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超声内镜检查:新的治疗前沿。

Echo-endoscopy: new therapeutic frontiers.

作者信息

Cho C M, Dewitt J, Al-Haddad M

机构信息

Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202-5149, USA.

出版信息

Minerva Gastroenterol Dietol. 2011 Jun;57(2):139-58.

Abstract

Endoscopic ultrasound (EUS) has been established as a valuable diagnostic modality as it offers high-resolution imaging and fine-needle biopsy, which is essential in detecting and staging malignancies. Since the introduction of EUS-guided fine needle aspiration (EUS-FNA) in 1992, numerous novel EUS-based interventions and techniques have emerged. Currently, established interventional EUS techniques include celiac plexus block and neurolysis, drainage of pancreatic pseudocysts and pelvic fluid collections, and implantation of fiducial markers and radioactive seeds into the malignant tumors. Emerging EUS-guided experimental techniques include antitumor injection, ablation of tumors, and vascular access. Diagnostic and therapeutic access to the biliary tree and pancreatic duct is increasingly being used for failed ERCP procedures or inaccessible ducts. Interventional EUS is a very promising technique with many potential applications. The future holds promise for substantial progress in EUS-guided therapeutic interventions and their applications in clinical gastroenterology.

摘要

内镜超声(EUS)已成为一种有价值的诊断方式,因为它能提供高分辨率成像和细针穿刺活检,这对检测恶性肿瘤及进行分期至关重要。自1992年引入内镜超声引导下细针穿刺抽吸术(EUS-FNA)以来,出现了许多基于内镜超声的新型介入技术。目前,成熟的内镜超声介入技术包括腹腔神经丛阻滞和神经松解、胰腺假性囊肿及盆腔积液引流,以及在恶性肿瘤中植入基准标记物和放射性粒子。新兴的内镜超声引导下实验技术包括抗肿瘤注射、肿瘤消融和血管通路建立。对于失败的内镜逆行胰胆管造影(ERCP)操作或难以到达的胆管,越来越多地采用诊断性和治疗性的胆管及胰管通路。内镜超声介入是一项非常有前景的技术,有许多潜在应用。未来,内镜超声引导下的治疗性干预及其在临床胃肠病学中的应用有望取得重大进展。

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