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Review
. 2021 Oct 31;11(11):2021.
doi: 10.3390/diagnostics11112021.

Role of Endoscopic Ultrasound in Liver Disease: Where Do We Stand?

Tajana Pavic  1 , Ivana Mikolasevic  2 , Dominik Kralj  1 , Nina Blazevic  1 , Anita Skrtic  3 , Ivan Budimir  1 , Ivan Lerotic  1 , Davor Hrabar  1
Affiliations
Review

Role of Endoscopic Ultrasound in Liver Disease: Where Do We Stand?

Tajana Pavic et al. Diagnostics (Basel). .

Abstract

As the burden of liver disease in the general populace steadily increases, so does the need for both advanced diagnostic and treatment options. Endoscopic ultrasound is a reliable diagnostic and therapeutic method that has an established role, foremost in pancreatobiliary pathology. This paper aims to summarize the growing role of endoscopic ultrasound in hepatology based on the search of the current literature. A number of applications of endoscopic ultrasound are reviewed, including both noninvasive methods and tissue acquisition in focal and diffuse liver disease, portal hypertension measurement, detection and management of gastric and esophageal varices, treatment of focal liver lesions and staging of pancreatobiliary malignancies, treatment of cystic and solid liver lesions, as well as liver abscess drainage. Both hepatologists and endoscopists should be aware of the evolving role of endoscopic ultrasound in liver disease. The inherent invasive nature of endoscopic examination limits its use to a targeted population identified using noninvasive methods. Endoscopic ultrasound is one the most versatile methods in gastroenterology, allowing immediate access with detection, sampling, and treatment of digestive tract pathology. Further expansion of its use in hepatology is immanent.

Keywords: EUS; chronic liver disease; endoscopic ultrasound; hepatology.

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Conflict of interest statement

The authors declare no conflict of interest regarding this manuscript.

Figures

Figure 1
Figure 1
Two visible liver core specimens following EUS-LB.
Figure 2
Figure 2
Illustrative histological features of NAFLD in an EUS-LB specimen. (A) Up to 75 portal triads per liver specimen obtained by EUS-LB using 19-gauge FNB needle (HE staining, magnification 20×); (B) Focal necrosis, macrovesicular steatosis, and ballooning of hepatocytes grade 1. (HE staining, magnification 400×); (C) Mild chronic infiltration in portal tract with the preserved limited plate. Panacinar steatosis (up to 30%); (HE staining, magnification 100×); (D) Moderate, zone 3 perisinusoidal fibrosis (Brunt, fibrosis stage 1b); (Gomori; magnification 100×); (E) Mild, zone 3 perisinusoidal fibrosis (Brunt, fibrosis stage 1a); (Masson; magnification 100×); (F) Bridging fibrosis (Brunt, fibrosis stage 3); (Masson; magnification 100×).
Scheme 1
Scheme 1
EUS-guided portal pressure gradient (PPG) measurement. PPG is calculated as the difference between hepatic vein pressure (HVP) and direct portal vein pressure (PVP).
See this image and copyright information in PMC

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