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Bài thuyết trình The update: Endoscopic ultrasound in the diagnosis and treatment of gastroenterology disease

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THE FIRST NATIONAL ULTRASOUND  
CONFERENCE  
THE UPDATE: ENDOSCOPIC ULTRASOUND IN  
THE DIAGNOSIS AND TREATMENT OF  
GASTROENTEROLOGY DISEASES  
Prof.Tran Van Huy - Dr.Vinh Khanh  
Department of Internal Medicine - Hue University of Medicine and Pharmacy  
OBJECTIVES  
1
2
3
1
2
Overview of endoscopic ultrasound  
The role of EUS in the diagnosis  
3
4
The role of EUS in the treatment  
Conclusion  
5
6
OBJECTIVES  
1
2
3
1
2
Overview of endoscopic ultrasound  
The role EUS in the diagnosis  
3
4
The role EUS in the treatment  
Conclusion  
5
6
ENDOSCOPIC ULTRASOUND  
The way to progress  
1st TTS EUS Probe (1976)  
• Integrated EUS scopes (1980)  
• Single frequency scopes (1980)  
• Variable frequency scopes (1985)  
• 1st EUS – FNA (1991)  
• Color Doppler  
• 1st EUS guided cholangiography (1996)  
• Large Channel Scopes  
• 1st EUS guided CD-stomy (2002)  
Interventional Endosonography (2017)  
ENDOSCOPIC ULTRASOUND  
Radial  
For diagnosis  
Linear  
Diagnosis and intervention  
Mini probe  
12MHz – 20 MHz  
RADIAL - LINEAR  
Radial EUS  
L
Imaging  
perpendicular to the  
endoscope  
Linear EUS  
L
Imaging parallel to  
the endoscope  
GI Atlas, Wiley  
Radial EUS  
Linear EUS  
OBJECTIVES  
1
2
3
1
2
Overview of endoscopic ultrasound  
The role of EUS in the diagnosis  
3
4
The role of EUS in the treatment  
Conclusion  
5
6
1. SUBMUCOSA TUMORS  
1. SUBMUCOSA TUMORS  
• Approximately 1 in 300 patients.  
• Diagnosed by endoscopy.  
• EUS: location, layer, size, contour, echogenicity, vascularity.  
- Follow up  
- Accuracy: 90%.  
1. Alexander J. Eckardt, Christian Jenssen (2015), Current endoscopic ultrasound-guided approach to incidental subepithelial lesions: optimal or optional?, Annals  
of Gastroenterology 28, 1-13.  
2. Hwang JH1, Saunders MD, Rulyak SJ, et al. A prospective study comparing endoscopy and EUS in the evaluation of GI subepithelial masses. Gastrointest  
Endosc 2005;62:202-208.  
1.Kazuya Akahoshi (2012),Practical Handbook of Endoscopic Ultrasonography.  
SUBMUCOSA TUMORS  
CYST  
2. GASTROINTESTINAL CANCER  
EUS  
Observe of  
chemo-  
radiotherapy  
Prognosis  
Staging  
THE ROLE OF EUS IN TMN  
STAGING  
N
EUS - FNA  
T
M
Accuracy: 74-  
92%  
TMN  
ACCURACY OF EUS v. CT BY STAGE  
OF ESOPHAGEAL CANCER  
ACCURACY OF EUS v. CT IN THE  
STAGING OF GASTRIC CANCER  
ESOPHAGUS CANCER  
T3N1Mx  
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