在由内视镜的 ultrasonography 的上面的胃肠的道的 subepithelial 肿瘤的诊断

• 作者: Hiroki Sakamoto Masatoshi Kudo Masayuki Kitano
• 来源期刊: 世界放射学杂志：英文版（电子版）
• 学科: 医学
• 关键词: ENDOSCOPIC ULTRASONOGRAPHY SUBMUCOSAL TUMOR Subepithelial TUMOR
• 年，卷（期）: 2010,（8）
• 页码范围: 289-297
• 页数: 9页
• 分类号: R739.8

摘要

Endoscopic ultrasonography(EUS) is the most accurate procedure for detecting and diagnosing subepithelial tumors,due to its higher sensitivity and specificity than other imaging modalities.EUS can characterize lesions by providing information on echogenic origin,size,borders,homogeneity,and the presence of echogenic or anechoic foci.Linear echoendoscopes,and recently also electronic radial echoendoscopes,can be used with color Doppler or power Doppler to assess the vascular signals from subepithelial masses,and thus permit the differentiation of vascular structures from cysts,as well as the assessment of the tumor blood supply.However,the diagnostic accuracy of EUS imaging alone has been shown to be low in subepithelial lesions with 3rd and 4th layers.It is also difficult to differentiate exactly between benign and malignant tumors and to gain an accurate picture of histology using EUS.On the other hands,EUS guided fine needle aspiration(EUS-FNA) can provide samples for cytologic or histologic analysis.Hypoechoic lesions of the 3rd and the 4th EUS layers,more than in 1 cm diameter are recommended,and histologic confirmation using endoscopic submucosal resection or EUSFNA should be obtained when possible.Therefore,EUSFNA plays an important role in the clinical management of subepithelial tumors.Furthermore improvements in endoscopic technology are expected to be more useful modalities in differential diagnosis and discrimination between benign and malignant subepithelial tumors