Fusaroli Pietro, Caletti Giancarlo
Gastroenterology Unit, Ospedale di Castel S. Pietro Terme, University of Bologna, Italy.
Eur J Gastroenterol Hepatol. 2005 Mar;17(3):293-301. doi: 10.1097/00042737-200503000-00006.
Endoscopic ultrasonography appeared in the clinical arena almost 20 years ago and it has now become a well integrated technique in everyday hospital practice. More than 2000 scientific papers published in the literature have demonstrated its high accuracy for the diagnosis and staging of a variety of benign and malignant conditions. The instrumentation consists of a special endoscope, modified by a high-frequency ultrasound transducer placed on its tip, and an ultrasound driving unit. The main indications to endoscopic ultrasonography can be explained by its ability to visualize the gut wall as a multi-layer structure corresponding to histological layers. Other important indications derive from its capability of displaying, very closely, the structures and lesions surrounding the gut wall, such as the pancreato-biliary area, masses and lymph nodes. Fine-needle aspiration has become an indispensable adjunct to the technique since 1993, when it was shown to be feasible and safe to obtain tissue diagnosis in the majority of the lesions under the reach of endoscopic ultrasonography. In recent years, some authors have dealt with the practical clinical applications of endoscopic ultrasonography, validating its use in many diagnostic and staging algorithms and showing that it is cost-effective and significantly affects patient outcome.
内镜超声检查术大约在20年前出现在临床领域，如今已成为医院日常实践中一项融合良好的技术。文献中发表的2000多篇科学论文已证明其在各种良性和恶性疾病的诊断及分期方面具有很高的准确性。该设备由一台特殊的内窥镜组成，其顶端装有高频超声换能器进行改良，还有一个超声驱动单元。内镜超声检查术的主要适应证可通过其将肠壁可视化为对应组织学层次的多层结构的能力来解释。其他重要适应证源于其能够非常清晰地显示肠壁周围的结构和病变，如胰胆区域、肿块和淋巴结。自1993年以来，细针穿刺已成为该技术不可或缺的辅助手段，当时已证明在内镜超声检查可触及的大多数病变中获取组织诊断是可行且安全的。近年来，一些作者探讨了内镜超声检查术的实际临床应用，验证了其在许多诊断和分期算法中的应用，并表明其具有成本效益且对患者预后有显著影响。
