Instruments And Techniques

Because EUS provides an inadequate endoscopic inspection of the upper gastrointestinal tract, every ultrasound

Figure 7-1 The Olympus GF-UM20 ultrasound endoscope. Upper inset, The distal tip of the ultrasound endoscope with the water-inflated contact balloon, which covers the ultrasound transducer. The forward oblique viewing endoscope and suction channel are proximal to the ultrasound transducer.

Figure 7-2 The radial mechanical blind probe. The tip is tapered, allowing for passage through tight strictures. The radial ultrasound transducer is positioned behind the tapered tip.

Figure 7-3 The Olympus EU-M20 Image processor (lower arrow) is rack-mounted in a standard cart, which includes the other essential endoscopic equipment. The keyboard (upper arrow) can be used to measure and mark ultrasound findings.

Figure 7-4 The curvilinear electronic endoscope (A) and image processor (B). The optics and operating channel, through which a fine needle is passed, are positioned behind the linear ultrasound transducer. This echoendoscope requires a separate image processor.

Figure 7-5 The esophageal wall is visualized as five alternating layers of differing echogenicity by esophageal ultrasound. The first layer, which is hyperechoic (white), represents the superficial mucosa (epithelium and lamina propria). The second layer, which is hypoechoic (black), represents the deep mucosa (muscularis mucosa). The third layer, which is hyperechoic (white), represents the submucosa. The fourth layer, which is black (hypoechoic), represents the muscularis propria. The fifth layer, which is hyperechoic (white) is the paraesophageal tissue.

Eprthetiüm

TABLE 7-1 -- TNM Staging of Esophageal Carcinomas

T: Primary Tumor

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