Читать книгу Atlas of Endoscopic Ultrasonography - Группа авторов - Страница 4

1 Chapter 1Figure 1.1 Visible Human Model of esophagus, stomach, and duodenum. The gree...Figure 1.2 Visible Human Model of esophagus, stomach, and duodenum. The red ...Figure 1.3 Transaxial cross‐section of digital anatomy taken at the level of...Figure 1.4 Sagittal cross‐section of digital anatomy at the level of the gas...Figure 1.5 Visible Human Model of an image plane that is in the location in ...Figure 1.6 The cross‐sectional anatomy within the plane shown in Figure 1.3....Figure 1.7 Visible Human Model with a plane that is in a location similar to...Figure 1.8 Cross‐sectional anatomy generated within the plane shown in Figur...Figure 1.9 Endobronchial view of the carina, showing the right (RMB) and lef...Figure 1.10 Endobronchial view of the first branch of the right mainstem bro...Figure 1.11 Endobronchial view of the bifurcation of the bronchus intermediu...Figure 1.12 Endobronchial view of bifurcation of the left mainstem bronchus ...Figure 1.13 A Visible Human Model of the bronchial tree.

2 Chapter 2Figure 2.1 (a) Radial array image of esophageal wall with small echolayer II...Figure 2.2 Radial array image at gastroesophageal (GE) junction. IVC, inferi...Figure 2.3 Radial array image at the level of the left atrium. PV, pulmonary...Figure 2.4 Radial array image at the level of the mitral valve.Figure 2.5 Radial array image at the level of the aortic root.Figure 2.6 Radial array image at the level of the azygos arch.Figure 2.7 Radial array image at the mid aortic arch.Figure 2.8 Radial array image at the level of the left carotid and subclavia...Figure 2.9 Radial array image at the level of the thyroid.Figure 2.10 Linear array image at the mid aorta.Figure 2.11 Linear array image at the level of the celiac artery.Figure 2.12 Linear array image at the aortic root.Figure 2.13 Linear array image at the aortopulmonary window (APW). PA, pulmo...

3 Chapter 3Figure 3.1 Mediastinal lymph node stations.Figure 3.2 Types of echoendoscopes: (a) linear probe; (b) endobronchial prob...Figure 3.3 Lymph node at station 8 (between calipers).Figure 3.4 Subcarinal station (station 7).Figure 3.5 Aortopulmonary window station (stations 4L, 5 and 6). AO, aorta; ...Figure 3.6 Endobronchial ultrasound (EBUS) images of common mediastinal stat...

4 Chapter 4Figure 4.1 Circumferential image of the gastric wall after filling and diste...Figure 4.2 Five‐layer structure of the gastric wall demonstrating a relative...Figure 4.3 Five‐layer structure of the gastric wall obtained with an electro...Figure 4.4 Nine‐layer structure of the gastric wall obtained with a 20 MHz c...

5 Chapter 5Figure 5.1 Bile duct as visualized from the duodenal bulb (radial echoendosc...Figure 5.2 Bile duct followed towards the head of the pancreas from the duod...Figure 5.3 Gallbladder from the duodenal bulb (radial echoendoscope). CBD, c...Figure 5.4 Bile duct and pancreatic duct from the second portion of the duod...Figure 5.5 Common hepatic duct and cystic duct as visualized from the duoden...Figure 5.6 Bile duct and pancreatic duct from the second portion of the duod...

6 Chapter 6Figure 6.1 Radial EUS: pancreatic body and portal/splenic vein confluence. P...Figure 6.2 Radial EUS: portal/splenic vein confluence. PV, portal vein; SMA,...Figure 6.3 Radial EUS: pancreas tail. PD, pancreatic duct; SA, splenic arter...Figure 6.4 Radial EUS: pancreas tail.Figure 6.5 Radial EUS: pancreas neck. PD, pancreatic duct; PV, portal vein; ...Figure 6.6 Radial EUS: head of pancreas. DP, dorsal pancreas; VP, ventral pa...Figure 6.7 Radial EUS: ampulla.Figure 6.8 Radial EUS: head of pancreas. CBD, common bile duct; PD, pancreat...Figure 6.9 Radial EUS: head of pancreas, vasculature. CBD, common bile duct;...Figure 6.10 Radial EUS: head of pancreas. CBD, common bile duct; PD, pancrea...Figure 6.11 Linear EUS: pancreas body. PD, pancreatic duct; SA, splenic arte...Figure 6.12 Linear EUS: pancreas tail. PD, pancreatic duct; SV, splenic vein...Figure 6.13 Linear EUS: ampulla.Figure 6.14 Linear EUS: head of pancreas. CBD, common bile duct; PD, pancrea...

7 Chapter 7Figure 7.1 Image of the liver scanned by radial ultrasound.Figure 7.2 Celiac artery imaging by linear ultrasound.Figure 7.3 Image of liver by linear ultrasound.Figure 7.4 Image of spleen by radial ultrasound.Figure 7.5 Image of spleen by linear ultrasound.Figure 7.6 Image of left kidney by radial ultrasound.Figure 7.7 Image of left kidney by linear ultrasound.Figure 7.8 Image of left adrenal gland by radial ultrasound.Figure 7.9 Image of left adrenal gland by linear ultrasound.

8 Chapter 8Figure 8.1 (a) Levator ani muscle with the puborectal part (PR) in between m...Figure 8.2 Internal anal sphincter (echo‐poor) and external anal sphincter (...

9 Chapter 9Figure 9.1 Distal esophageal adenocarcinoma shown to be T1a on pathology. (a...Figure 9.2 T1b adenocarcinoma in a background of Barrett’s esophagus at the ...Figure 9.3 (a) T1b adenocarcinoma at the gastroesophageal junction with cent...Figure 9.4 (a) T2N1Mx lesion, squamous cell cancer with ulceration 24 cm fro...Figure 9.5 (a) T2N0Mx lesion, adenocarcinoma of lower thoracic esophagus inv...Figure 9.6 T3N3Mx lesion, adenocarcinoma involving the lower thoracic esopha...Figure 9.7 (a) T3N1Mx adenocarcinoma with friable mass at the gastroesophage...Figure 9.8 T4a lesion, adenocarcinoma in lower thoracic esophagus invading t...Figure 9.9 T4b lesion, squamous cell cancer in upper thoracic esophagus inva...

10 Chapter 10Figure 10.1 The muscularis propria is divided into two layers, the outer lon...Figure 10.2 Normal esophageal wall layer pattern. Normal thickness of muscul...Figure 10.3 Thickening of the circular muscle wall layer to 3 mm in a patien...Figure 10.4 Thickening of the circular muscle wall layer to an average of 2....Figure 10.5 Thickening of the circular muscle wall layer to an average of 3....Figure 10.6 Thickening of the circular muscle wall layer to an average of 3....Figure 10.7 Uniform thickening of the circular muscle wall layer to an avera...

11 Chapter 11Figure 11.1 American Thoracic Society staging diagram for posterior mediasti...Figure 11.2 Metastatic posterior mediastinal melanoma. Endoscopic ultrasound...Figure 11.3 Renal cell cancer metastasis. The lesion was identified slightly...Figure 11.4 Lung cancer mass. Endoscopic ultrasound‐guided fine needle aspir...Figure 11.5 Malignant lymph node. The needle is within the rounded, well‐dem...

12 Chapter 12Figure 12.1 Benign subcarinal lymph nodes. Note the oval and triangular‐shap...Figure 12.2 Sarcoid lymph nodes. Note the matted together, draping nodes wit...Figure 12.3 Cryptococcal lymph node. These were incidental lymph nodes found...Figure 12.4 Duplication cyst. Note the anechoic appearance with acoustic enh...Figure 12.5 Enlarged lymph node due to Blastocystis hominis infection.

13 Chapter 13Figure 13.1 T1 gastric cancer. This is a 2.2 × 0.5 cm thick tumor confined t...Figure 13.2 T2 gastric cancer. This large 4.2 × 3.6 cm exophytic tumor invad...Figure 13.3 T3 gastric cancer. This 2.5 × 1.6 cm tumor invades through all l...Figure 13.4 T4 gastric cancer. This invasive poorly differentiated cancer in...Figure 13.5 Diffuse gastric cancer. The stomach is thickened to 0.8 cm (norm...Figure 13.6 Pseudo‐linitis plastica. A patient with breast cancer has metast...Figure 13.7 Gastric lymphoma causing a linitis plastica appearance. This pat...Figure 13.8 Gastric lymphoma. The five‐layer wall pattern is obliterated and...Figure 13.9 Perigastric lymphadenopathy in a patient with primary gastric ly...Figure 13.10 Ascites. A large pocket of hypoechoic material is seen next to ...Figure 13.11 Endoscopic ultrasound‐guided fine needle aspiration (EUS‐FNA) o...

14 Chapter 14Figure 14.1 Lipoma. (a) Endoscopic view of lipoma with smooth overlying muco...Figure 14.2 Carcinoid tumor. (a) Endoscopic view of a carcinoid tumor. (b) E...Figure 14.3 Granular cell tumor. (a) Endoscopic view of esophageal granular ...Figure 14.4 Esophageal duplication cysts. (a) Endoscopic view of several eso...Figure 14.5 Pancreatic rest. (a) Endoscopic view of a gastric antral pancrea...Figure 14.6 Esophageal varices. (a) Endoscopic view of grade 3 esophageal va...Figure 14.7 Gastric gastrointestinal stromal tumor (GIST). (a) Endoscopic vi...Figure 14.8 Leiomyoma. (a) Endoscopic view of an esophageal leiomyoma. (b) E...Figure 14.9 Glomus tumor. (a) Endoscopic view of a gastric antral glomus tum...Figure 14.10 Gastritis cystica profunda (GCP). (a) Endoscopic view showing G...Figure 14.11 Extrinsic compression. (a) Endoscopic and EUS view of extrinsic...

15 Chapter 15Figure 15.1 (a) A T1 rectal adenocarcinoma (by radial EUS) arising in a vill...Figure 15.2 (a) A rectal adenocarcinoma that appears to be T2 (penetration i...Figure 15.3 Radial EUS of a T3 lesion showing the primary rectal tumor penet...Figure 15.4 Radial EUS of the patient in Figure 15.3 showing a 7‐mm round, p...Figure 15.5 EUS‐guided fine needle aspiration of a perirectal lymph node. Th...Figure 15.6 Recurrent rectal cancer. During surveillance colonoscopy in a pa...Figure 15.7 (a) A subepithelial bulge in the rectum from a large intramural ...Figure 15.8 Rectal carcinoid. (a) A rectal bulge was noted during routine co...

16 Chapter 16Figure 16.1 Schematic diagram of the anal canal. EAS, external anal sphincte...Figure 16.2 Normal anal sphincter complex. The internal anal sphincter (IAS)...Figure 16.3 Normal anal sphincter complex. The internal anal sphincter (IAS)...Figure 16.4 Forty percent defect in both the internal hypoechoic anal sphinc...Figure 16.5 Forty percent defect in external anal sphincter (EAS), likely du...Figure 16.6 Thirty percent defect in both the internal anal sphincter (IAS) ...Figure 16.7 Transperineal three‐dimensional ultrasound images showing the an...Figure 16.8 Transverse (cross‐sectional) 1‐mm multislice imaging of the norm...Figure 16.9 Perianal fistula. Note that the anechoic tubular structure is ou...Figure 16.10 Perianal fistula with small perianal abscess measuring 11 × 7 m...Figure 16.11 Perianal abscess and fistula.Figure 16.12 Post‐hydrogen peroxide injection image of the perianal fistula ...Figure 16.13 Perianal fistula. A hyperechoic path is visible, starting on th...Figure 16.14 The path of a complex perianal fistula is identified by inserti...Figure 16.15 Perirectal abscess. A 36‐year‐old woman with history of Crohn’s...Figure 16.16 Anastomotic abscess. A patient with history of sigmoidectomy fo...

17 Chapter 17Figure 17.1 (a, b) Classification of intestinal endometriosis according to R...Figure 17.2 Endometriosis sites with alteration of the colonic wall of the r...Figure 17.3 (a, b) Endoscopic view of the area of sigmoid substenosis. (c) P...Figure 17.4 Radial scanning with two foci in different locations: (a, b) rec...Figure 17.5 (a) Bulging of the upper rectum wall. (b–d) Radial exploration o...Figure 17.6 (a, b) Radial exploration of sites of hypoechoic, homogeneous, s...Figure 17.7 (a, b) Radial exploration of a heterogeneous hypoechoic focus wi...Figure 17.8 (a, b) Endoscopic view of the upper rectum showing bulging of th...Figure 17.9 (a, b) Extrinsic sigmoid compression of a left ovary endometriom...Figure 17.10 (a) Colonoscopy showing a subepithelial lesion as sigmoid bulgi...Figure 17.11 (a) Bulging of the rectosigmoid junction. (b, c) Sectoral explo...Figure 17.12 Endometrial gland and endometrial stroma and superficial coloni...Figure 17.13 Radial scanning EUS of two foci of endometriosis located in two...Figure 17.14 Glandular cells aspirated from endometrial lining.

18 Chapter 18Figure 18.1 A radial array endoscopic ultrasound image of a calcific aortic ...Figure 18.2 A linear array image of the aortopulmonary window with an isoech...Figure 18.3 A linear array image showing the aortic root with clot due to an...Figure 18.4 Radial array Doppler image of a clot in the splenic vein.Figure 18.5 A linear array image of a metastasis (T) from breast cancer to t...Figure 18.6 A linear array image of a rhabdomyosarcoma infiltrating into the...

19 Chapter 19Figure 19.1 The linear array echoendoscope is in the duodenum directly adjac...Figure 19.2 A hypoechoic mass is seen here arising from the ampulla. The mal...Figure 19.3 An ampullary lesion is noted endoscopically. On EUS, water is in...

20 Chapter 20Figure 20.1 In this example of a small bile duct malignancy, a focal hypoech...Figure 20.2 The linear array echoendoscope is positioned in the second porti...Figure 20.3 This 78‐year‐old woman has unresectable pancreatic cancer. Endos...Figure 20.4 This 46‐year‐old woman presented with elevated liver function te...

21 Chapter 21Figure 21.1 Gallbladder stone (arrow) with posterior shadowing.Figure 21.2 Gallbladder stone (arrow) with posterior shadowing.Figure 21.3 Gallbladder sludge (arrow).Figure 21.4 Gallbladder microlithiasis (arrows).Figure 21.5 Gallbladder polyps (arrows). Notice the lack of shadowing.Figure 21.6 Gallbladder polyps (arrows). Notice the lack of shadowing.Figure 21.7 Gallbladder carcinoma (arrow).Figure 21.8 Thickened gallbladder wall (arrow).

22 Chapter 22Figure 22.1 (a) Representative EUS image of a large pancreatic adenocarcinom...Figure 22.2 EUS‐guided FNA of a pancreatic adenocarcinoma with a 22‐gauge ne...Figure 22.3 EUS image of a pancreatic adenocarcinoma in the body of the panc...Figure 22.4 A 2‐cm pancreatic head mass seen to abut and compress the common...Figure 22.5 Large pancreatic cancer in the head of the pancreas seen to enca...Figure 22.6 A 15‐mm peripancreatic lymph node. Node is hypoechoic, round, we...Figure 22.7 EUS‐guided FNA of a large, 4‐cm peripancreatic node in a patient...

23 Chapter 23Figure 23.1 Images obtained from a patient with a gastrinoma following helic...Figure 23.2 Following a negative computed tomography (CT) to search for a pr...Figure 23.3 Linear endoscopic ultrasound imaging of a patient with a pancrea...Figure 23.4 Endoscopic ultrasound revealed a large well‐circumscribed hypoec...Figure 23.5 A pancreatic head acinar cell tumor is identified by endoscopic ...Figure 23.6 The varied appearance of metastatic tumors to the pancreas is de...

24 Chapter 24Figure 24.1 Classic endoscopic ultrasound appearance of autoimmune pancreati...Figure 24.2 Almost classic endoscopic ultrasound appearance of autoimmune pa...Figure 24.3 Almost classic endoscopic ultrasound appearance of autoimmune pa...Figure 24.4 Endoscopic ultrasound finding of a mass‐like lesion in a patient...Figure 24.5 Endoscopic ultrasound features of nonspecific chronic pancreatit...Figure 24.6 Histologic examination of endoscopic ultrasound‐guided Tru‐cut b...Figure 24.7 IgG₄ immunostaining of the Tru‐cut biopsy specimen reveals the f...

25 Chapter 25Figure 25.1 Thick‐walled cystic lesion undergoing fine needle aspiration (FN...Figure 25.2 Serous cystadenoma. Multicystic lesion in the body of the pancre...Figure 25.3 (a) Mucinous cystic neoplasm with multiple septations. The lesio...Figure 25.4 (a) Thinly septated intraductal papillary mucinous neoplasm (IPM...Figure 25.5 (a) Pancreatic cystic endocrine tumor. Note the presence of the ...

26 Chapter 26Figure 26.1 Reformatted computed tomography scan demonstrating a side‐branch...Figure 26.2 Magnetic resonance cholangiopancreatography demonstrating a side...Figure 26.3 Linear endoscopic ultrasound image demonstrating a dilated main ...Figure 26.4 Linear endoscopic ultrasound image revealing a small cystic lesi...Figure 26.5 Linear endoscopic ultrasound image of a malignant‐appearing 2.9‐...Figure 26.6 Fine needle aspiration of a malignant cystic mass.Figure 26.7 International Association of Pancreatology (IAP) algorithm for m...

27 Chapter 27Figure 27.1 Endoscopic ultrasound (linear) showing features of chronic pancr...Figure 27.2 Endoscopic ultrasound showing a hyperechoic duct wall (crossmark...

28 Chapter 28Figure 28.1 (a) Cirrhosis. The cirrhotic liver is characterized by diffuse, ...Figure 28.2 Fatty liver is described as diffuse or as foci of hyperechoic or...Figure 28.3 Simple hepatic cyst can be seen here as an anechoic fluid‐filled...Figure 28.4 (a, b) Metastatic liver disease. Lesions found within the hepati...Figure 28.5 Dilated intrahepatic ducts (arrows) are visualized here and are ...

29 Chapter 29Figure 29.1 (a) Core biopsies demonstrate intact tissue architecture and str...Figure 29.2 Diagnostic features of autoimmune pancreatitis rely on the demon...Figure 29.3 Aspirate smears demonstrate fine cellular detail such as squamou...Figure 29.4 Cell blocks, prepared from fine needle aspirate material and pla...Figure 29.5 Clotted blood within the needle obscures lesional tissue (a). Op...Figure 29.6 Air‐dried slides stained with a modified Romanowsky stain demons...Figure 29.7 Distinctive or commonly encountered in endoscopic ultrasound‐gui...

30 Chapter 30Figure 30.1 The International Association for the Study of Lung Cancer (IASL...

31 Chapter 31Figure 31.1 (a) Hypoechoic, irregular, 3‐cm adenocarcinoma in the head of pa...Figure 31.2 (a) Small adenocarcinoma in the head of pancreas adjacent to the...Figure 31.3 (a) Large 5‐cm adenocarcinoma in the tail of pancreas. (b) Mass ...Figure 31.4 (a) A 2‐cm mass in the head of pancreas with acoustic interferen...Figure 31.5 (a) Small 1‐cm hypoechoic neuroendocrine tumor in the head of pa...Figure 31.6 (a) Cystic neoplasm with malignant degeneration in the head of p...Figure 31.7 Hepatic metastases visualized during EUS examination for a pancr...

32 Chapter 32Figure 32.1 EUS of left lobe of liver.Figure 32.2 EUS of aorta, celiac artery (CA), and superior mesenteric artery...Figure 32.3 Transgastric EUS examination of pancreas (genu, body, tail).Figure 32.4 Transduodenal EUS examination of pancreas (head and uncinate pro...Figure 32.5 (a) EUS of anechoic septated lobular cyst in tail of pancreas. (...Figure 32.6 Position lesion at 6 o’clock for FNA/FNB.Figure 32.7 EUS with Doppler showing blood vessels (purple) in path of needl...Figure 32.8 EUS needle handle.Figure 32.9 FNA needle within pancreatic cyst (yellow arrow indicates tip of...Figure 32.10 Vacuum syringe.Figure 32.11 Serous fluid aspirated from large pancreatic cyst.Figure 32.12 String sign consistent with mucinous cyst.

33 Chapter 33Figure 33.1 A large unilocular pseudocyst with clear contents as visualized ...Figure 33.2 Two pseudocysts are seen at EUS: the promixal lesion on FNA anal...Figure 33.3 Presence of intervening vasculature between the EUS transducer a...Figure 33.4 Endoscopic ultrasound guidance enables access to the pseudocyst ...Figure 33.5 Pseudocyst accessed with a 19‐gauge FNA needle.Figure 33.6 (a) Acute angulation encountered when the echoendoscope is locat...Figure 33.7 A 0.035‐inch guidewire is coiled within the pseudocyst under flu...Figure 33.8 The transmural tract is dilated using a 5‐Fr endoscopic retrogra...Figure 33.9 The transmural tract is subsequently dilated using an 8 mm over‐...Figure 33.10 Multiple 7‐Fr transmural stents are deployed (fluoroscopy view)...Figure 33.11 (a) Endoscopic view of the proximal flange of the LAMS in the s...

34 Chapter 34Figure 34.1 The alcohol free EUS‐guided cyst ablation process. The FNA needl...Figure 34.2 A high‐pressure gun, syringe, and short connector tubing assembl...Figure 34.3 (a) Magnetic resonance image showing a 76‐year‐old female with a...Figure 34.4 (a) MRI (top) and magnetic resonance cholangiopancreatography (M...

35 Chapter 35Figure 35.1 Hypoechoic pancreatic mass as seen by EUS.Figure 35.2 Endoscopic ultrasound demonstration of lobularity, one of the ma...Figure 35.3 Celiac axis (CA) as seen by EUS. AO, aorta.Figure 35.4 Celiac axis confirmed by the aorta, celiac artery (CA) and super...Figure 35.5 Insertion of the EUS‐guided fine needle aspiration needle into t...

36 Chapter 36Figure 36.1 Gold coil fiducial marker is (a) flexible and (b) has a coiled d...Figure 36.2 Gold coil fiducial preloaded on needle‐carrier delivery device....Figure 36.3 Endoscopic ultrasound image (linear array) of fiducial within an...Figure 36.4 Abdominal radiograph (anteroposterior view) demonstrating three ...

37 Chapter 37Figure 37.1 Initial assessment of tumor size by endoscopic ultrasound (EUS) ...Figure 37.2 Endoscopic ultrasound (EUS)‐guided fine needle injection (FNI) o...Figure 37.3 Tumor assessment during weekly injections of chemotherapeutic ag...Figure 37.4 Gross specimen of the resected pancreas in Figure 37.3 revealing...Figure 37.5 Histology from the specimen in Figure 37.4 demonstrating a compl...

38 Chapter 38Figure 38.1 Computed tomography (CT) scan of the pelvis revealing an 8 × 7 c...Figure 38.2 Passage of a 19‐gauge fine needle aspiration (FNA) needle into t...Figure 38.3 A 0.035‐inch guidewire is then coiled within the abscess cavity:...Figure 38.4 Fluoroscopy view revealing dilation of the tract using an endosc...Figure 38.5 Fluoroscopic view revealing the presence of a stent within the p...

39 Chapter 39Figure 39.1 VTI endoscopic Doppler system. (a) A 20‐MHz pulsed‐wave Doppler ...Figure 39.2 Endo‐Dop, 16‐MHz pulsed‐wave, multigated Doppler ultrasound (Dop...Figure 39.3 Illustration of a bleeding peptic ulcer with a non‐bleeding visi...Figure 39.4 Doppler ultrasound (DopUS) in acute peptic ulcer bleeding. (a) E...Figure 39.5 Doppler ultrasound‐guided hemostasis in acute peptic ulcer bleed...Figure 39.6 Atypical peptic ulcer bleeding: recurrent major bleeding from a ...Figure 39.7 Doppler‐negative non‐bleeding visible vessel. Endoscopic image o...Figure 39.8 Atypical appearance of a bleeding gastric varix. Mild active ooz...Figure 39.9 Doppler ultrasound examination of a gastrointestinal stromal tum...Figure 39.10 Dieulafoy lesion in gastric cardia. (a) Active bleeding. (b) Do...Figure 39.11 Dieulafoy lesion in rectum, Doppler with strong arterial signal...

40 Chapter 40Figure 40.1 Compact manometer for EUS‐guided portal pressure measurement....Figure 40.2 EUS‐guided portal pressure measurement apparatus showing noncomp...Figure 40.3 EUS image (a) and schematic (b) of needle puncture of the middle...Figure 40.4 EUS Doppler flow image of the middle hepatic vein demonstrating ...Figure 40.5 EUS image (a) and schematic (b) of needle puncture of the left p...Figure 40.6 EUS Doppler flow image of the left portal vein demonstrating typ...

41 Chapter 41Figure 41.1 Visualization of the left hepatic lobe from the proximal stomach...Figure 41.2 View of liver (on the left) and spleen (on the right) from the p...Figure 41.3 Right lobe biopsies are obtained with the echoendoscope tip plac...Figure 41.4 Close‐up of the tips of the core needles used for EUS‐LB: (left)...Figure 41.5 Comparison of a 19G FNB needle to 19G FNA needle in terms of (a...Figure 41.6 Excellent core of cirrhotic liver obtained with the 19G FNB nee...Figure 41.7 Priming the needle with heparin for wet suction technique.Figure 41.8 (a) Use of tissue sieve (CoreCatcher; ProAct Ltd, Center Hall, P...Figure 41.9 Long liver core is placed in formalin jar without excessive hand...

42 Chapter 42Figure 42.1 Endoscopic imaging of gastric varix.Figure 42.2 Gastric varix seen by endoscopic ultrasonography.Figure 42.3 Gastric varix seen with color Doppler.Figure 42.4 Needle inside the varix.Figure 42.5 Obliterated varix right after treatment.Figure 42.6 Radiographic image of the coil inside the varix.

43 Chapter 43Figure 43.1 Patient 1 with refractory bleeding due to gastric cancer. (a) Bl...Figure 43.2 Patient 2 with bleeding pseudoaneurysm located to the pancreatic...

44 Chapter 44Figure 44.1 EUS‐guided RFA with contrast enhancement control for NET located...

45 Chapter 45Figure 45.1 Access points and routes for EUS‐PDD: 1, transgastric rendezvous...Figure 45.2 Transgastric EUS‐guided rendezvous for MPD drainage. (a) Dilated...Figure 45.3 Transgastric EUS‐PDD. (a) Dilated MPD at the level of the pancre...Figure 45.4 The novel wire‐guided fine‐gauge electrocautery dilator, with a ...Figure 45.5 Algorithm for EUS‐PDD. *, depending on the anatomic conditions a...

46 Chapter 46Figure 46.1 Puncture of gallbladder with 19‐gauge needle with linear echoend...Figure 46.2 Contrast injection within the gallbladder.Figure 46.3 Puncturing of gallbladder with forward‐viewing echoendoscope.Figure 46.4 Looping of guidewire within the gallbladder.Figure 46.5 Tract dilatation with 4‐mm biliary balloon (EUS view).Figure 46.6 (a) Distal flange of AXIOS stent deployed under EUS guidance. (b...Figure 46.7 (a) Luminal view of “black mark” with the AXIOS stent. Once the ...Figure 46.8 (a) Luminal view with SPAXUS stent using the deployment‐in‐chann...Figure 46.9 Direct puncture with the Hot AXIOS into the gallbladder.

47 Chapter 47Figure 47.1 Puncture of the targeted bowel under endosonography.Figure 47.2 Deployment of the lumen‐apposing metal stent into the small bowe...Figure 47.3 Balloon dilatation of the lumen‐apposing metal stent.Figure 47.4 Visualization of the bowel through the fully distended lumen‐app...

48 Chapter 48Figure 48.1 Standard EUS elastographic image. A ROI is used to define the ar...Figure 48.2 EUS‐guided elastography of a malignant lymph node. This image em...Figure 48.3 Pancreatic adenocarcinoma displaying a predominantly heterogeneo...Figure 48.4 Mass forming chronic pancreatitis displaying a predominantly het...Figure 48.5 EUS‐guided elastography from normal pancreas showing a predomina...Figure 48.6 EUS‐guided elastography displaying a blue pattern in a metastati...Figure 48.7 EUS‐guided elastography of a typical benign lymph node.Figure 48.8 Elastographic evaluation of a subepithelial lesion showing a het...Figure 48.9 Metastatic lesion on left adrenal gland, from a lung cancer, dis...

49 Chapter 49Figure 49.1 Principle of contrast harmonic imaging.Figure 49.2 Behavior of microbubbles when exposed to ultrasound beams based ...Figure 49.3 Contrast‐enhanced endoscopic ultrasonography (CH‐EUS) procedures...Figure 49.4 Contrast‐enhanced pattern compared to the surrounding tissue: (a...Figure 49.5 Comparison of contrast‐enhanced patterns in the lesion: (a) homo...Figure 49.6 Detecting a lesion via contrast‐enhanced endoscopic ultrasonogra...Figure 49.7 Distinguishing a mural nodule from a mucous clot using contrast‐...Figure 49.8 Typical contrast‐enhanced endoscopic ultrasonography (CH‐EUS) fi...Figure 49.9 Contrast‐enhanced endoscopic ultrasonography (CH‐EUS) for gastro...Figure 49.10 Distinguishing malignant from benign lymph nodes in contrast‐en...

50 Chapter 50Figure 50.1 EUS‐RFA radiofrequency system. a) EUSRA (STARmed, Goyang, South ...Figure 50.2 EUS‐guided radiofrequency ablation of a pancreatic tail symptoma...Figure 50.3 EUS‐guided radiofrequency ablation of a pancreatic tail symptoma...Figure 50.4 EUS‐guided radiofrequency ablation of a pancreatic tail symptoma...

51 Chapter 51Figure 51.1 Moray micro forceps.Figure 51.2 Overview of nCLE technique.

52 Chapter 52Figure 52.1 (a) Dissected specimen: esophagus, stomach, duodenum, pancreas, ...Figure 52.2 Vascular simulation of aorta and use of the color Doppler featur...Figure 52.3 Simulation of hepatic nodules and lymph nodes. (a) Incision in t...Figure 52.4 Simulation of subepithelial lesions. (a) Serous and muscle layer...Figure 52.5 Ex vivo model for EUS‐FNA of cystic lesions. The cysts were crea...Figure 52.6 Ex vivo model for pseudocyst drainage. The pseudocysts were crea...Figure 52.7 Ex vivo model for dilated hepatocholedochus evaluation. The hepa...Figure 52.8 Ex vivo model for EUS biliary drainage. The dilated biliary trac...

53 Chapter 53Figure 53.1 There is a perigastric varix present within the wall of a necrot...Figure 53.2 (a, b) Hyperechoic and isoechoic solid necrosis within necrotic ...Figure 53.3 (a, b) Clots and blood products within a peripancreatic collecti...Figure 53.4 Lumen‐apposing metal stent placed for cystgastrostomy.Figure 53.5 CT scan demonstrates two LAMS stents from the stomach and duoden...Figure 53.6 (a, b) Endoscopic necrosectomy with rat tooth forceps and retrie...Figure 53.7 CT scan shows local pneumoperitoneum around the cystastrostomy s...Figure 53.8 Over‐the‐scope clip placement for closure of cystgasatrostomy si...Figure 53.9 Purulence and infection as a result of occlusion of LAMS cystgas...

54 Chapter 54Figure 54.1 Fine needle aspiration versus fine needle biopsy needles.Figure 54.2 EUS of aorta, celiac artery (CA) and superior mesenteric artery ...Figure 54.3 Tail of pancreas (yellow arrow) and spleen.Figure 54.4 EUS‐guided (a) transgastric and (b) transduodenal pancreatic tis...Figure 54.5 Large heterogeneous well‐defined pancreatic head mass.Figure 54.6 Vessels (yellow arrow) in path of FNB needle to pancreatic mass....Figure 54.7 Fine needle biopsy handle.Figure 54.8 EUS‐FNB of pancreatic mass. Tip of FNB needle seen within mass (...Figure 54.9 Fanning to increase tissue acquisition.Figure 54.10 Macroscopically visible strands of fine needle biopsy tissue....

55 Chapter 55Figure 55.1 View of the excluded stomach from the gastric pouch using a line...Figure 55.2 A 19‐gauge needle is used to puncture the excluded stomach under...Figure 55.3 Fluoroscopic view of the excluded stomach after injection of con...Figure 55.4 View of lumen‐apposing metal stent after deploying the proximal ...Figure 55.5 Fluoroscopic view after successful creation of a gastro‐gastric ...Figure 55.6 Dilation of the lumen‐apposing metal stent channel during the in...Figure 55.7 Careful advancement of a duodenoscope through a freshly placed l...Figure 55.8 Fluoroscopic view of a double pigtail stent placed within the lu...Figure 55.9 Gastro‐gastric fistula seen endoscopically following removal of ...