Diagnostic imaging techniques for gastrointestinal tract pathology

This is an automatically translated article.

The article was professionally consulted with resident doctor Nguyen Quynh Giang - Department of Diagnostic Imaging and Nuclear Medicine - Vinmec Times City International General Hospital.
Currently, gastrointestinal disease is one of the common diseases. The introduction of the method of surveying the digestive tract plays a huge role in the diagnosis and treatment of digestive diseases, in which the gastrointestinal ultrasound technique is a widely used diagnostic tool. most today.

1. Examination of the digestive tract

Gastrointestinal diseases are a group of diseases that are encountered a lot in patients of all ages, genders and in any country. Therefore, the research on pathology, diagnostic means as well as effective treatment methods is always improved and enhanced every day with the desire to bring the best health to patients. In order to be able to survey the digestive tract and timely detect diseases appearing in these organs, a number of techniques and paraclinical methods have been born, contributing a great deal to doctors in the treatment of diseases. diagnose and find out the causes of the physical symptoms of the gastrointestinal tract upon clinical examination, with some typical methods such as gastrointestinal ultrasound, gastrointestinal endoscopy, abdominal computed tomography, Magnetic resonance imaging... In which, gastrointestinal ultrasound is the most popular method because it is easy to perform, affordable, fast and brings high efficiency in diagnosis and treatment monitoring.

The digestive system or digestive tract is defined as a hollow tube, extending in the body, consisting of many layers of concentric cells, in order from the inside out, the mucosa, submucosa, muscle layer, layer serosa and connective tissue. With different structures and characteristics, the images of these cell layers when performing gastrointestinal ultrasound are also very different and need to be distinguished clearly to determine the most accurate lesion location. The thickness of these cell walls is about 3mm - 5mm and can vary with the tension of the digestive tract lumen. In addition, the contents of the lumen of the digestive organs also change according to other factors, and certain characteristics such as intestinal and gastric motility can also help identify cases of fluid accumulation in the intestine. some gastrointestinal diseases.

2. Gastrointestinal ultrasound

Unlike other diagnostic methods of gastrointestinal diseases such as endoscopy or computed tomography, gastrointestinal ultrasound can give cross-sectional imaging results of the gastrointestinal tract wall and surrounding tissues. Some common pathologies that gastrointestinal ultrasound can detect are cases of gastrointestinal wall thickening, gastrointestinal wall tumor with or without ulceration, dilatation and collection of fluid around the intestinal loop or a number of soft tissues of the mesentery, great omentum:
Cases of gastrointestinal wall thickening: Ultrasound can detect focal, diffuse, symmetric or asymmetrical gastrointestinal wall thickening images... with Images such as the pseudorenal sign, a target image characterized by an inferior echo ring on the outside, with a central echo, indicate that the bowel is narrowing or that an ulcer is present at the site. this. These results of thickening of the gastrointestinal tract wall can be directed to a number of pathological causes such as enteritis, colitis, intestinal cell hyperplasia, edema in pseudomembranous colitis, etc.
Case of gastrointestinal wall tumor:

Tumors of the gastrointestinal tract usually occur within the lumen, septum, or protrusion outside the gastrointestinal tract, with possible tumor origins being smooth muscle and lymphoma. If the tumor is due to smooth muscle then it will show features of necrosis, the cells are usually dense and cystic. As for tumors of Lymphoma origin, the echo will be less when ultrasound. In other cases, when the tumor is smaller in size and located right next to the intestine in the gastrointestinal tract, most of the origin will be from the intestine. However, it is also not possible to exclude tumors that are larger in size but cannot be found from the beginning, which may be intraperitoneal or retroperitoneal. Tumors of the gastrointestinal tract wall often encounter ulcer formation, when ultrasound gives images of thick echo, back shadow... and this is also a type of lesion that is difficult to find on ultrasound because it is in the gastrointestinal tract. Gaseous chemicals and various substances in the intestinal lumen can mask these lesions.
Case of dilated and stagnant bowel loops: Dilated and stagnant bowel loops are the typical picture in intestinal obstruction or gastrointestinal obstruction. When intestinal obstruction occurs, there will be a lot of gas in the intestinal lumen, causing artifacts on ultrasound and it is difficult to detect these cases by gastrointestinal ultrasound. Therefore, it is necessary to remove gas as well as stagnant dilated bowel loops so that ultrasound can be performed most easily, helping to find intestinal obstruction and paralytic ileus in the patient as soon as possible.
Cases of soft tissue tumors in the mesentery and great omentum:

When soft tissue tumors are present in the mesentery or the greater omentum, it is difficult to use ultrasound as a diagnostic tool for gastrointestinal disorders. In this case, computed tomography will be indicated more to strengthen the doctor's diagnosis, especially in some diseases such as Crohn's disease, diverticulitis... with surrounding soft tissue tumors.

3. Conclusion

In order to diagnose as well as monitor the effectiveness of treatment of gastrointestinal diseases, it is indispensable to receive support from the methods of surveying the digestive tract, in which the easiest to perform is the extremely advanced gastrointestinal ultrasound technique. Fast, convenient and economical but still extremely effective.
Vinmec International General Hospital applies gastrointestinal endoscopy, helping to accurately diagnose patients' digestive diseases, helping to provide the right treatment regimen, timely intervention, and limiting complications.
Vinmec is equipped with synchronously the most modern flexible endoscope system of Olympus - Japan, a prestigious manufacturer of the world's leading quality. The foot pedal irrigation system helps the doctor to take the initiative in irrigating the patient's gastrointestinal tract.

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