Gastrointestinal imaging: Endoscopic ultrasound

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Presentation transcript:

Gastrointestinal imaging: Endoscopic ultrasound Michael F. Byrne, Paul S. Jowell Gastroenterology Volume 122, Issue 6, Pages 1631-1648 (May 2002) DOI: 10.1053/gast.2002.33576 Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 1 (A) Endoscopic image showing submucosal mass in lower esophagus. (B) EUS with a 20-MHz miniprobe shows an anechoic structure (single arrowhead) in the submucosa. This likely represents a duplication cyst. The muscularis propria is also labeled (double arrowhead). Gastroenterology 2002 122, 1631-1648DOI: (10.1053/gast.2002.33576) Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 2 EUS image of a mass (single arrowhead) in the head of pancreas. EUS FNA was performed and confirmed pancreatic adenocarcinoma. The tip of the needle (double arrowhead) is seen in the mass. A bile duct stent previously placed is also visualized (triple arrowhead). Gastroenterology 2002 122, 1631-1648DOI: (10.1053/gast.2002.33576) Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 3 (A) Endoscopic image of a TI lesion (adenocarcinoma) at the gastroesophageal junction. (B) EUS shows this as a hypoechoic mass (single arrowhead) superficial to the muscularis propria (double arrowhead). Gastroenterology 2002 122, 1631-1648DOI: (10.1053/gast.2002.33576) Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 4 Stromal tumor in the rectum measuring 9 mm × 14 mm (single arrowhead), contiguous with the muscularis propria (double arrowhead). Gastroenterology 2002 122, 1631-1648DOI: (10.1053/gast.2002.33576) Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 5 A hypoechoic lesion measuring 1.5 cm in the head of the pancreas (single arrowhead). It is seen to invade the CBD (double arrowhead) and was confirmed at EUS FNA as a pancreatic adenocarcinoma. Gastroenterology 2002 122, 1631-1648DOI: (10.1053/gast.2002.33576) Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 6 EUS appearances of liver metastases. (A) A 5-mm hypoechoic lesion and (B) a 35-mm × 30-mm hyperechoic lesion. These masses in 2 different patients were both in the left lobe of the liver and EUS FNA confirmed metastatic pancreatic adenocarcinomas. Gastroenterology 2002 122, 1631-1648DOI: (10.1053/gast.2002.33576) Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 7 Pancreatic neuroendocrine tumors. A 6-mm hypoechoic mass (single arrowhead) is seen immediately adjacent to the pancreatic head (double arrowhead). This was confirmed as a gastrinoma in a patient with known Zollinger-Ellison syndrome. Gastroenterology 2002 122, 1631-1648DOI: (10.1053/gast.2002.33576) Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 8 EUS appearances of pancreatic cystic lesions. (A and B) Serous cystadenomas in 2 different patients but (A) 1 appears as a multilocular cystic lesion and (B) the other as a unilocular large cyst. Abbreviations: C, cyst; PD, pancreatic duct; HOP, head of pancreas. Gastroenterology 2002 122, 1631-1648DOI: (10.1053/gast.2002.33576) Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 9 A mucinous cystadenoma appearing as a small unilocular cyst in the pancreatic body measuring 10 × 14 mm. Gastroenterology 2002 122, 1631-1648DOI: (10.1053/gast.2002.33576) Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 10 An EUS image of a mucinous cystadenocarcinoma with intraluminal ingrowth (arrows). Gastroenterology 2002 122, 1631-1648DOI: (10.1053/gast.2002.33576) Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 11 EUS image of a TI rectal tumor (single arrowhead), which is superficial to the muscularis propria (double arrowhead). Gastroenterology 2002 122, 1631-1648DOI: (10.1053/gast.2002.33576) Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 12 Lung cancer staging. A mediastinal lymph node is seen on (A) MRI (arrow) and also on (B) EUS (arrow). This was a patient with non–small cell cancer and recurrent nodal disease. Gastroenterology 2002 122, 1631-1648DOI: (10.1053/gast.2002.33576) Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 13 Radiofrequency ablation. This image shows a gross section of the pancreas after RF ablation. Note the sharp border. (Courtesy of W. Brugge.) Gastroenterology 2002 122, 1631-1648DOI: (10.1053/gast.2002.33576) Copyright © 2002 American Gastroenterological Association Terms and Conditions