Value Of Endoscopic Ultrasonography In Diagnosis Of Subepithelial Lesions Of Upper Gastrointestinal Tract

Objective: To explore the diagnestic value of endoscopic ultrasonography(EUS)in diagnosis of subepithelial lesions of upper gastrointestinal tract.Methods: This was a retrospective study on patients discovered as upper gastrointestinal subepithelial masses by EUS,who were admitted to The First Affiliated Hospital Of XinJiang Medical University between March 2011 and May 2017.All the patients received endoscopic treatment or surgical treatment and had the final pathological results.In the manner of comparing the EUS diagnosis with the pathological diagnosis,to evaluate the diagnostic value of EUS for submucosal lesions of upper gastrointestinal tract,as well as improve the diagnostic consistent rate of EUS.Results:Among 178 patients,the total diagnostic consistent rate for submucosal lesions of upper gastrointestinal tract is 71.9%.Most of patients detected by normal endoscopy are not given the definite diagnosis,so the accuracy of EUS was significantly higher than that of electronic endoscope.As to the origin level of submucosal lesion diagnosed by EUS,the total consistent rate is 91.0%。To compare the length-width diameter of lesions which endoscopic ultrasonography was consistent with pathology and that of inconsistent the difference was statistically significant(P<0.01).Conclusion: EUS is quite a valuable means for the diagnosis of upper gastrointestinal submucosal lesions,especially for the origin level,EUS has a higher diagnostic value.It also plays a key role in the treatment options,as well as has that advantage of simple operation,high safety and the like,has a highly clinical application value,but there are still some limitations to diagnose some smaller lesions,it is required to have a long-term follow-up,regular review of endoscopic ultrasonography to examine the evolution of lesions.For hypochoic lesions originating from the mucosa in third or fourth layers are diagnosed by EUS,the misdiagnosis rate is high.For such lesions,it is necessary to carry through multi-point,multi-directional exploration,in order to find thecharacteristic audio-visual characteristics.So these patients who accepted endoscopic operation,and send the lesions which were resected to pathological examination,so as to achieve the effect of diagnosis and treatment at the same time.