Endosonographic diagnosis of submucosal upper gastrointestinal tract lesions and large fold gastropathies by catheter ultrasound probe

Background: The unique ability of EUS to depict wall layers makes it possible to accurately evaluate submucosal lesions of the digestive tract and large-fold gastropathies. Although EUS requires a second endoscopic examination, miniature US probes introduced through the accessory channel of a conventional endoscope permit US examination during routine endoscopy. Methods: By means of catheter probe sonography and conventional EUS, we evaluated 33 patients with a radiographic or endoscopic finding of a submucosal lesion of the upper GI tract or with large-fold gastropathies and histologically negative biopsies obtained at a previous endoscopy. A miniature multifrequency probe was used for catheter probe sonography. Results: For 25 submucosal lesions catheter probe sonography results were superimposable on those obtained with EUS. In evaluating submucosal lesions, catheter probe sonography yielded the same results as conventional EUS in terms of depiction, measurement, and identification of the originating layer of the tumor. In the study of 8 large-fold gastropathies, catheter probe sonography missed the presence of ascites and enlarged lymph nodes in a case of gastric linitis, but produced the same results as conventional EUS in the other cases. Conclusions: For the evaluation of benign submucosal lesions and large-fold gastropathies, catheter probe sonography appears to be sufficient and could thus replace conventional EUS for these indications.