Shami / Kahaleh Endoscopic Ultrasound

1. Auflage 2010
ISBN: 978-1-60327-480-7
Verlag: Humana Press
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 540 Seiten

Reihe: Clinical Gastroenterology

Endoscopic ultrasound has revolutionized the approach to lesions inside and outside the gastrointestinal tract. It has opened the door for gastroenterologists to explore organs outside of the GI lumen, such as the lymph nodes, lung, pancreas, and liver. Endoscopic Ultrasound covers all aspects of endoscopic ultrasound, from the basics to the interventional indications. Richly detailed chapters describe the utility of EUS in different parts of the body and are organized based on body site Pioneers in the field summarize new studies, and the direction of EUS in practice. Endoscopic Ultrasound provides a ready reference that will help physicians and support staff that are beginning EUS, as well as trained ultrasonographers who wish to arm themselves with a comprehensive reference and explore the future of the field.

Autoren/Hrsg.

Shami, Vanessa M.

Kahaleh, Michel

Inhaltsverzeichnis

1;Endosonographic Instrumentation;13
1.1;INTRODUCTION: BASICS OF ULTRASOUND AND RATIONALE FOR EUS;14
1.2;THE ULTRASOUND TRANSDUCER;15
1.3;RADIAL ARRAY VERSUS LINEAR ARRAY;15
1.4;BASIC ECHOENDOSCOPE DESIGN;18
1.5;LINEAR ARRAY ECHOENDOSCOPES;20
1.6;RADIAL ECHOENDOSCOPES;20
1.7;ENDOBRONCHIAL ULTRASOUND DEVICES;25
1.8;OTHER SPECIALIZED DEVICES;27
1.9;EUS MINIPROBES;31
1.10;ULTRASOUND CONSOLES;31
1.11;EUS NEEDLES;36
1.12;CONCLUSION;40
1.13;REFERENCES;41
2;Probe Ultrasonography;42
2.1;INTRODUCTION;43
2.2;INSTRUMENTS AND EXAMINATION TECHNIQUES;44
2.3;GASTROINTESTINAL WALL ANATOMY;45
2.4;CLINICAL INDICATIONS;47
2.4.1;Esophagus;47
2.4.2;Stomach;47
2.4.3;Small Bowel and Colon;51
2.5;INTRADUCTAL ULTRASOUND;55
2.6;TECHNICAL CONSIDERATIONS;55
2.7;BILIARY TRACT ANATOMY;55
2.8;CLINICAL INDICATIONS;56
2.8.1;Choledocholithiasis;56
2.8.2;Bile Duct Strictures;57
2.8.3;Cholangiocarcinoma;57
2.9;PANCREATIC INTRADUCTAL ULTRASOUND;59
2.9.1;Pancreatic Duct Strictures and Pancreatic Adenocarcinoma;59
2.9.2;Mucin-Producing and Islet-Cell Tumors;59
2.10;PAPILLA OF VATER INTRADUCTAL ULTRASOUND;60
2.11;FUTURE PROBE TECHOLOGY;60
2.12;CONCLUSION;61
2.13;REFERENCES;62
3;Radial Endoscopic Ultrasound;71
3.1;INTRODUCTION;72
3.2;EQUIPMENT;73
3.3;GASTROINTESTINAL TRACT WALL;77
3.4;MEDIASTINUM AND ESOPHAGUS;78
3.4.1;Distal Esophagus;78
3.4.2;Midesophagus;80
3.4.3;Proximal Esophagus;83
3.5;STOMACH;83
3.6;PANCREAS AND EXTRAHEPATIC BILE DUCT;87
3.7;RECTUM;92
3.8;SUMMARY;96
3.9;REFERENCES;97
4;Linear Endoscopic Ultrasound;98
4.1;INTRODUCTION;99
4.2;TECHNIQUE;99
4.2.1;Maneuvering the Linear Echoendoscope;99
4.2.2;Value of a Forward Viewing Endoscopy Prior to EUS;101
4.2.3;Mediastinum;101
4.2.4;Celiac Axis and Adjacent Structures;103
4.2.5;Liver and Gallbladder;105
4.2.6;Pancreas, Bile Duct, and Ampulla;106
4.2.7;Rectum;109
4.3;ACCESSORIES;109
4.3.1;Balloons;109
4.3.2;Buttons and Caps;109
4.4;Role of linear eus in Gi diseases;110
4.4.1;Esophageal Cancer;110
4.4.2;Stomach Cancer;111
4.4.3;Pancreatic Cancer;112
4.4.4;Chronic Pancreatitis and Pancreatic Ductal Anatomy;113
4.4.5;Common Bile Duct Stones;114
4.4.6;Rectal Cancer;115
4.5;SUMMARY;115
4.6;REFERENCES;115
5;The Cytopathology of Endoscopic Ultrasound-Guided Fine Needle Aspiration;118
5.1;INTRODUCTION;119
5.2;PRINCIPLES OF CYTOLOGY;119
5.2.1;Preparations;119
5.3;TERMINOLOGY;121
5.4;BIOPSY OF LUMINAL GUT;122
5.4.1;Epithelial Malignancy;122
5.4.1.1;Adenocarcinoma;122
5.4.1.2;Squamous cell carcinoma;124
5.4.1.3;Spindle cell (sarcomatoid) carcinoma;125
5.4.1.4;Carcinoid tumors and other well-differentiated neuroendocrine carcinomas;126
5.4.2;Mesenchymal Neoplasia;128
5.4.3;Lymphoma;132
5.4.4;Melanoma;135
5.4.5;Other Lesions;137
5.5;BIOPSY OF LYMPH NODES;138
5.5.1;The Staging of Malignancy;138
5.5.2;Adenopathy of Other Etiology;138
5.6;BIOPSY OF THE LUNG AND MEDIASTINUM;140
5.7;BIOPSY OF THE PANCREAS, EXTRAHEPATIC BILIARY SYSTEM, AND GALLBLADDER;144
5.7.1;Pancreas;144
5.7.1.1;Pancreatic ductal adenocarcinoma;146
5.7.1.2;Other primary pancreatic solid neoplasms;148
5.7.1.3;Solid lesions mimicking solid pancreatic neoplasia;152
5.7.1.4;Cystic lesions;154
5.7.2;Extrahepatic Biliary System and Gallbladder;159
5.8;BIOPSY OF THE LIVER;159
5.9;ADRENAL GLAND;161
5.10;CONCLUSION;162
5.11;REFERENCES;162
6;Pitfalls in Endoscopic Ultrasound;171
6.1;SEDATION;172
6.2;ENDOSCOPE INTUBATION AND PASSAGE;172
6.3;ORIENTATION;173
6.4;TECHNICAL ISSUES;177
6.5;EUS INDICATIONS;178
6.6;EQUIPMENT SELECTION;179
6.7;FNA CONSIDERATIONS;180
6.8;Sec8_6;181
6.9;CONCLUSION;184
6.10;REFERENCES;184
7;The Role of EUS in Esophageal Cancer;188
7.1;INTRODUCTION;189
7.2;DIAGNOSIS;189
7.3;STAGING ESOPHAGEAL CANCER;189
7.4;T STAGING;192
7.5;N STAGING;196
7.5.1;Staging in the Setting of Malignant Strictures;199
7.6;M STAGING;200
7.7;RESTAGING;201
7.8;DETECTING TUMOR RECURRENCE;202
7.9;BARRETT’S ESOPHAGUS;203
7.10;QUALITY INDICATORS;203
7.11;CONCLUSION;204
7.12;REFERENCES;204
8;Role of EUS in Mediastinal Nodes, Masses, Cysts, and Lung Cancer;209
8.1;INTRODUCTION;210
8.1.1;Mediastinal Cysts;211
8.2;ROLE OF FNA;212
8.3;THE LUNG MASS;212
8.4;LUNG CANCER;214
8.5;RATIONALE FOR EUS;214
8.6;BEFORE YOU START;215
8.7;WHICH TEST IS BEST?;217
8.8;CROSS-SECTIONAL IMAGING;218
8.9;FUNCTIONAL IMAGING;219
8.10;FAILED BRONCHOSCOPY AND EUS RESCUE;220
8.11;EUS AND MEDIASTINOSCOPY;220
8.12;MEDICAL MEDIASTINOSCOPY;220
8.13;ENDOBRONCHIAL ULTRASOUND;220
8.14;SHOULD EUS BE EMPLOYED IN SUSPECTED EARLY LUNG CANCER?;222
8.15;THE LINEAR EXAM;222
8.16;THE FNA TECHNIQUE;222
8.17;SELECTIVE NODAL TARGETING;224
8.18;DOES EUS PREDICT T4 DISEASE?;225
8.19;EUS AFTER INDUCTION THERAPY;225
8.20;NEW APPLICATIONS;226
8.21;COST EFFECTIVENESS OF EUS IN LUNG CANCER;226
8.22;TRAINING;226
8.23;CONCLUSION;227
8.24;References;227
9;The Role of Endoscopic Ultrasound in Gastric Cancer;231
9.1;INTRODUCTION;232
9.2;GASTRIC CANCER STAGING SYSTEMS;233
9.3;DIAGNOSIS AND STAGING OF GASTRIC CANCER;235
9.4;EUS TECHNIQUE;235
9.5;PRIMARY TUMOR ASSESSMENT (T-STAGE) OF GASTRIC CANCER BY EUS;237
9.6;LYMPH NODE ASSESSMENT (N-STAGING) OF GASTRIC CANCER BY EUS;240
9.7;ASSESSMENT OF DISTANT METASTASES (M-STAGING) OF GASTRIC CANCER BY EUS;242
9.8;TECHNICAL LIMITATIONS OF EUS FOR TNM STAGING OF GASTRIC CANCER;242
9.9;COMPARISON OF EUS TO OTHER IMAGING MODALITIES FOR STAGING OF GASTRIC CANCER;243
9.10;EUS IN THE EVALUATION OF EARLY GASTRIC CANCER;243
9.11;EUS IN THE EVALUATION OF LOCALLY ADVANCED GASTRIC CANCER;245
9.12;CONCLUSION;246
9.13;REFERENCES;247
10;The Role of EUS in Subepithelial Lesions;252
10.1;INTRODUCTION;252
10.2;EXTRAMURAL LESIONS;254
10.3;INTRAMURAL LESIONS;255
10.3.1;Benign;255
10.3.1.1;Lipoma;255
10.3.1.2;Leiomyoma;257
10.3.1.3;Varices;259
10.3.1.4;Pancreatic Rest;259
10.3.1.5;Duplication Cyst;261
10.3.1.6;Inflammatory Fibroid Polyp;261
10.3.2;Malignant or Premalignant;262
10.3.2.1;Gastrointestinal Stromal Tumor;262
10.3.2.2;Carcinoid Tumor;262
10.3.2.3;Lymphoma;264
10.3.2.4;Glomus Tumors;264
10.3.2.5;Granular Cell Tumors;264
10.3.2.6;Metastasis;265
10.4;CONCLUSIONS;265
10.5;REFERENCES;265
11;Endoscopic Ultrasound of Ampullary and Duodenal Lesions;270
11.1;INTRODUCTION;271
11.2;AMPULLA OF VATER;271
11.2.1;Benign Lesions of the Ampulla of Vater;271
11.2.2;Malignant Lesions of the Ampulla of Vater;272
11.2.3;Lesions Involving the Minor Duodenal Ampulla;273
11.3;TECHNIQUE OF EUS EXAMINATION;273
11.3.1;EUS-Guided FNA;274
11.3.2;Intraductal Ultrasound;274
11.4;STAGING ACCURACY OF EUS;277
11.5;TREATMENT;280
11.6;DUODENAL LESIONS;280
11.6.1;Benign Lesions of the Duodenum;281
11.7;CONCLUSIONS;281
11.8;REFERENCES;282
12;The Role of EUS in Pancreatic Cancer;286
12.1;Introduction;287
12.2;PRESENTATION AND INITIAL EVALUATION;287
12.3;RADIOGRAPHIC IMAGING STUDIES;292
12.4;ENDOSCOPIC ULTRASOUND (EUS);292
12.5;REFERENCES;298
13;The Role of EUS in Cystic Lesions of the Pancreas;302
13.1;INTRODUCTION;303
13.2;EUS VERSUS OTHER IMAGING MODALITIES IN THE DIAGNOSIS OF CPLs;304
13.3;EUS-FNA of CPLs: TECHNIQUE;306
13.4;EUS-GUIDED TRUCUT BIOPSIES;307
13.5;CYST FLUID EVALUATION;308
13.5.1;Cytology;308
13.5.2;Tumor Markers;309
13.5.3;Genetic Markers;310
13.6;SEROUS CYSTIC NEOPLASMS;311
13.7;MUCINOUS CYSTIC NEOPLASMS;313
13.8;INTRADUCTAL PAPILLARY MUCINOUS NEOPLASMS;316
13.9;OTHER RARE TYPES OF CPLs;320
13.10;TREATMENT OF CPLs;322
13.10.1;Expectant Management;322
13.10.2;Surgical Management;323
13.10.3;Alternate Nonsurgical Management and Future Developments;323
13.11;CONCLUSION;324
13.12;REFERENCES;324
14;The Role of EUS in the Biliary System;331
14.1;TECHNIQUE OF BILIARY IMAGING;332
14.1.1;Standard Endoscopic Ultrasonography;332
14.1.2;Intraductal Ultrasonography;335
14.1.3;Normal Findings;337
14.2;GALLSTONE DISEASE;338
14.2.1;Introduction;338
14.2.2;Technique;339
14.2.3;Results;340
14.2.4;Particular Case: “Idiopathic” Acute Pancreatitis;344
14.3;BILIARY STRICTURES;346
14.3.1;Standard Endoscopic Ultrasonography;346
14.3.1.1;Detection and Characterization of Biliary Strictures and Lymph Nodes;346
14.3.1.2;Sampling;347
14.3.1.3;Longitudinal Tumor Extent, TNM Stage, and Resectability;350
14.3.1.4;Impact of EUS-FNA on Patient Management;352
14.3.2;Intraductal Ultrasonography;354
14.3.2.1;Introduction;354
14.3.2.2;Distinction Between Benign and Malignant Strictures;354
14.3.2.3;Staging of Cholangiocarcinomas;355
14.3.3;Particular Case: Primary Sclerosing Cholangitis;356
14.3.4;Therapeutic EUS for Biliary Strictures;357
14.3.4.1;Preamble;357
14.3.4.2;Technique;358
14.3.4.3;Results;358
14.4;GALLBLADDER;358
14.4.1;Normal Findings;358
14.4.2;Stones;358
14.4.3;Polypoid Lesions;359
14.4.3.1;Description;359
14.4.3.2;Role of EUS in the Management of Gallbladder Polypoid Lesions;360
14.4.4;Carcinoma;361
14.5;REFERENCES;364
15;The Role of EUS in Rectal Cancer and Fecal Incontinence;373
15.1;EUS AND RECTAL CANCER;374
15.1.1;Background;374
15.1.2;EUS Technique;374
15.1.3;T Staging;374
15.1.4;N Staging;377
15.1.5;Fine Needle Aspiration;377
15.1.6;Clinical Significance of EUS in Rectal Cancer Staging;380
15.1.7;Factors Affecting EUS Accuracy;380
15.1.8;Tumor Recurrence;380
15.1.9;Future EUS Applications in Rectal Cancer;381
15.2;EUS AND FECAL INCONTINENCE;381
15.2.1;Background;381
15.2.2;Normal Anatomy of the Anal Sphincter;382
15.2.3;EUS Technique;382
15.2.4;EUS Accuracy in Identifying Sphincter Tears;383
15.2.5;EUS Compared to Other Modalities;384
15.2.6;Clinical Impact of EUS on Fecal Incontinence;384
15.2.7;Future EUS Applications in Fecal Incontinence;385
15.3;SUMMARY;385
15.4;References;386
16;Interventional Endoscopic Ultrasound-Guided Cholangiopancreatography;392
16.1;INTRODUCTION;393
16.1.1;Patient Selection;393
16.1.2;Endoscopist Selection;394
16.1.3;Patient Preparation;394
16.1.4;Techniques;394
16.1.4.1;EUS-guided Biliary Drainage;395
16.1.4.1.1;Intrahepatic Approach;395
16.1.4.1.2;Extrahepatic Approach;396
16.1.4.2;EUS-guided pancreatic drainage;398
16.2;LITERATURE REVIEW;399
16.2.1;EUS-Guided Biliary Drainage;399
16.2.2;EUS-Guided Pancreatic Drainage;401
16.3;SUMMARY;404
16.4;References;405
17;Endoscopic Ultrasound-Guided Drainage of Pancreatic Fluid Collections;409
17.1;INTRODUCTION;410
17.2;MATERIALS AND METHODS;411
17.2.1;Appropriate Candidates;411
17.2.2;Appropriate Endoscopists;411
17.2.3;Patient Preparation;411
17.2.4;Instrumentation;412
17.2.5;Predrainage Evaluation;412
17.3;PROCEDURE DESCRIPTION;412
17.4;LITERATURE REVIEW;414
17.5;CONCLUSION;420
17.6;REFERENCES;420
18;Endoscopic Ultrasound-Guided Celiac Plexus Block and Celiac Plexus Neurolysis;424
18.1;INTRODUCTION;425
18.2;ANATOMICAL AND FUNCTIONAL CONSIDERATIONS;426
18.2.1;Pancreas;426
18.3;CELIAC PLEXUS;426
18.4;TECHNIQUE;427
18.5;CPN;431
18.6;Celiac plexus block;431
18.7;PREPARATION PREPROCEDURE;432
18.8;POSTPROCEDURE MONITORING;433
18.9;SIDE EFFECTS AND COMPLICATIONS OF THE PROCEDURE;433
18.10;PROCEDURE EFFICACY;434
18.11;REFERENCES;437
19;Fine Needle Injection Therapy;441
19.1;INTRODUCTION;441
19.2;TUMOR ABLATION;442
19.2.1;Injection Therapy;443
19.2.1.1;Biologics;443
19.2.1.2;Ethanol;445
19.2.2;Thermal/Energy Delivery;447
19.2.2.1;Radiofrequency Ablation;447
19.2.2.2;Cryoablation;450
19.2.2.3;Photodynamic Therapy;452
19.2.2.4;High-Intensity Focused Ultrasound;455
19.2.3;Implantable Therapy;455
19.2.3.1;Chemotherapy;455
19.2.3.2;Brachytherapy;457
19.3;PRETREATMENT TUMOR IDENTIFICATION;459
19.3.1;Fiducial Placement;459
19.3.2;Tumor Marking;461
19.4;PANCREATIC CYST ABLATION;461
19.5;SUMMARY;463
19.6;REFERENCES;464
20;Contrast-Enhanced Endoscopic Ultrasound;473
20.1;INTRODUCTION;474
20.2;GENERAL CONSIDERATIONS;474
20.3;COMMERCIALLY AVAILABLE UCA IN EUROPE;475
20.4;PANCREATIC EUS AND US CONTRAST AGENTS;476
20.5;CONTRAST-ENHANCED EUS IN DISCRIMINATION BETWEEN BENIGN AND MALIGNANT MEDIASTINAL AND ABDOMINAL LYMPH NODES;480
20.6;CONCLUSION;481
20.7;References;482
21;Endosurgical Applications of EUS;485
21.1;INTRODUCTION;486
21.2;ENDOLUMINAL ENDOSURGICAL METHODS;487
21.2.1;EUS-Guided Pancreatic Necrosectomy;487
21.2.2;EUS-Guided Drainage of the Biliary Tract;489
21.2.3;EUS-Guided Bilioma Drainage;491
21.2.4;EUS-Guided Pancreatic Duct Interventions;491
21.2.5;EUS-Guided Vascular Interventions;492
21.3;EXPERIMENTAL EUS-GUIDED ENDOSURGERY: TOWARD NOTES;494
21.3.1;EUS-Guided Anastomosis;498
21.3.2;EUS-Guided Cardiac Interventions;499
21.4;EUS-GUIDED ENDOSURGERY;501
21.4.1;EUS-Guided Transluminal (NOTES) Access;501
21.4.2;EUS-Guided Mediastinal Drainages and NOTES;502
21.4.3;Transluminal EUS;503
21.5;CONCLUSION;503
21.6;REFERENCES;504
22;The Future of EUS;510
22.1;INTRODUCTION;510
22.2;FUTURE EUS EQUIPMENT;511
22.2.1;EUS Scopes;511
22.2.2;Future EUS Ultrasound Processors;512
22.2.3;Future EUS Accessories;512
22.3;EUS INDICATIONS IN THE FUTURE;514
22.3.1;Mediastinal EUS;514
22.3.2;Luminal GI Tract Cancer;515
22.3.3;Pancreatic Cancer;515
22.3.4;Pancreatic Cysts;516
22.3.5;EUS Pseudocyst Drainage;517
22.3.6;EUS Celiac Plexus Neurolysis;517
22.3.7;CBD Stones;518
22.3.8;Biliary Drainage;518
22.3.9;Hemostasis and Vascular EUS;518
22.3.10;EUS and NOTES/Surgery;519
22.4;FUTURE TRAINING AND QUALITY ISSUES;519
22.5;CONCLUSIONS;520
22.6;REFERENCES;521