WFUMB Course Book

Elastography - Chapter 33 Media Library

Chapter Images

Fig 34.1 Wall layers of the stomach as shown using a radial echoendoscope (1st echogenic layer, internal interface echo; 2nd hypoechoic level; mucosa; 3rd hyperechoic layer; submucosa; 4th hypoechoic level; muscularis propria; 5th hyperechoic level, external interface echo corresponding to serosal layer)
Fig 34.2a Scirrhous gastric cancer. Endoscopic image showing thickened and flat gastric folds)
Fig 34.2b Scirrhous gastric cancer. With radial EUS marked thickening of gastric wall (between markers) with partial loss of layering and a small amount of perigastric fluid are visible (1st echogenic layer, internal interface echo; 2nd hypoechoic level; mucosa; 3rd hperechoic layer; submucosa; 4th hypoechoic level; muscularis propria; 5th hyperechoic level, external interface echo corresponding to serosal layer)
Fig 34.3a Mediastinal LN as shown using longitudinal EUS. Large lymph node with a benign phenotype (flat-oval; hyperechoic hilum) in a patient with sarcoidosis
Fig 34.3b Mediastinal LN as shown using longitudinal EUS. Large LN with a malignant phenotype (round-oval, hypoechoic with loss of echogenic hilum) in a patient with small cell lung cancer
Fig 34.4 Common bile duct stone (between markers, 5 x 2.9 mm; longitudinal EUS)
Fig 34.5a Dilated intrahepatic bile ducts (left liver love) in a patient with primary sclerosing cholangitis and extrahepatic bile duct cancer (longitudinal EUS)
Fig 34.5b Irregular hypoechoic thickened wall of the common hepatic duct (wall between markers) in a patient with primary sclerosing cholangitis and extrahepatic bile duct cancer (longitudinal EUS)
Fig 34.6a Longitudinal EUS in a patient with a pancreatic tumor. B-Mode EUS shows a well circumscribed large hypoechoic pancreatic body tumor
Fig 34.6b Longitudinal EUS in a patient with a pancreatic tumor. With Color Doppler (CD) EUS many irregular branching vessels are visible
Fig 34.6c Longitudinal EUS in a patient with a pancreatic tumor. EUS-FNA (22 Gauge needle, markers) confirmed diagnosis of pancreatic neuroendocrine tumor
Fig 34.7a Longitudinal EUS in a patient with a pancreatic tumor. B-Mode EUS shows a well circumscribed large hypoechoic pancreatic head tumor
Fig 34.7b Longitudinal EUS in a patient with a pancreatic tumor. With EUS elastography the tumor is markedly (x 126) harder compared to surrounding pancreatic parenchyma
Fig 34.7c Longitudinal EUS in a patient with a pancreatic tumor. In contrast to the pancreatic neuroendocrine tumor shown in figure 4, CD EUS shows only a few peripheral vessels
Fig 34.7d Longitudinal EUS in a patient with a pancreatic tumor. EUS-FNA (22 Gauge needle, markers) confirmed diagnosis of pancreatic ductal adenocarcinoma
Fig 34.8 Microcystic serous cystadenoma of the pancreas (longitudinal EUS). Note the multiple small and larger cysts and echogenic septae
Fig 34.9a EUS-FNA of a small liver nodule (10 mm) suspected to be a metastasis of ductal pancreatic carcinoma (same patient as Fig 34.7). The nodule (between markers) is hypoechoic and hard by elastography
Fig 34.9b EUS-FNA of a small liver nodule (10 mm) suspected to be a metastasis of ductal pancreatic carcinoma (same patient as Fig 34.7). The nodule (between markers) is hypoechoic and EUS-FNA confirmed diagnosis of metastasis of adenocarcinoma (pancreatobiliary immunotype)
Fig 34.10a Subepithelial rectal tumor 1 year after endoscopic resection of a T1a rectal cancer. Radial EUS; 1st echogenic layer, internal interface echo; 2nd hypoechoic level; mucosa; 3rd hperechoic layer; submucosa; 4th hypoechoic level; muscularis propria)
Fig 34.10b Subepithelial rectal tumor 1 year after endoscopic resection of a T1a rectal cancer. EUS-FNA (longitudinal EUS; 22 Gauge needle, markers) revealed diagnosis of adenocarcinoma (intestinal immunotype)
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