Challenges in radiologic diagnostics of esophageal leiomyomas

Abstract

Today there is a large number of oesophageal tumours, and the need for their differential diagnosis is conditioned of different treatment paradigm. This is especially true for oesophageal benign mass lesions (leiomyomas) and gastrointestinal stromal tumours (GIST). Since the most frequent and accessible examinations of patients with the upper gastrointestinal events are radiological methods, a necessity arises to evaluate their efficacy in differentiating between various oesophageal neoplasms and detecting oesophageal leiomyomas in the preoperative period.

Objective: to determine the efficacy of radiologic imaging techniques for the oesophageal leiomyoma detection.

Materials and methods. A retrospective chart review of 59 patients with oesophageal leiomyoma was carried out. The radiological methods conducted in patients were as follows: esophagography with aqueous barium solution (n=48), chest computed tomography with contrast enhancement (chest CT) (n=35), magnetic resonance imaging with contrast enhancement (chest MRI) (n=4).

Results. The sensitivity of radiological diagnostic methods is low and for X-rays made up 31.25 per cent, for chest CT – 22.85 per cent, and for MRI – 50 per cent.

Conclusions. Each particular method of radiological diagnostics does not have specific signs for oesophageal leiomyomas; however, using X-radiography, chest CT and MRI in a complex diagnostics allows more precisely determine a diagnosis.