The Evaluation Of Endoscopic Ultrasonography In Gastroenterological Leisions

ObjectiveTo evaluate the effect of endoscopic ultrasonography in diagnosis of gastroenterological leisions and pancreaticobiliary junction lesions.MethodsRetrospective analyzed the results of2093gastroenterological leisions performed endoscopic ultrasonography from2005January to2009November in a single center.Results1. A total1353leisions were included,327leisions were diagnosed pathologically.2. There were387leisions located at the esophagus, of which149cases,152leisions were diagnoses with pathologically. These diagnosed leisions were mainly leiomyoma from the mucosal of the esophageal wall.Nine esophageal tuberculosis patients were found that mimic a submucosal tumor under upper endoscopy. Endoscopic ultrasonography showed five patients were with heterogeneous hyperechoic or isoechoic masses and the local wall layers were intact. Two patients were with hypoechoic masses with hyperechoic bands in the parenchyma and the local wall layers were interrupted. Two ulcerative lesions showed hyperechoic interrupted wall layers. A similar echogenic mediastinal lymph node to the near lesion was observed in three patients.3. In the599gastric patients, EUS found244definitely diagonosised cases;34.43%(84/244) cases of extraluminal compression,47gastrointestinal stromal tumors,18cases of ectopic pancreas,8cases of leiomyoma. The EUS findings confirmed that leiomyomas were smaller than GISTs, and the echo of leiomyoma is similar to the surrounding muclar propria. GISTs had higher echo than the surrounding muclar propria. They were often heterogeneity. When the cut off point was3.9cm, GISTs were tended to be highly malignant.4. Compared with mesenchymal tumors, ectopic pancreases showed a significant difference in the lesion location, growth pattern, layer of origin, presence of layer disruption, margin, and internal echo (P<0.05). There was no statistical difference in the lesion size and presence of focal anechoic portion.5. The sensitivity and specialty of EUS are superior to that of ultrasound, CT and MRCP in pancreaticobiliary junction lesions.ConclusionEUS is essential in diagnosis and management for gastroenterological leisions. A biliopancreatic EUS has a significant impact on the patient diagnosis.