Utility of colour Doppler endoscopic ultrasound evaluation and guided therapy of submucosal tumours of the upper gastrointestinal tract.
OBJECTIVE
Endoscopic ultrasound is considered the method of choice for evaluation of submucosal tumours. Endoscopic therapy of selected lesions represents a useful mini-invasive approach. The aim of this study was to assess the endoscopic management of submucosal tumours of the upper gastrointestinal tract (GIST), with emphasis on the use of colour and power Doppler endoscopic ultrasound.


METHODS
The study included 35 consecutive patients referred to endoscopic ultrasound with submucosal tumours of the upper gastrointestinal tract. Colour and power Doppler imaging were performed with radial or linear instruments in all patients and allowed a better characterisation of the submucosal lesions. Histology was obtained in 22 patients and permitted a correct diagnosis, as well as confirmation or exclusion of malignancy.


RESULTS
In 18 patients (51.4%) there was discrepancy between the suspected endoscopic diagnosis and the diagnosis made by endoscopic ultrasound. Most of the malignant GISTs had significant intratumoural vessels detected by colour or power Doppler EUS (5 out of 6 patients, 83.3%), as compared with the benign GISTs (2 out of 7 patients, 28.6%). Colour Doppler EUS was essential, both to diagnose and to direct therapy in vascular submucosal lesions (two haemangiomas). The same technique was useful to better characterise lipomas or cysts.


CONCLUSIONS
Endoscopic ultrasound management of submucosal tumours was enhanced by the use of colour and power Doppler imaging. A precise management plan, supported by colour and power Doppler findings improved the diagnostic options and increased the feasibility and safety of endoscopic ultrasound guided therapeutic interventions.
Săftoiu
A
A
Department of Gastroenterology, University of Medicine and Pharmacy Craiova, Romania. adry@umfcv.ro
Vilmann
P
P
Hassan
H
H
Krag Jacobsen
G
G
D004379:Duodenal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D006391:Hemangioma / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007413:Intestinal Mucosa / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color