Endo oesophageal ultrasound
The ultrasound layers of the oesophagus
1 Innermost layer represents superficial mucosa
2 Hypoechoic (black) represents deep mucosa
3 Hyperechoic (white) represents submucosa
4 Hypoechoic (black) represents muscularis propria
The whole staging system for oesophageal cancer resets on the degree of involvement of the muscularis propria
5 Hyperechoic (white) represents periesophageal tissue
The various layers of the oesophagus are seen below ( 5 on the left 3 on the right)
Additional normal endooesophageal images
The hypoechoic (black) tumor invades the hyperechoic third ultrasound layer, the submucosa, but not breach boundary between the 3rd and 4th layers
The hypoechoic (black) tumor invades the hyperechoic fourth ultrasound layer, but not between the 4th and 5th layers
The black tumour invades the space between the 4th and 5th layers, and invades the hyperechoic ultrasound 5th layer (perioesophageal tissue)
N0 on left N1 on right
Normal lymph nodes are white with poorly defined borders, unlike tumour filled ones which are black with well defined borders.
Hepatic metastasis
Leiomyoma arising from the 4th ultrasound layer
