title: Esophageal insufflation computed tomography for the diagnosis and management of esophageal submucosal tumors.
abstract: The selection of therapy for benign esophageal lesions depends in part on whether the lesion extends to or through the esophageal muscle wall. The advent of endoscopic dissection of deep lesions has made this distinction important in the choice between different forms of advanced endoscopic therapy. The goal of this study was to evaluate esophageal insufflation computed tomography (EICT) for the diagnosis and management of esophageal submucosal tumors (SMTs).
  
  
  
  Between April 2011 and May 2013 at the Second Affiliated Hospital of Harbin Medical University, 27 patients with esophageal SMTs diagnosed by gastroscopy were studied observationally. Entry criteria included tumors larger than 0.5 cm. We compared endoscopic ultrasound (EUS) and EICT to assess lesion depth and the relationship between the submucosal lesion and the esophageal wall using the resected lesion as the gold standard.
  
  
  
  Twenty-seven esophageal SMTs were evaluated. EUS and EICT accurately identified nine as superficial to the muscularis propria. EICT correctly identified the relation of the tumor extension and the outer esophageal wall in all 18 lesions that originated from the muscularis propria; only nine were correctly assessed by EUS (P < 0.001).
  
  
  
  EICT enables improved judgment of the relation of esophageal lesions and the esophageal-mediastinal border. We propose EICT as a new, safe, effective, useful, simple and high-tolerance method for assessing the depth and relationships of esophageal submucosal lesions.
authors.affiliation: Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, Heilongjiang Province, China. bingrongliu@qq.com.
authors.forename: Bing-Rong
authors.initials: BR
authors.lastname: Liu
authors.affiliation: Department of Radiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
authors.forename: Bai-Lu
authors.initials: BL
authors.lastname: Liu
authors.affiliation: Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, Heilongjiang Province, China.
authors.forename: Xin-Hong
authors.initials: XH
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, Heilongjiang Province, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhan
authors.affiliation: Department of Radiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Liu
authors.affiliation: Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, Heilongjiang Province, China.
authors.forename: Ji-Tao
authors.initials: JT
authors.lastname: Song
authors.affiliation: Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, Heilongjiang Province, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Du
authors.affiliation: Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, Heilongjiang Province, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Cui
authors.affiliation: Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, Heilongjiang Province, China.
authors.forename: Su-Qin
authors.initials: SQ
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D004210:Dissection / Q000379:methods; D019160:Endosonography / Q000379:methods*; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D005260:Female; D005753:Gastric Mucosa / Q000000981:diagnostic imaging / Q000601:surgery; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D007327:Insufflation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed
keywords: Diagnosis; Esophageal insufflation computed tomography; Esophageal submucosal tumors; Gastroscopic ultrasonography