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Color Doppler‐enhanced Endoscopic Ultrasonographic Diagnosis of Upper Gastrointestinal Submucosal Lesions
Author(s) -
IWASE Hiroaki,
KUSUGAMP Kazuo,
SUGA Shoji,
KYOKANE Kazuhiro,
YAMAGUCHP Takeo
Publication year - 1997
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1997.tb00470.x
Subject(s) - medicine , radiology , pulsatile flow , leiomyosarcoma , biopsy , leiomyoma , gastrointestinal tract , angiography , color doppler , pathology , ultrasonography
We investigated the usefulness of color Doppler‐enhanced endoscopic ultrasonography for the assessment of upper gastrointentinal tract submucosal lesions. The subjects were 61 patients with endoscopically detected lesions : five extraluminal, four solitary varices, 26 leiomyomas, seven leiomyosarcomas, five aberrant pancreata, five cysts, three granular cell tumors, three lipomas, two schwannomas and one fibroma. Lesions were confirmed by surgery, biopsy or angiography, as appropriate. The ultrasonographic appearance of the lesions and their locations within the five‐layered structure of the wall are described. For leiomyomatous tumors less than 5 cm including leiomysarcoma, the presence of turbulent, pulsatile flow, as demonstrated on fast Fourier transform analysis, was associated with a sensitivity of 100% (7/7) and a specificity of 77.8% (7/9). We speculate that the flow pattern is related to abnormal vessels in the malignant tumors. Evaluation of the ultrasonographic characteristics of leiomyomatous tumors utilizing the pulsatile wave pattern may allow the diagnosis of leiomyosarcoma. Color Doppler‐enhanced endoscopic ultrasonography is potentially useful in the preoperative diagnosis of submucosal lesions involving the upper gastrointestinal tract.