Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Nov-Dec;10(6):406-413.
doi: 10.4103/EUS-D-21-00019.

Practical approach to linear EUS examination of the mediastinum

Hussein Hassan Okasha  1 , Ahmed El-Meligui  1 , Katarzyna M Pawlak  2 , Michał Żorniak  3 , Hassan Atalla  4 , Amr Abou-Elmagd  5 , Sameh Abou-Elenen  6 , Ramy El-Husseiny  7 , Ahmed Alzamzamy  6
Affiliations
Review

Practical approach to linear EUS examination of the mediastinum

Hussein Hassan Okasha et al. Endosc Ultrasound. 2021 Nov-Dec.

Abstract

EUS has become a substantial diagnostic and therapeutic modality for many anatomical regions. The extent of endosonographic assessment is wide, and among others, allows for the evaluation of the mediastinal anatomy and related pathologies such as mediastinal lymphadenopathy and staging of central malignant lung lesions. Moreover, EUS assessment has proved more accurate in detecting small lesions missed by standard imaging examinations such as computed tomography or magnetic resonance. Endosonographically, various mediastinal anatomical landmarks and stations can be visualized by transesophageal scanning, thus providing arranged systematic examination of the mediastinum. In addition, the correct position during the examination is crucial for EUS-guided procedures such as tissue sampling and drainage of mediastinal abscesses. The evolution of EUS-guided diagnostic and interventional procedures has contributed to the increasing importance of understanding the mediastinal anatomy during the EUS examination.

Keywords: EUS; anatomy; linear; mediastinal stations.

PubMed Disclaimer

Conflict of interest statement

None

Figures

Figure 1
Figure 1
Anatomical stations of the mediastinum seen by EUS, EBUS or both. R: Right, L: Left; EBUS: Endobronchial Ultrasound
Figure 2
Figure 2
(a) Diagram of the anatomical location of Station 9 (b) Station 9 as seen by linear EUS. Rt: Right; IVC: Inferior vena cava
Figure 3
Figure 3
(a) Diagram of the anatomical location of the subcarinal area and station 7. (b) Subcarinal area and station 7 as seen by linear EUS. MV: Mitral Valve; AV: Aortic Valve
Figure 4
Figure 4
(a) Diagram of the anatomical location of station 10R (b) Station 10R as seen by linear EUS. IVC: Inferior vena cava; SVC: Superior vena cava; Rt PA: Right Pulmonary artery; 10R: 10 Right
Figure 5
Figure 5
(a) Diagram of the anatomical location of station 8. (b) Station 8 as seen by linear EUS.
Figure 6
Figure 6
(a) Diagram of the anatomical location of the aorto-pulmonary window (A-P window) and Stations 4L, 5, 6, and 10L (b) The A-P window and Stations 4L, 5, 6, and 10L as seen by linear EUS. LPA: Left pulmonary artery; 4L: 4 Left; 10L: 10 Left
Figure 7
Figure 7
(a) Diagram of the anatomical location of station 2L. (b) Station 2L as seen by linear EUS. 2L: 2 Left
Figure 8
Figure 8
(a) Diagram of the anatomical location of Station 3A (b) Station 3A as seen by linear EUS. SCV: Subclavian vein; IJV: Internal jugular vein; CCA: Common carotid artery; 3A: 3 Anterior
Figure 9
Figure 9
Diagram of the anatomical location of station 1 in the neck.
See this image and copyright information in PMC

References

    1. Jenssen C, Annema JT, Clementsen P, et al. Ultrasound techniques in the evaluation of the mediastinum, part 2: Mediastinal lymph node anatomy and diagnostic reach of ultrasound techniques, clinical work up of neoplastic and inflammatory mediastinal lymphadenopathy using ultrasound techniques and how to learn mediastinal endosonography. J Thorac Dis. 2015;7:E439–58. - PMC - PubMed
    1. Tanoue LT. Staging of non-small cell lung cancer. Semin Respir Crit Care Med. 2008;29:248–60. - PubMed
    1. Sharma M, Pathak A, Shoukat A, et al. Imaging of spaces of neck and mediastinum by endoscopic ultrasound. Lung India. 2016;33:292–305. - PMC - PubMed
    1. Rivera MP, Mehta AC, Wahidi MM. Establishing the diagnosis of lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2013;143(5 Suppl):e142S–65S. - PubMed
    1. Gilbert C, Akulian J, Ortiz R, et al. Novel bronchoscopic strategies for the diagnosis of peripheral lung lesions: Present techniques and future directions. Respirology. 2014;19:636–44. - PubMed