| Theme |
Barrett's Esophagus |
| Title |
Endoscopic Ultrasonography in Diagnosis of Barrett's Esophagus and Barrett's Esophageal Cancer |
| Author |
Miwako Arima |
Department of Gastroenterology, Saitama Cancer Center |
| Author |
Masahiro Tada |
Department of Gastroenterology, Saitama Cancer Center |
| [ Summary ] |
We undertook this study to determine whether EUS is useful in the diagnosis of Barrett's esophagus and the depth of invasion of Barrett's esophageal cancer. Observation of Barrett's esophagus with a miniature ultrasound probe revealed a poorly demarcated wall structure due to fibrosis with diffuse, relatively hyper echoic wall thickening. Barrett's adenocarcinoma typically displays a hypo echoic heterogeneous pattern. The underlying submucosa is usually heterogeneous due to fibrosis and the intermingling of esophageal glands and vessels, resulting in a poorly demarcated border. The depth of invasion is therefore difficult to evaluate. Linear type EUS can produce transverse images of the gastrointestinal wall acquired in long axis views and thereby identify the location of the esophagogastric junction on the basis of changes in wall structure and assess its position with respect to the esophageal hiatus on acquired images. EUS is of limited value for the assessment of mucosal cancers remaining within the glandular epithelium, but could accurately be used to estimate the depth of invasion of sm or deeper cancers. |