Endoscopic Ultrasound最新文献

{"title":"EUS-guided ablation of a symptomatic renal cyst in a patient with autosomal dominant polycystic kidney disease.","authors":"Jessica Arnold, Sebastian Zundler","doi":"10.1097/eus.0000000000000153","DOIUrl":"10.1097/eus.0000000000000153","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 6","pages":"357-358"},"PeriodicalIF":5.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146051042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clip-assisted therapy <i>versus</i> EUS-guided coil embolization for secondary prophylaxis of isolated gastric varices: A multicenter study.","authors":"Huixian Li, Wei Chen, Wei Zhang, Zhihong Wang, Lingfang Shi, Xuecan Mei, Qianqian Zhang, Chao Ma, Derun Kong, Hongtan Chen","doi":"10.1097/eus.0000000000000152","DOIUrl":"10.1097/eus.0000000000000152","url":null,"abstract":"<p><strong>Background and objectives: </strong>Bleeding from isolated gastric varix type I (IGV1) is less common but more dangerous and fatal than other varices. This study compared the safety and efficacy of endoscopic clipping and cyanoacrylate injection (EC-CYA) with EUS-guided coil and cyanoacrylate injection (EUS-coil/CYA) in the secondary prophylaxis of IGV1.</p><p><strong>Methods: </strong>A retrospective study was conducted on 131 patients with cirrhosis and a history of IGV1 bleeding who underwent either EC-CYA (<i>n</i> = 55) or EUS-coil/CYA (<i>n</i> = 76) at three medical centers. Primary outcomes were gastric variceal rebleeding and ectopic embolism. Secondary outcomes were technical success, variceal obliteration rate, cyanoacrylate volume, cyanoacrylate embolization efficiency, other causes of rebleeding, other adverse events, and mortality.</p><p><strong>Results: </strong>In the EC-CYA group, the gastric variceal rebleeding rate (14.5% <i>vs</i>. 8.7%, <i>P</i> = 0.307), technical success rate (96.4% <i>vs</i>. 94.7%, <i>P</i> > 0.999), other causes of rebleeding rate (12.7% <i>vs</i>. 5.8%, <i>P</i> = 0.303), other adverse events rate (5.5% <i>vs</i>. 5.8%, <i>P</i> > 0.999), and mortality (12.7% <i>vs</i>. 8.7%, <i>P</i> = 0.467) showed no significant differences compared with the EUS-coil/CYA group. No ectopic embolism was found in either group. The EC-CYA group had a higher cyanoacrylate volume (3.14 ± 1.45 mL <i>vs</i>. 1.99 ± 0.72 mL, <i>P</i> < 0.001) and a higher variceal obliteration rate at first follow-up (82.23% ± 27.09% <i>vs</i>. 66.59% ± 30.28%, <i>P</i> = 0.032). However, the EUS-coil/CYA group was superior to the EC-CYA group in terms of cyanoacrylate embolization efficiency (2.85 ± 2.05 cm²/mL <i>vs</i>. 1.98 ± 1.46 cm²/mL, <i>P</i> = 0.044).</p><p><strong>Conclusions: </strong>Both EC-CYA and EUS-coil/CYA are safe and effective in preventing rebleeding of IGV1. The EUS-coil/CYA has better embolization efficiency, whereas EC-CYA has better operational convenience.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 6","pages":"334-342"},"PeriodicalIF":5.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146045892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transesophageal EUS-guided fine-needle biopsy for the diagnosis of primary prevertebral spinal carcinosarcoma (with video).","authors":"Tianze Shi, Zhenyun Gong, Guilian Cheng, Duanmin Hu","doi":"10.1097/eus.0000000000000159","DOIUrl":"10.1097/eus.0000000000000159","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 6","pages":"361-362"},"PeriodicalIF":5.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146051008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUS-guided liver biopsy: A useful and cost-effective alternative for specific indications in the study of liver diseases.","authors":"Teresa Alvarez-Nava, Carolina Ibarrola, Felipe de la Morena, José Díaz-Tasende, Yolanda Rodríguez-Gil, Carlos de la Serna, Cristina Martin-Arriscado, Ana Martín, Inmaculada Fernández, Ángel Sánchez, Mercedes Pérez-Carreras","doi":"10.1097/eus.0000000000000155","DOIUrl":"10.1097/eus.0000000000000155","url":null,"abstract":"<p><strong>Background and objectives: </strong>Comparative studies have demonstrated that EUS-guided liver biopsy (EUS-LB) is a useful and safe technique. However, there is not sufficient evidence information on their cost differences and potential applications. We aimed to investigate whether EUS-LB is a cost-effective alternative to traditional LB methods (percutaneous [PC-LB], transjugular [TJ-LB]) and determine its indications in clinical practice.</p><p><strong>Methods: </strong>In this observational, prospective, and multicenter study, patients who underwent EUS-LB at different tertiary centers (<i>N</i> = 52) were compared with a similar number of PC-LB (<i>N</i> = 50) and TJ-LB (<i>N</i> = 37) collected retrospectively. Diagnostic yield (percentage of conclusive histological diagnosis), specimen quality, adverse events, and cost-effectiveness were analyzed.</p><p><strong>Results: </strong>EUS-LB had 87% of diagnostic yield and 4% of mild adverse events, similar to traditional techniques (<i>P</i> = 0.097 and <i>P</i> = 0.252, respectively). Despite higher tissue fragmentation and lower longest specimen length in EUS-LB, no differences were found in the number of complete portal tracts, tissue adequacy (EUS-LB, 19%; PC-LB, 30%; TJ-LB, 36%; <i>P</i> = 0.164) or pathologist satisfaction, allowing adequate fibrosis stage assessment, particularly in metabolic dysfunction-associated steatotic liver disease. EUS-LB was more cost-effective when both LB and EUS were indicated (saving: €112.20 × 15% additional histological diagnosis [AHD]); in patients with cholestasis unsuitable for magnetic resonance cholangiopancreatography (MRCP) prior to LB; contraindication for the PC-LB, including cases of uncooperative individuals (saving: €234.75 × 15% AHD).</p><p><strong>Conclusions: </strong>EUS-LB is a useful alternative to traditional methods and the most cost-effective option when both LB and EUS are indicated, in cases of cholestasis as an alternative to MRCP and when the PC route is contraindicated.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 6","pages":"304-313"},"PeriodicalIF":5.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146045961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUS-guided hepaticoduodenostomy with angled puncture technique to avoid the interposed gallbladder (with video).","authors":"Haruo Miwa, Hiromi Tsuchiya, Kazuki Endo, Ritsuko Oishi, Yuichi Suzuki, Akihiro Funaoka, Shin Maeda","doi":"10.1097/eus.0000000000000157","DOIUrl":"10.1097/eus.0000000000000157","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 6","pages":"359-360"},"PeriodicalIF":5.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146051040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of thin convex probe EBUS scope for the diagnosis of peripheral pulmonary lesions.","authors":"Si Chen, Hao Ji, Han Yang, Shuaiyang Liu, Houteng Xi, Lijun Yan, Jiayuan Sun","doi":"10.1097/eus.0000000000000132","DOIUrl":"10.1097/eus.0000000000000132","url":null,"abstract":"<p><strong>Background and objectives: </strong>Despite the emergence of advanced ancillary technologies, the transbronchial method to peripheral pulmonary lesions (PPLs) remains a challenge for bronchoscopists. The objective of the study is to assess the diagnostic value and safety of a novel thin Convex Probe Endobronchial Ultrasound (TCP-EBUS) scope in transbronchial needle aspiration (TBNA) for PPLs suspicious of malignancy.</p><p><strong>Methods: </strong>This single-center feasibility study prospectively enrolled patients with PPLs between August 2022 and January 2023. All lesions were biopsied by EBUS-TBNA using the novel TCP-EBUS scope (BF-UC290F, Olympus) and the prototype 22G aspiration needle (Vizishot2 22G, Olympus). The primary end point was the diagnostic yield.</p><p><strong>Results: </strong>Thirty-three subjects were evaluated, and 30 subjects were included in the final analysis. The mean patients' age was 62.4 ± 10.2 years, and 60% were male. The mean lesion size was 25.7 ± 6.8 mm, and 22 nodules were ≤30 mm. PPLs were situated adjacent to the subsegmental or sub-subsegmental bronchi (25 and 5, respectively), and the EBUS scope was advanced into segmental or subsegmental bronchi (12 and 18, respectively). Average number of punctures was 3.8 ± 1.3. Adequate specimens were obtained in all 30 (100%) of the cases. The overall diagnostic yield was 90% (27/30). No serious adverse events were observed.</p><p><strong>Conclusions: </strong>The TCP-EBUS has decent accessibility to more distal intrapulmonary lesions. TCP-EBUS-TBNA is a safe real-time procedure with a high sensitivity for malignant PPLs in the inner two-thirds of the lung, irrespective of the presence of a bronchus sign.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 5","pages":"256-265"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multimodal artificial intelligence system for the detection and diagnosis of solid pancreatic lesions under EUS.","authors":"Chenxia Zhang, Xiao Tao, Jun Zhang, Wei Tan, Wei Zhou, Shan Hu, Bing Xiao, Honggang Yu","doi":"10.1097/eus.0000000000000145","DOIUrl":"10.1097/eus.0000000000000145","url":null,"abstract":"<p><strong>Background and objectives: </strong>Accurate differentiation of solid pancreatic lesions (SPLs) is crucial for treatment planning, but current methods still have limitations. Artificial intelligence (AI) has the potential to contribute to such diagnoses, yet existing AI models are restricted to focusing on a single modality. This study aims to develop a deep learning-based multimodal AI system to improve diagnostic accuracy for SPLs.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 492 patients who underwent EUS for SPLs at Renmin Hospital of Wuhan University between December 2016 and September 2024. The AI system consisted of four deep learning models: DCNN1 for focal pancreatic lesion detection, DCNN2 for classifying pancreatic lesions as cystic or solid, DCNN3 for lesion boundary segmentation and size measurement, and DCNN4 for classifying carcinoma and noncancerous lesions. For DCNN4, four different modality models were constructed: (1) model A: EUS B-mode images only. (2) model B: EUS-E images only. (3) model C: EUS B-mode images and EUS-E images. and (4) model D: EUS B-mode images, EUS-E images, and clinical data. The model performance was compared with the diagnostic performance of endoscopists.</p><p><strong>Results: </strong>The accuracy values of DCNN1 and DCNN2 were 96.8% and 98.9%, respectively. The Dice coefficient of the DCNN3 was 0.876. Our AI system demonstrated high accuracy, sensitivity, and specificity in differentiating carcinoma from noncancerous SPLs. The multimodal models, particularly those integrating EUS B-mode and EUS-E images, outperformed single-modality models, achieving an accuracy of 94.0% and an AUC of 0.937. The AI model showed superior performance compared to endoscopists, with improved diagnostic consistency and sensitivity.</p><p><strong>Conclusion: </strong>The multimodal AI system significantly improves the diagnostic accuracy of SPLs, providing a promising tool for the early detection and differentiation of pancreatic cancer.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 5","pages":"274-281"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Needle-based confocal laser endomicroscopy-assisted ultrasound-guided pleural biopsy for diagnosis of pleural effusion (with videos).","authors":"Jia Li, Ziwen Zheng, Liwei Liao, Mingming Deng, Run Tong, Gang Hou","doi":"10.1097/eus.0000000000000150","DOIUrl":"10.1097/eus.0000000000000150","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 5","pages":"294-295"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146051052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons learned from performing 100 EUS-guided portal pressure gradient measurement procedures.","authors":"Douglas G Adler","doi":"10.1097/eus.0000000000000149","DOIUrl":"10.1097/eus.0000000000000149","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 5","pages":"237-238"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146051031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of indwelling double-pigtail stents after endoscopic necrosectomy in patients with necrotizing pancreatitis complicated with disconnected pancreatic duct syndrome: A follow-up study.","authors":"Zhengang Zhou, Qian Liao, Jingwen Rao, Tianming Lai, Mei Yang, Haonan Liu, Kunpeng Yang, Jie Wu, Yong Zhu, Liang Xia, Yupeng Lei, Xin Huang, Jianhua Wan, Huifang Xiong, Lingyu Luo, Zhijian Liu, Xu Shu, Nonghua Lu, Yin Zhu, Wenhua He","doi":"10.1097/eus.0000000000000141","DOIUrl":"10.1097/eus.0000000000000141","url":null,"abstract":"<p><strong>Background and objectives: </strong>Disconnected pancreatic duct syndrome (DPDS) is a significant cause of pancreatic fluid collection (PFC) recurrence in patients with necrotizing pancreatitis (NP). Effective management strategies for DPDS are crucial to improve patient outcomes. This study aimed to evaluate the efficacy and safety of indwelling double-pigtail stents (DPSs) after endoscopic necrosectomy (EN) in patients with NP complicated with DPDS, focusing on the impact on PFC recurrence rates and readmission.</p><p><strong>Methods: </strong>We conducted a 1-year follow-up of patients with NP complicated with DPDS who underwent drainage or/and EN from June 2015 to November 2022. Patients were divided into 2 groups according to whether with DPS after removal of the metal stent. Additionally, a subgroup analysis was performed to evaluate the impact of stent type (7Fr and 10Fr DPS) after EN. The primary outcome was to assess the 1-year PFC recurrence rate.</p><p><strong>Results: </strong>Seventy-eight patients with DPDS were included in the study. Recurrence was seen in 7/30 (23.3%) patients with DPS replacement and 34/48 (70.83%) without DPS replacement within 1 year of discharge; the difference was statistically significant. Additionally, the readmission rate significantly decreased in the group with DPS (10.00% <i>vs.</i> 31.25%, <i>P</i> = 0.03). Subgroup analysis indicated that 7Fr DPSs were associated with lower PFC recurrence and adverse event rates compared to 10Fr DPSs.</p><p><strong>Conclusion: </strong>In patients with NP complicated with DPDS, the replacement and long-term indwelling of DPS can reduce the recurrence rate and hospital readmission rate. Furthermore, the 7Fr DPS size may offer better outcomes in terms of recurrence and safety.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 5","pages":"249-255"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}