Endoscopic Ultrasound: A Meta-analysis of Test Performance in Suspected Biliary Obstruction  Donald Garrow, Scott Miller, Debajyoti Sinha, Jason Conway, Brenda J. Hoffman, Robert H. Hawes, Joseph Romagnuolo  Clinical Gastroenterology and Hepatology  Volume 5, Issue 5, Pages 616-623.e1 (May 2007) DOI: 10.1016/j.cgh.2007.02.027 Copyright © 2007 AGA Institute Terms and Conditions

Figure 1 Electronic radial EUS (7.5 MHz) of the apex of the duodenal bulb showing a nondilated common bile duct (CBD), the pancreatic duct (pd), and the portal vein (PV) alongside one another in a “stack sign” view with a hyperechoic (bright) 2.5 mm CBD stone (calipers) with hypoechoic (dark) shadowing (thick arrow), along with downstream wedge-shaped shadowing from multiple other stones (small arrows). MRCP before EUS in this patient suspected an intraductal tissue mass. Stones were removed at ERCP. Clinical Gastroenterology and Hepatology 2007 5, 616-623.e1DOI: (10.1016/j.cgh.2007.02.027) Copyright © 2007 AGA Institute Terms and Conditions

Figure 2 Flowchart summarizing the study exclusion process. Clinical Gastroenterology and Hepatology 2007 5, 616-623.e1DOI: (10.1016/j.cgh.2007.02.027) Copyright © 2007 AGA Institute Terms and Conditions

Figure 3 Receiver operating characteristic curves for EUS targeted at overall biliary construction, bile duct stones, and malignancy. Clinical Gastroenterology and Hepatology 2007 5, 616-623.e1DOI: (10.1016/j.cgh.2007.02.027) Copyright © 2007 AGA Institute Terms and Conditions

Figure 4 Influence of a positive or negative EUS result on the pretest probability of disease for various indications of EUS. Clinical Gastroenterology and Hepatology 2007 5, 616-623.e1DOI: (10.1016/j.cgh.2007.02.027) Copyright © 2007 AGA Institute Terms and Conditions