Department of Radiology, Addenbrooke's Hospital Cambridge, Box 219, Hills Road, Cambridge CB2 2QQ, UK.
Postgrad Med J. 2010 Jun;86(1016):346-53. doi: 10.1136/pgmj.2009.096065.
Endoscopic ultrasound (EUS) has become important in a variety of clinical settings. Echoendoscopes may be categorised into radial and linear configurations. Radial devices are used for diagnostic imaging, whereas linear echoendoscopes also facilitate image guided tissue sampling and intervention. EUS is an established primary diagnostic tool for a number of conditions including choledocholithiasis and biliary microlithiasis. It is therefore well suited to the investigation of the aetiology of pancreatitis where simpler measures fail to identify the aetiology. It can also be used to identify chronic non-calcific pancreatitis. EUS is important in the secondary evaluation of abnormalities detected by other imaging modalities-for example, cystic pancreatic lesions. The high resolution of EUS allows more detailed image based analysis than other imaging modalities. The ability to sample cyst fluid significantly increases the accuracy of lesion characterisation. Most importantly, EUS has become indispensable in the staging of a variety of upper gastrointestinal tract tumours. If resection is being considered, the high resolution images obtained via EUS are invaluable for local tumour staging. EUS guided tissue sampling permits accurate nodal staging without relying on lymph node size as proxy for malignant infiltration. In patients with contraindications to magnetic resonance imaging, EUS is an alternative for the staging of rectal carcinoma. It is used in the staging of lung cancer, often in combination with endobronchial ultrasound. Finally, EUS is used therapeutically in image guided drainage (such as gastrocystostomy in pancreatic pseudocyst) and coeliac plexus neurolysis in patients with abdominal pain caused by pancreatic cancer or pancreatitis.
内镜超声（EUS）在各种临床环境中变得越来越重要。超声内镜可分为径向和线性两种配置。径向设备用于诊断成像，而线性超声内镜还可辅助图像引导的组织取样和介入治疗。EUS 是许多疾病的既定主要诊断工具，包括胆总管结石和胆微石症。因此，它非常适合于胰腺炎病因的调查，对于那些简单措施无法确定病因的情况尤其适用。它也可用于识别慢性非钙化性胰腺炎。EUS 在其他影像学检查方法发现的异常的二级评估中很重要，例如囊性胰腺病变。EUS 的高分辨率允许比其他影像学检查更详细的基于图像的分析。对囊液进行取样的能力显著提高了病变特征描述的准确性。最重要的是，EUS 在各种上消化道肿瘤的分期中变得不可或缺。如果考虑进行手术切除，EUS 获得的高分辨率图像对于局部肿瘤分期非常有价值。EUS 引导下的组织取样允许进行准确的淋巴结分期，而无需依赖淋巴结大小作为恶性浸润的替代指标。对于磁共振成像禁忌的患者，EUS 是直肠癌分期的替代方法。它用于肺癌的分期，通常与支气管内超声联合使用。最后，EUS 可在图像引导引流（如胰腺假性囊肿的胃囊造口术）和腹腔神经丛松解术治疗中发挥作用，用于治疗因胰腺癌或胰腺炎引起的腹痛。
