Diagnosis of Gastric Lesions Comparison of Radiology with Gastrocamera

胃部疾病的診斷放射線和胃鏡檢查的比較

李三剛(S. K. Lee) ； 張嘉桂(J. K. Chang)

《中華放射線醫學雜誌》 3卷4期 (1978/12) Pp. 287-291

摘要

我們統計了360例的鋇劑上腸胃道攝影和胃鏡照像檢查的結果，發現其中250例X光的診斷和胃鏡是完全相同的（占69.44%），另外32例屬假陽性，47例假陰性，而31例為二者有不同之診斷。
在所統計的胃部疾病153例中有128例(83.66%)是位在胃角部和前庭區，所以大部分的毛病都是發生在胃的後半部，而在不相符合的診斷110例中，有87例（占79.09%）是因為胃炎的診斷分岐而造成，所以胃炎的診斷對X光來講是比較困難的。
雖然X光的檢查有可能發生假陽性、假陰性和其他不符合處，但這大部分都是因為胃炎的診斷所造成的；對於其他病灶的診斷X光仍是非常準確的，所以我們以為：
1．如果X光檢查是正常的，則胃鏡的檢查就可以不必考慮。
2．因為內視鏡只能看見胃內部表面，不能看到整體結構，所以在接受胃鏡或胃纖維鏡檢查前，完整的上腸胃道X光攝影和判讀是必需而且不可缺少的。
同時，X光檢查對於胃炎（或胃前庭區病灶）的診斷僅以傳統的單對比檢查是很難得到正確的結果，我們認為今後一定要改進檢查的技巧，如做雙重對比檢查，同時在透視下，更要注意胃角部小彎側和前庭區的變化，方能增加X光的診斷率。

並列摘要

In 360 cases, gastrocamera examinations were performed after single contrast barium meal study. 250 cases revealed the same findings; 32 cases revealed false negative results and 31 cases revealed different findings. In the group (153 cases) resulted in positive results from both studies, there were angularis and antrum (including prepyloric and pyloric) lesions in 128 cases (83.66%). From the gastrocamera findings, there were 99 cases of gastric ulcers with 74 cases (74.75%) located at the angularis and antrum region. The incidence of lesions over the distal half of stomach was rather high. Even in the 17 cases of suspected cancer of the stomach on gastrocamera findings were 11 cases (64.70%) located at the angularis and antrum. In the remaining 6 cases, 2 showed extensive infiltrating cancer and 1 exhibited linitis plastica.
The greatest source of incompatibility of radiologic and gastrocamera findings were from gastritis. There were 23 cases of gastritis in the false positive group, 36 cases in the false negative group and 28 cases were seen with difficulty in differentiation from either gastritis or tiny ulcers in the stomach. The total number of x-ray misdiagnosis of gastritis were 87 cases in the 110 cases of inconsistent group (79.09%).