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Review
. 2015 Apr 28;21(16):4809-16.
doi: 10.3748/wjg.v21.i16.4809.

New endoscopic ultrasound techniques for digestive tract diseases: A comprehensive review

Fan-Sheng Meng  1 , Zhao-Hong Zhang  1 , Feng Ji  1
Affiliations
Review

New endoscopic ultrasound techniques for digestive tract diseases: A comprehensive review

Fan-Sheng Meng et al. World J Gastroenterol. .

Abstract

Endoscopic ultrasound (EUS) is one of the most important modalities for the diagnosis of digestive tract diseases. EUS has been evolving ever since it was introduced. New techniques such as elastography and contrast enhancement have emerged, increasing the accuracy, sensitivity and specificity of EUS for the diagnosis of digestive tract diseases including pancreatic masses and lymphadenopathy. EUS-elastography evaluates tissue elasticity and therefore, can be used to differentiate various lesions. Contrast-enhanced EUS can distinguish benign from malignant pancreatic lesions and lymphadenopathy using the intravenous injection of contrast agents. This review discusses the principles and types of these new techniques, as well as their clinical applications and limitations.

Keywords: Contrast-enhanced; Digestive tract diseases; Elastography; Endoscopic ultrasound; New techniques.

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Figures

Figure 1
Figure 1
A patient with a malignant pancreatic tumor. The elastography image in the left panel shows a homogeneous blue mass (red circle). The B-mode reference image is shown in the right panel (Popescu et al[4]).
Figure 2
Figure 2
A patient with chronic pancreatitis. The elastography image in the left panel shows a heterogeneous green mass (red circle). The B-mode reference image is shown in the right panel (Popescu et al[4]).
Figure 3
Figure 3
Typical contrast-enhanced harmonic endoscopic ultrasound images of pancreatic tumors. A: Pancreatic carcinoma with hypoenhancement. Conventional EUS (left) shows a hypoechoic mass at the pancreas tail. Contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) (right) indicates that the mass has hypoenhancement compared with the surrounding tissue; B: Chronic pancreatitis with isoenhancement. Conventional EUS (left) shows a hypoechoic mass at the pancreas body. CH-EUS (right) indicates homogeneous enhancement mass similar to the surrounding tissue; a margin is not observed; C: Neuroendocrine tumor with hyperenhancement. Conventional EUS (left) shows a hypoechoic mass at the pancreas body. CH-EUS (right) indicates that enhancement in the mass is higher than in the surrounding tissue (Kwek et al[65]).
See this image and copyright information in PMC

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