Miniature ultrasonic probes for diagnosis and treatment of digestive tract diseases

Abstract

AIM:To investigate the clinical value of miniature ultrasonic probes (MUPs) for the diagnosis and treatment of digestive tract diseases. METHODS:Endoscopic ultrasonography (EUS) was performed for patients with its indications with 7.5-20 MHz MUPs and double-cavity electronic endoscope. According to the diagnosis of MUPs, patients who had indications of treatment received endoscopic resection or surgical excision. Postoperative histological results were compared with the preoperative diagnosis of MUPs. A few patients without endoscopic resection or surgical excision were periodically followed up with MUPs. RESULTS:A total of 537 patients were examined by MUPs, of them, 256 were diagnosed with gastrointestinal submucosal lesions, 146 with pseudo-submucosal lesions, 50 with digestive tract cancers, 17 with peptic ulcer, 11 with cholecystolithiasis, 8 with chronic pancreatitis, and 2 with achalasia and 47 were diagnosed as normal. After MUPs examinations, 220 patients received endoscopic resection or surgical excision, and the postoperative histological results of 211 patients were completely consistent with the preoperative diagnosis of MUPs. The diagnostic accuracy of MUPs was 95.9%. The result of follow-up with MUPs indicated that gastrointestinal leiomyoma, lipoma, phlebangioma and cyst were unchanged within 1-2 years. The patients who received endoscopic resection or centesis did not have any complications. CONCLUSION:MUPs are of value in diagnosing gastrointestinal submucosal lesions, staging of digestive tract cancers and biliary-pancreatic diseases. They play a very important role in making therapeutic plans.

Endoscopic ultrasonography for the diagnosis and selecting treatment of esophageal leiomyoma

“…3,4 The high diagnostic accuracy of EUS observed in this study suggested that EUS is preferable for the diagnosis of esophageal leiomyoma. Spiral CT might find an esophageal wall thickening focally for a lesion > 10 mm, but it is not sensitive enough to show an esophageal lesion Յ 10 mm, nor is it able to indicate the nature, origin, or mucosal surface of a lesion.…”

“…3,4 Therefore, EUS could be a useful technique for the diagnosis of esophageal submucosal tumors, and decisions related to their treatment. 3,4 Therefore, EUS could be a useful technique for the diagnosis of esophageal submucosal tumors, and decisions related to their treatment.…”

Values of endoscopic ultrasonography for diagnosis and treatment of duodenal protruding lesions

“…The postoperative histopathological results showed that the size, origin and number of lesions of all patients were completely consistent with the diagnoses of EUS; the nature of lesions of 70 patients agreed with preoperative EUS diagnosis. Diagnosis accuracy of EUS was 93.33%, which disclosed that EUS was almost as valuable as pathology for duodenal protruding lesions, especially for inflammatory swelling, polyps, extrinsic compressions, cysts, Brunner's gland adenoma and lipoma (Xu et al, 2004;2006;Rösch et al, 2002). However, lesions with an untypical echoic image tend to be misdiagnosed, for instance, polyps, ectopic pancreas or stromal tumors became unspecific under EUS when they were small.…”

“…Three of these patients underwent surgery, and the postoperative diagnoses were confirmed to be the same as preoperative EUS diagnosis. It is suggested that EUS has the incomparable superiority in diagnosing polyps, inflammatory protrusions and extrinsic compressions in the duodenum (Xu et al, 2004) that may be difficult for conventional endoscope to examine. Duodenal minor papilla could be easily misdiagnosed as polyps or others; nevertheless, EUS can give right diagnosis due to its echo characteristics (Fig.1h).…”

“…The application of EUS has greatly improved the diagnosis of gastrointestinal diseases (Pfau and Chak, 2002;Menzel and Domschke, 2000;Xu et al, 2004;Rösch, 2003). It is difficult to diagnose and treat duodenal diseases because of Duodenum's complex and specific surroundings.…”