Endoscopic ultrasound advances, part 1: diagnosis.

Abstract

Initially developed in the 1980s, interest in EUS has increased in the past decade. Introduced primarily as a diagnostic modality, it has enabled the endosonographer to visualize details of anatomy and pathology not previously attainable by most gastroenterologists or radiologists. The list of indications for EUS is growing, which has forced gastroenterologists to ‘think outside the lumen’. The introduction of linear echoendoscopes facilitated FNA by enabling the endosonographer to trace the path of the needle tip during the puncture process. FNA techniques have allowed for tissue and fluid sampling for diagnostic purposes. The most common diagnostic indications of EUS are summarized in Table 1. TABLE 1 Diagnostic indications for endoscopic ultrasound EUS may not be foremost in the minds of gastroenterologists as a diagnostic and therapeutic tool. However, the combined ability to image the layers of the bowel wall and adjacent structures, and to sample these by FNA, has resulted in a powerful modality that can influence clinical decision making. A previous review in this Journal (5) discussed the more common indications for EUS. The present article discusses some of the recent advances in the diagnostic role of EUS.