Keter Daniel, Melzer Ehud
Department of Gastroenterology and Liver Diseases, Kaplan Medical Center, Rehovot, Israel.
Acta Gastroenterol Latinoam. 2008 Jun;38(2):146-51.
Endoscopic ultrasonography (EUS) is an accurate technique for the diagnosis and staging of benign and malignant lesions in the gastrointestinal tract and the mediastinum. EUS overcomes the limitations of other imaging diagnostic methods and gives the possibility to obtain tissue for histologic diagnosis (EUS guided FNA). The most useful indications of EUS are differentiation of submucosal tumors, staging for neoplasia, examination of the pancreato-biliary system and therapeutics. EUS can distinguish extrinsic compressions from intramural lesions and defines their nature (solid, cystic or vascular) and origin. EUS is useful for local staging of esophageal, gastric, duodenal, and rectal cancer using the TNM (tumor, node, metastases) system, as well as for diagnosing and staging of pancreatic lesions. The addition of EUS-guided FNA has improved the ability to detect malignant lymph node invasion. EUS is also highly sensitive for the diagnosis of choledocholithiasis, avoiding unnecessary danger of diagnostic ERCP. New therapeutic indications of EUS include drainage of pancreatic pseudocysts and abscesses and celiac plexus block and neurolysis. EUS has become an indispensable diagnostic method in gastroenterological everyday practice and should be part of most endoscopy units.
内镜超声检查（EUS）是诊断和分期胃肠道及纵隔良性与恶性病变的一种准确技术。EUS克服了其他影像诊断方法的局限性，并提供了获取组织进行组织学诊断的可能性（EUS引导下细针穿刺抽吸活检）。EUS最有用的适应证是黏膜下肿瘤的鉴别、肿瘤分期、胰胆系统检查及治疗。EUS能够区分外在压迫与壁内病变，并确定其性质（实性、囊性或血管性）及起源。EUS对于使用TNM（肿瘤、淋巴结、转移）系统对食管癌、胃癌、十二指肠癌和直肠癌进行局部分期很有用，对胰腺病变的诊断和分期也很有用。增加EUS引导下细针穿刺抽吸活检提高了检测恶性淋巴结侵犯的能力。EUS对胆总管结石的诊断也高度敏感，避免了诊断性内镜逆行胰胆管造影（ERCP）带来的不必要风险。EUS的新治疗适应证包括胰腺假性囊肿和脓肿引流、腹腔神经丛阻滞及神经松解。EUS已成为胃肠病日常诊疗中不可或缺的诊断方法，应成为大多数内镜科室的一部分。
