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New endoscopic ultrasonography techniques for pancreaticobiliary diseases
Ken Kamata,Masayuki Kitano,Shunsuke Omoto,Kumpei Kadosaka,Takeshi Miyata,Kosuke Minaga,Kentaro Yamao,Hajime Imai,Masatoshi Kudo 대한초음파의학회 2016 ULTRASONOGRAPHY Vol.35 No.3
Endoscopic ultrasonography (EUS) is widely used to evaluate pancreaticobiliary diseases,especially pancreatic masses. EUS has a good ability to detect pancreatic masses, but it isnot sufficient for the differential diagnosis of various types of lesions. In order to address thelimitations of EUS, new techniques have been developed to improve the characterization ofthe lesions detected by EUS. EUS-guided fine needle aspiration (EUS-FNA) has been used fordiagnosing pancreatic tumors. In order to improve the histological diagnostic yield, a EUS-FNAneedle with a core trap has recently been developed. Contrast-enhanced harmonic EUS is a newimaging modality that uses an ultrasonographic contrast agent to visualize blood flow in finevessels. This technique is useful in the diagnosis of pancreatic solid lesions and in confirmingthe presence of vascularity in mural nodules for cystic lesions. EUS elastography analyzes severaldifferent variables to measure tissue elasticity, color patterns, and strain ratio, using analyticaltechniques such as hue-histogram analysis, and artificial neural networks, which are useful forthe diagnosis of chronic pancreatitis and pancreatic cancer.