Characterization of intra-abdominal lesions of undetermined origin by contrast-enhanced harmonic EUS (with videos)

Gastrointestinal Endoscopy
Yu XiaTakamitsu Komaki

Abstract

The diagnosis of intra-abdominal lesions of undetermined origin is often a challenge for endoscopists and radiologists. To evaluate the microvasculature of benign and malignant intra-abdominal lesions by contrast-enhanced harmonic EUS (CEH-EUS) and to investigate its usefulness for discriminating between malignant and benign lesions. The vascularity of intra-abdominal lesions of undetermined origin was observed by using CEH-EUS. The lesions were classified according to their vascular patterns. The effectiveness of CEH-EUS in differentiating malignant from benign lesions was evaluated. Kinki University School of Medicine, Osaka, Japan. Forty-three patients, each with a lesion of undetermined origin, were evaluated prospectively by CEH-EUS between March 2007 and March 2009. CEH-EUS was performed by using a prototype echoendoscope and the extended pure harmonic detection mode (a specific mode for contrast harmonic imaging). The lesions were categorized by 2 physicians as having no, homogeneous, or heterogeneous enhancement. A consensus was reached for each case offline. How the benign and malignant groups differed in terms of their enhancement patterns was examined. The kappa coefficient of the interobserver agreement test was 0.9...Continue Reading

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