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2015 ; 7
(9
): E311-25
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Ultrasound techniques in the evaluation of the mediastinum, part I: endoscopic
ultrasound (EUS), endobronchial ultrasound (EBUS) and transcutaneous mediastinal
ultrasound (TMUS), introduction into ultrasound techniques
#MMPMID26543620
Dietrich CF
; Annema JT
; Clementsen P
; Cui XW
; Borst MM
; Jenssen C
J Thorac Dis
2015[Sep]; 7
(9
): E311-25
PMID26543620
show ga
Ultrasound imaging has gained importance in pulmonary medicine over the last
decades including conventional transcutaneous ultrasound (TUS), endoscopic
ultrasound (EUS), and endobronchial ultrasound (EBUS). Mediastinal lymph node
staging affects the management of patients with both operable and inoperable lung
cancer (e.g., surgery vs. combined chemoradiation therapy). Tissue sampling is
often indicated for accurate nodal staging. Recent international lung cancer
staging guidelines clearly state that endosonography (EUS and EBUS) should be the
initial tissue sampling test over surgical staging. Mediastinal nodes can be
sampled from the airways [EBUS combined with transbronchial needle aspiration
(EBUS-TBNA)] or the esophagus [EUS fine needle aspiration (EUS-FNA)]. EBUS and
EUS have a complementary diagnostic yield and in combination virtually all
mediastinal lymph nodes can be biopsied. Additionally endosonography has an
excellent yield in assessing granulomas in patients suspected of sarcoidosis. The
aim of this review, in two integrative parts, is to discuss the current role and
future perspectives of all ultrasound techniques available for the evaluation of
mediastinal lymphadenopathy and mediastinal staging of lung cancer. A specific
emphasis will be on learning mediastinal endosonography. Part I is dealing with
an introduction into ultrasound techniques, mediastinal lymph node anatomy and
diagnostic reach of ultrasound techniques and part II with the clinical work up
of neoplastic and inflammatory mediastinal lymphadenopathy using ultrasound
techniques and how to learn mediastinal endosonography.