Saitoh Y, Obara T, Einami K, Nomura M, Taruishi M, Ayabe T, Ashida T, Shibata Y, Kohgo Y
Third Department of Internal Medicine, Asahikawa Medical College, Japan.
Gastrointest Endosc. 1996 Jul;44(1):34-9. doi: 10.1016/s0016-5107(96)70226-2.
Flat and depressed nonpolypoid types of colorectal tumors have drawn much attention. Since endoscopic mucosal resection technique is available, it is of great importance to distinguish intramucosal carcinoma from invasive carcinoma because determination of the invasion depth is essential for choosing this therapy. The usefulness of high-frequency (20 MHz) ultrasound probes for preoperative staging of invasion depth in this type of colorectal tumor was evaluated.
Forty-nine cases of flat and depressed tumors were examined with the ultrasound probe and diagnostic accuracy was confirmed by comparing ultrasonic images with the pathologic findings of the specimens resected either by endoscopic mucosal resection or surgical operation.
The normal colonic wall was visualized as a nine-layered structure and the muscularis mucosae was depicted in 37 (76%) of 49 cases. Flat and depressed tumors were visualized as hypoechoic lesions and the invasion depth was accurately diagnosed in 43 (88%) of 49 lesions.
High-frequency ultrasound probes proved to be useful in determining the invasion depth and therapeutic strategy in flat and depressed colorectal tumors.
结直肠扁平及凹陷型无息肉肿瘤已备受关注。由于内镜黏膜切除术技术已可应用，区分黏膜内癌与浸润癌非常重要，因为确定浸润深度对于选择该治疗方法至关重要。评估了高频（20兆赫）超声探头对这类结直肠肿瘤术前浸润深度分期的有效性。
用超声探头检查49例扁平及凹陷型肿瘤，并通过将超声图像与经内镜黏膜切除术或手术切除标本的病理结果相比较来确认诊断准确性。
正常结肠壁显示为九层结构，49例中有37例（76%）显示出黏膜肌层。扁平及凹陷型肿瘤显示为低回声病变，49个病变中有43个（88%）浸润深度被准确诊断。
高频超声探头被证明在确定扁平及凹陷型结直肠肿瘤的浸润深度和治疗策略方面是有用的。
