Original Article
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World J Gastroenterol. Dec 21, 2013; 19(47): 9034-9042
Published online Dec 21, 2013. doi: 10.3748/wjg.v19.i47.9034
Superficial esophageal lesions detected by endoscopic ultrasound enhanced with submucosal edema
Jian-Jun Li, Long-Jun He, Hong-Bo Shan, Thomas D Wang, Huan Xiong, Li-Ming Chen, Guo-Liang Xu, Xiao-Hai Li, Xin-Xin Huang, Guang-Yu Luo, Yin Li, Rong Zhang
Jian-Jun Li, Long-Jun He, Hong-Bo Shan, Li-Ming Chen, Guo-Liang Xu, Xiao-Hai Li, Xin-Xin Huang, Guang-Yu Luo, Yin Li, Rong Zhang, Department of Endoscopy, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong Province, China
Thomas D Wang, Division of Gastroenterology, University of Michigan, Ann Arbor, MI 48109, United States
Huan Xiong, Department of Medical Record Statistics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
Xiao-Hai Li, Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou 510405, Guangdong Province, China
Author contributions: Li JJ, He LJ and Shan HB contributed equally to this work. Li JJ designed this study and was responsible for this work; He LJ, Shan HB and Luo GY were clinical investigators; Xiong H, Chen LM, Li Y and Zhang R collected the data; Li XH and Huang XX performed thoracic anatomy; Xu GL and Wang TD served as scientific advisors; Li JJ, He LJ and Shan HB drafted and revised this manuscript; all authors obtained the data and proved the final vision.
Supported by The Science and Technology Plan Projects of Guangdong Province, China, No. 2011B080701015 and No. 2012B061700076
Correspondence to: Jian-Jun Li, MD, PhD, Associate Professor, Department of Endoscopy, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651, Dongfeng East RD, Guangzhou 510060, Guangdong Province, China. lijj@sysucc.org.cn
Telephone: +86-20-87343381 Fax: +86-20-8734224
Received: August 1, 2013
Revised: October 7, 2013
Accepted: November 3, 2013
Published online: December 21, 2013
Abstract

AIM: To determine if there is consistency between endoscopic ultrasound (EUS) findings and pathological results for detecting lesions of different depth in the esophageal mucosa.

METHODS: A canine (Beagle) model was established in which lesions of different depths were created in the esophageal mucosa by thermal burning. Seventy-two hours later, these lesions and adjacent tissue in the esophagus were examined by EUS. EUS findings including infiltrating depth, strength of echogenicity and homogeneity were recorded. Dogs were sacrificed and tissue specimens were obtained. We then compared the EUS findings with the pathology reports.

RESULTS: Thermal burns created at different power settings caused lesions of different depth in the esophageal mucosa. When the echo strength was shifted from high, medium, to low echogenicity, an increase in the infiltrating depth of the lesion was noted, which coincided with results of the pathology examination. Obvious submucosal edema visualized by EUS was also detected by pathology. Furthermore, because of the enhancement caused by the submucosal edema, the lesions invading into the submucosa were easily visualized by EUS.

CONCLUSION: There is consistency between EUS findings and pathological results of esophageal lesions with different depths. Submucosal edema can serve as an ultrasonic contrast agent.

Keywords: Endoscopic ultrasound, Pathology, Lesion, Esophagus, Canine

Core tip: Nowadays, endoscopic ultrasound (EUS) is an optimal modality to detect early esophageal cancer (EC); however, it is still unknown whether there is correlation between EUS findings and pathological results. In this animal study, superficial esophageal lesions with different infiltrating depth in dogs were created by thermal burning. There is consistency between EUS imaging and pathology. The accompanied submucosa edema can sever as an ultrasonic contrast agent.