The Capabilities of Advanced Echography Techniques in Diagnosis of Gastric Submucous Masses
The aim of the investigation was a comparative study of the possibilities of modern ultrasound diagnostic techniques (sonoelastography and amplitude sonohistography) to reveal gastric submucous masses.
Materials and Methods. 61 patients with gastric submucous masses were examined. All patients underwent esophagogastroduodenoscopy and ultrasound on apparatuses Aplio MX (Toshiba, Japan), Hitachi HI VISION Preirus (Japan), Voluson 730 Expert (GE, USA) with 3.5–12 MHz sensors, using sonoelastography and amplitude sonohistography. 12 patients underwent endoscopic ultrasound investigation. The diagnoses were morphologically verified (bioptates, operative material). Sonoelastography was used to determine a mass strain ratio — SR (Strain Ratio). Amplitude sonohistography to determine histographic index (I) was used as an additional method to determine density and elasticity of tumors.
Results. Qualitative parameters of sonographic signs of gastric submucous masses do not always enable to determine the presence of malignant transformation. The most challenging in differential diagnosis are gastric submucous infiltrates either of ulcerative or cancer origin, lymphomas, and aberrant (ectopic) pancreas. Resistance index (RI) of arterial vessels of the tumors, histographic index, and strain ratio appeared to be the most informative ones among quantitative parameters of sonographic signs of gastric submucous masses. There is a clear tendency for histographic index decrease and SR increase in gastric malignant submucous tumors.
Conclusion. Complex ultrasound diagnosis using advanced techniques and technologies (sonoelastography and amplitude sonohistology) is a sensitive and precise method to reveal gastric submucous tumors. Joint use of ultrasound and endoscopy promotes more qualitative use of differential diagnosis and making adequate management.
- Starkov Yu.G., Solodinina E.N., Shishin K.V., et al. Endoskopicheskaya diagnostika i lechebnaya taktika pri podslizistykh novoobrazovaniyakh verkhnikh otdelov zheludochno-kishechnogo trakta [Endoscopic diagnosis and management in upper gastrointestinal submucous masses]. Khirurgiya. Zhurnal im. N.I. Pirogova — Surgery. Journal named after N.I. Pirogov 2011; 2: 15–20.
- Bulganina N.A. Diagnosticheskaya konveksnaya endosonografiya pri zabolevaniyakh verkhnikh otdelov zheludochno-kishechnogo trakta. Avtoref. dis. … kand. med. nauk [Diagnostic convex endosonography in upper gastroenterological diseases. Abstract for Dissertation for the degree of Candidate of Medical Science]. Moscow; 2010.
- Perfil’ev I.B. Sovremennye metody endoskopicheskoy diagnostiki i lecheniya neyroendokrinnykh opukholey zheludka. Avtoref. dis. … kand. med. nauk [Modern methods of endoscopic diagnosis and treatment of gastric neuroendocrine tumors. Abstract for Dissertation for the degree of Candidate of Medical Science]. Moscow; 2012.
- Zubarev A.R., Fedorova V.N., Demidova A.K., et al. Ul’trazvukovaya elastografiya kak novaya stupen’ v differentsial’noy diagnostike uzlovykh obrazovaniy shchitovidnoy zhelezy: obzor literatury i predvaritel’nye klinicheskie dannye [Ultrasound elastography as a new step in differential diagnostics of nodal thyroid masses: review and preliminary clinical findings]. Meditsinskaya vizualizatsiya — Medical Imaging 2010; 1: 1–6.
- Giovannini M. Endoscopic ultrasound elastography. Pancreatology 2011; 11(Suppl. 2): 34–39, http://dx.doi.org/10.1159/000323496.
- Ryoji Miyahara, Yasumasa Niwa, Masanao Nakamura, et al. Endoscopic ultrasound elastography for the upper gastrointestinal tract disease. In: Digestive Disease Week, May 17th–22nd, 2008. San Diego, USA; 2008.
- Dietrich C.F. Real-time tissue elastography. Multiple clinical applications. Multiple clinical solutions. Endoskopie Heute 2011; 24: 177–212.
- Zubarev A.V., Gazhonova V.E., Khokhlova E.N., et al. Elastografiya — novyy metod poiska raka razlichnykh lokalizatsiy [Elastography — a new search technique of various tumor localizations]. Radiologiya – Praktika — Radiology – Practice 2008; 6: 6–18.
- Mikhaylov M.K., Tukhbatullin M.G. Kompleksnaya luchevaya diagnostika opukholey zheludka [Complex radiodiagnosis of gastric carcinomas]. Kazan: FEN; 2001.
