Endosonography of the esophagus

Endoscopic ultrasonography has emerged as a new method for obtaining highly detailed images of the esophagus. This novel imaging modality is useful in determining the etiology of submucosal esophageal lesions, has detected anatomic abnormalities in certain motility disorders, and has been used to study patients with portal hypertension. Endosonography should be considered the imaging method of choice for the pretherapeutic evaluation of patients with esophageal cancer. Recent data demonstrate its superior ability to determine the depth of tumor infiltration (T stage) and assess regional lymph adenopathy. Endoscopic ultrasonography provides important information that may help predict outcome in some patients and detect posttherapeutic recurrence in others. Certain technical limitations, such as patients with high-grade malignant stenosis that preclude complete endosonographic assessment of esophageal cancer, may be addressed in the future with novel, high-frequency endosonographic probes capable of traversing high-grade malignant stenoses.