA1, Yasushi KYO1, Hajime YUASA3, Takashi HIROOKA1

1岸和田徳洲会病院内科, 2岸和田徳洲会病院腹部超音波室, 3天竜厚生会さいわい医療保健部

1Department of Internal Medicine Kishiwada Tokusyukai Hospital, 4-22-38 Isonokami-cho, Kishiwada-shi, Osaka 596-0001, Japan, 2Department of Abdominal Ultrasonography Kishiwada Tokusyukai Hospital, 4-22-38 Isonokami-cho, Kishiwada-shi, Osaka 596-0001, Japan, 3Department of Health Insurance Tenryu Koseikai Saiwai Hospital, 217-3 Watagashima, Tenryu-shi, Shizuoka-ken 431-23, Japan

キーワード : Duodenal ulcer, Endoscopy, Gastric ulcer, Gastrointestinal bleeding, Ultrasonography

Objective: To assess the usefulness of pre-endoscopic ultrasonography to detect peptic ulcers in patients with upper gastrointestinal bleeding.
Subjects and Methods: Extracorporeal ultrasonography was performed on 465 patients with upper gastrointestinal bleeding prior to endoscopic examination. The diagnosis of peptic ulcer was made when criteria 1 and 2 or 1 and 3 were present, where 1 indicates localized mural wall thickening; 2, exhibition of ulcer contour; and 3, high ulcer echo.
Results: The sensitivity of ultrasonography for gastric ulcers was 43.3%; its specificity was 96.4%. Sensitivity was highest at the gastric angle lesser curvature (76%). It was high (67%) in the angle, whereas it decreased in higher ulcer locations (33% at the upper corpus). Sensitivity was low (33%) in the antrum but was high in the lesser curvature (68%) and low in the greater curvature (19%). The sensitivity of ultrasonography for duodenal ulcer was 53.6%; specificity was 97.3%. Sensitivity in the bulbus was high at the anterior wall (67%) and low at the posterior wall (10%).
Conclusion: The specificity of ultrasonography for hemorrhagic peptic ulcer was high; sensitivity, however, varied with the location of the lesion.