Japanese

Efficacy of EUS for the Diagnosis of Infiltration Depth in Colorectal Laterally-Spreading Tumors Seiji Shimizu 1 , Naohisa Yoshida 2 , Yasutaka Morimoto 1 , Ryuki Minami 1 , Tatsushi Naitou 1 , Ryohei Hirose 1 , Wataru Fukuda 1 , Kayoko Shimizu 1 , Yasuhida Mitsumoto 1 , Takahiro Mori 1 , Hajime Honjo 3 , Naoki Wakabayashi 2 , Nobuaki Yagi 2 , Yuji Naitou 2 , Toshikazu Yoshikawa 2 1Division of Gastroenterology, Osaka Railway Hospital, Osaka, Japan 2Department of Gastroenterology, Kyoto Prefectural University of Medicine, Kyoto, Japan 3Division of Gastroenterology, Ohtsu Red Cross Hospital, Ohtsu, Japan Keyword: 側方発育型大腸腫瘍 , LST(laterally spreading tumor) , EUS , 超音波内視鏡 , 深達度診断 pp.981-988
Published Date 2010/5/25
DOI https://doi.org/10.11477/mf.1403101956
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 We retrospectively evaluated the efficacy of EUS for diagnosis of the infiltration depth of colorectal laterally-spreading tumors. The subjects were 63 lesions including 39 lesions of granular type(homogenous 11, nodular mixed 28)and 24 lesions of non-granular type. A 20MHz miniature ultrasonic probe(MUSP)was used for observation in all lesions, and a 7.5MHz ultrasonic endoscope was used for 23 lesions at the same time. The depth of invasion was divided into SM-slight>and SM-massive≦, and the results of EUS and histological diagnoses were compared. The infiltration depth was correctly diagnosed by MUSP in 79.8%. The cause of diagnostic failure in diagnosis was poor visualization. In granular type lesions, those with submucosal or deeper invasion were not included, and EUS diagnoses were correct except for one cecal lesion. For granular type lesions, EUS is considered unnecessary. The major reason for poor visualization was echo attenuation which was most remarkable in nodular mixed type of granular lesions larger than 30mm in diameter and 10mm in thickness. Such lesions, however, could be sufficiently visualized with the 7.5MHz echoendoscope. Other causes of poor visualization included inability to obtain perpendicular cross-sectional images of the lesions or to fill the lumen with deaerated water. These tendencies were often observed in the transverse or sigmoid colon. Since the histology, infiltration depth, mode of invasion and site of lesion differ according to the macroscopic type of lesions, the needs and difficulty in using EUS should be considered and an appropriate instrument should be selected.


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