Diagnosis of one small bowel tumor: the role of conventional ultrasound and elastography

Abstract

Neuroendocrine tumors are the most common primary tumors of the small bowel, but diagnosis is usually delayed as the lesions are small and symptoms are mild or nonspecific. Diagnosis of this disease is currently based on radiologic or endoscopic findings. Ultrasound (US) is used as a first-line examination in patients with abdominal symptoms, as this technique permits an overall view of the gastrointestinal tract providing diagnosis of inflammatory and/or neoplastic disorders in a large proportion of patients. The aim of this case report is to describe the feasibility and diagnostic accuracy of elastography in the diagnosis of a tumor of the ileum. The patient underwent conventional gray-scale US and elastography before surgery and these examinations were repeated postoperatively on the surgical specimen confirming preoperative outcome.Keywords Tumor Á Neuroendocrine tumors Á Small bowel Á Ultrasound Riassunto Il tumore neuroendocrino, tra le neoplasie primitive dell'intestino tenue, è il più frequente, la diagnosi è usualmente tardiva per le piccole dimensioni e per la sintomatologia lieve, poco specifica. La diagnosi di questa forma morbosa si basa attualmente su metodiche radiologiche o endoscopiche. L'ecografia è indagine di primo livello in soggetti con sintomatologia addominale ed in una percentuale di soggetti permette anche lo studio del tubo digerente e la diagnosi di patologie neoplastiche o infiammatorie. Scopo del lavoro è di descrivere l'utilità della elastografia nella diagnosi di un tumore dell'ileo in cui l'esame ecografico convenzionale ed elastografico sono stati effettuati sul paziente prima dell'intervento chirurgico e successivamente sul pezzo operatorio con conferma dei riscontri precedenti all'intervento.

SICUS and CEUS imaging in Crohn’s disease: an update

“…The introduction of dedicated US software for elastographic assessments would greatly improve the diagnostic potential of CEUS for assessing bowel wall fibrosis grade in patients with CD [78][79][80][81].…”

Adding trans-abdominal elastography to the diagnostic tool for an ileal gastrointestinal stromal tumor: a case report

“…Recently, SE or SWE has been suggested as an adjunct tool for assessing GI diseases [15–17]. However, the data is still limited at transabdominal elastography [11, 18]. Previous study reported that gastric GIST was a harder tumor than other SMTs in EUS elastography [7].…”

“…Tsuji et al reported that EUS-elastography could be used to differentiate gastric GISTs with other SMTs because of its stiffness [7]. Few data exists regarding transabdominal elastography for SB GISTs [11].…”

Improvement of diagnostic efficiency in distinguishing the benign and malignant thyroid nodules via conventional ultrasound combined with ultrasound contrast and elastography

“…Conventional ultrasound (US) examination has become one of the preferred imaging examination methods of thyroid disease, but thyroid diseases are complex and diverse; in the two-dimensional ultrasonogram, there are overlapping benign and malignant nodules, and some nodules have the features of both benign nodular and malignant nodules, known as an uncertain nodule and it is difficult to determine its nature only from the ultrasonogram, so there are still some limitations on its differential diagnosis, directly affecting the choices of clinical treatment and surgical methods, which requires the physicians to make a preliminary qualitative diagnosis of lesions, so as to provide the reference basis for clinicians ( 1 – 4 ).…”