Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), New Delhi, India.
Dig Endosc. 2014 May;26(3):482-90. doi: 10.1111/den.12216. Epub 2013 Dec 19.
Endoscopic ultrasound (EUS) can demonstrate the detailed anatomy of the liver from the transgastric and transduodenal routes. Most of the liver segments can be imaged with EUS, except the right posterior segments. The intrahepatic vascular landmarks include the major hepatic veins, portal vein radicals, hepatic arterial branches, and the inferior vena cava, and the venosum and teres ligaments are other important intrahepatic landmarks. The liver hilum and gallbladder serve as useful surface landmarks. Deciphering liver segmentation and anatomy by EUS requires orienting the scan planes with these landmarkstructures, and is different from the static cross-sectional radiological images. Orientation during EUS requires appreciation of the numerous scan planes possible in real-time, and the direction of scanning from the stomach and duodenal bulb. We describe EUS imaging of the liver with a curved linear probe in a step-by-step approach, with the relevant anatomical details, potential applications, and pitfalls of this novel EUS application.
内镜超声（EUS）可通过经胃和经十二指肠途径显示肝脏的详细解剖结构。除了右后叶段外，大多数肝段均可通过 EUS 成像。肝内血管标志包括肝静脉主干、门静脉分支、肝动脉分支和下腔静脉，以及静脉韧带和尾状叶韧带是其他重要的肝内标志。肝门和胆囊是有用的表面标志。通过 EUS 解读肝分段和解剖结构需要用这些标志结构定向扫描平面，这与静态的影像学图像不同。EUS 定向需要实时评估实时可能的多个扫描平面，以及从胃和十二指肠球部进行的扫描方向。我们以逐步的方式描述了使用弯曲线性探头进行的肝脏 EUS 成像，包括相关的解剖细节、这种新型 EUS 应用的潜在应用和陷阱。
