Endosonography

Endosonography is a diagnostic technique that combines the capabilities of endoscopic and ultrasound examination of internal organs. It is performed using a fibroendoscope equipped with an ultrasound probe or sensor that is inserted into the lumen of a hollow organ (esophagus, stomach, intestines, bronchi). Allows for highly sensitive scanning of these organs and adjacent anatomical structures (pancreas, bile ducts, mediastinal organs, etc.). Dopplerometry of intraorgan blood flow, biopsy, drainage of cysts, duct stenting and other manipulations can be performed during endoussis. 

Preparation

8-12 hours before the study, it is necessary to refuse to eat. The best option is to conduct an endouzi in the morning, after a night period of hunger. 5-7 days before the diagnosis, you need to inform your doctor about the medications you are taking. Since some medications can affect the reliability of the results, if possible, their use will be temporarily canceled.

What shows

In endosonography of the esophagus, intestines and stomach, the structure of the walls of the digestive tract is visualized in a two-dimensional plane. In the form of alternating dark and light stripes, anatomical layers are displayed: mucous, submucosal, muscular, adventitial. Pancreatic endousis allows you to evaluate the structure of the parenchyma of the organ and ducts. In the process of examining the biliary tract, the diameter and uniformity of their lumen, the presence of concretions are determined.

Intravascular ultrasound is used to study the structure of coronary arteries, aorta, peripheral veins and arteries. The morphology of the vessel walls and the size of the lumen are projected onto the ultrasound monitor of the device. Dopplerography reflects the characteristics of blood flow in the studied organ. With the help of endosonography , the following groups of pathologies are identified:

• Malignant tumors of the gastrointestinal tract. Endoussis is performed as part of the diagnosis of cancer of the stomach, esophagus, colon. The key ultrasound signs of the disease are local thickening of the walls of the organ, a decrease in the clarity of the boundaries of the layers, unevenness and indistinctness of the external contours, uneven echogenicity of the lesion, chaotic arrangement of small vessels.
• Submucosal formations of the gastrointestinal tract. The method is used to differentiate submucosal neoplasms and extra-organically located pathological foci that compress the hollow organ. By visualizing the structure of the layers, the doctor determines the presence of a neoplasm, its size, and sometimes its type. By changing the echogenicity of the focus and the clarity of the contour of the layer, cysts, lipomas, fibroids, neuroendocrine tumors, leiomyomas are detected.
• Diseases of the pancreas. Endosonography is used to detect tumors, cysts, concretions and inflammatory pathologies. With pancreatitis, a diffuse decrease in tissue density and swelling is recorded. Fibrosis, chronic pancreatitis and fibromatosis are characterized by a change in the homogeneity of the parenchyma. Tumors, cysts and pancreatic stones are displayed as focal and dystrophic changes of the gland.
• Diseases of the biliary tract. The main pathologies diagnosed with endoussis include tumors, concretions, strictures of the bile ducts. With the development of neoplasia, local expansion of the bile duct, focal changes in the walls are visualized, metastases in the lymph nodes may be detected. Stones are defined as formations of high echo density with an ultrasonic shadow, stenosis – as a narrowing area of the lumen of the bile duct.
• Vascular pathologies. Vascular diseases are confirmed by Doppler ultrasound and intravascular ultrasound. Signs of atherosclerosis are a decrease in blood flow rate, the presence of formations of various shapes and echogenicity (depending on the type of plaque). Endosonography is effective in the diagnosis of parietal venous thrombi, which are visualized as foci of increased echogenicity.

The results of endosonography are interpreted taking into account the clinical picture, laboratory data. During the procedure, it is possible to take biopsy material from the neoplasm for further histological and cytological examination. The diagnosis is established after carrying out all the necessary diagnostic procedures.

Advantages

In endoscopic sonography, ultrasound waves do not pass through the skin, subcutaneous fat and soft tissues, the sensors are located directly near the organ under study. Devices with the use of high-frequency ultrasound are used to obtain high-resolution images, which is impossible during conventional ultrasound, CT, MRI and endoscopic radiography. The limitation of the method is the inability to perform the procedure after operations and injuries, with severe stenosis. Standard ultrasound has a lower cost than endosonography, but it is not always informative enough.