Applications of Endoscopic Ultrasonography

, and , Harbor-UCLA Medical Center, Torrance, California.

Disclosures

Medscape General Medicine. 2001;3(3) 

In This Article

Abstract and Introduction

Endoscopic ultrasonography (EUS) employs the technology of endoscopy and internally placed high-frequency ultrasound waves to visualize the gastrointestinal wall and adjacent structures. Conventional EUS has 2 designs: the radial scanner and the sector scanner. In addition, high-frequency ultrasound probes that are passed through the biopsy channel of an endoscope are available. EUS has emerged as an important modality for the diagnosis and staging of benign and malignant lesions of the gut wall and surrounding structures of the mediastinum, abdomen, and pelvis. It is also used as a diagnostic tool for the evaluation of submucosal masses of the upper gastrointestinal tract and the rectosigmoid, for locating pancreatic endocrine tumors, and for the assessment of vascular disease. Interventional applications, such as EUS-guided fine-needle aspiration (EUS-FNA) for obtaining tissue/fluid samples, for pseudocyst drainage, and also for delivery of local therapy, will likely enhance the clinical utility and cost-effectiveness of this imaging modality. The widest application of EUS is, however, in the diagnosis and staging of esophageal, gastric, rectal, and pancreaticobiliary carcinoma. EUS has been shown to change the approach to clinical management in a significant proportion of patients to a less costly, risky, or invasive strategy. This article update reviews recent literature on the role of EUS in guiding FNA; in the diagnosis, staging, and management of patients with benign and malignant lesions of the gastrointestinal tract and adjacent structures; and in the assistance of interventions such as pseudocyst drainage and endoscopic mucosal resection.

Endoscopic ultrasound (EUS) is an imaging technique that combines endoscopy and ultrasonography. An ultrasound transducer is mounted on the tip of the endoscope, allowing accurate imaging of tumors and lesions located within and adjacent to the gastrointestinal wall. EUS-guided fine-needle aspiration (EUS-FNA) or fine-needle injection (FNI) may be performed in adjunct to confirm tumor diagnosis and staging.

EUS was introduced in the early 1980s and has developed into an important modality for the diagnosis and staging of benign and malignant lesions. A multicenter study conducted by the American Endosonography Club reported that findings obtained by EUS changed the clinical management in over two thirds of patients.[1] In over half of the patients studied, the change was to less costly, risky, or invasive management. In another study, Jafri and colleagues[2] reported similar findings.

Thus, EUS has developed as an important tool for the management of patients with benign and malignant lesions of the gastrointestinal tract and adjacent structures.

Comments

3090D553-9492-4563-8681-AD288FA52ACE

processing....