Ultralydsymposium - NORSK FORENING FOR ULTRALYD ...

More documents

Recommendations

Info

StomachThe stomach has a well-developed five-layered wall structure. This is easily visualizedwhen water is placed in the lumen. The second layer is often prominent because of therelatively thick columnar mucosa and glands. The fourth layer is often thicker in the distalstomach compared to the proximal stomach. The fifth layer generally corresponds tosurrounding structures and perigastric fat as the serosa is too thin to be resolved withultrasound.DuodenumThe five-layered structure is usually visible in the duodenum, although the first and secondlayers are also quite thin and difficult to image without the water-filled lumen technique.The muscularis propria layer is also generally thin and the separate inner circular and outerlongitudinal muscle layers are rarely resolved.Colon and RectumThe five layers of the colonic wall are usually well developed. The muscularis proprialayer is focally thickened in certain areas where the taenia coli form a well-developed outerlongitudinal muscle layer.Indications for Imaging the Wall of the GI TractThe ultrasound structure of the GI wall can be affected by a variety of pathologicalchanges. Inflammation and malignant infiltration both usually present as echo-poorprocesses blurring the normal architecture and sometimes extending beyond the normaldelineation. This may in both instances lead to loss of layers and broken integrity of theouter borders of the GI wall. So far, no definite ultrasound criteria have been established todifferentiate between inflammatory and malignant infiltration. The TNM staging system isideally suited for use with ultrasound staging of GI cancer. Malignancy confined to themucosal or submucosal layers is a T1 cancer whereas invasion of the muscularis propriarepresents a T2 stage. When the cancer has invaded outside of the GI wall, a T3 stage ispresent. These stages correlate very well with the US layer system. The influence ofinterface echoes on staging inaccuracy has not been fully explored, although there is apotential for these interface echoes to affect staging accuracy. For example, a malignancythat focally invades the muscularis mucosae may indent the superficial aspect of the thirdultrasound layer and appear to represent submucosal invasion, when in fact, onlymuscularis mucosae invasion is present. Similarly, a cancer that is focally invading themuscularis propria might be obscured by the interface echo between the tumor and themuscularis propria. US imaging is also useful in detecting the cause of a subepithelial massin the GI tract and furthermore imaging the GI wall also include imaging situations wherethe wall is diffusely thickened e.g. lymphomas, Linitis plastica, Mentriere disease,inflammatory and ischemic bowel disease.ConclusionsUltrasound examination allows imaging of the GI wall beyond the mucosal surface. It is avaluable diagnostic tool to assess pathology in the GI tract. Selection of the correcttransducer and using good technique are important in obtaining high-quality images. Thehighest frequency available should be used to image the wall of the GI tract. Using ahigher frequency transducer will result in better resolution and allow for betteridentification of the layers involved. The field of US continues to evolve withimprovements in transducer technology, signal processing, and the broadening ofindications.
Schematic illustration of the relationship between histological wall layers and theultrasonographic 5-layered structure of the gastric wall (above). By thickening of themuscularis mucosae (M.m.) and a visible interface echo generated between inner andouter part of the muscularis propria, up to nine different layers can be separated byultrasonography (below).The 5 layered gastrointestinal wall on EUS imaging (12 MHz).
Page 1: Ultralydsymposium 2012 Stavanger14.
Page 4 and 5: ProgramOnsdag 14. marsFellessesjon1
Page 6 and 7: Torsdag 15. marsFellessesjon09.00 -
Page 8 and 9: Fredag 16. marsFellessesjon09.00 -
Page 10 and 11: AbstraktUltrasound in critical care
Page 12 and 13: Ultralydveiledet leddpunksjonMoritz
Page 14 and 15: signaler, vi ser flere gråtoner og
Page 16 and 17: The haemodynamic instable patient -
Page 18: ReferencesPrice S, Nicol E, Gibson
Page 21 and 22: Ultralyd ved entesitterHilde Berner
Page 23 and 24: NÅR CT IKKE GIR SVARET: CEUS ELLER
Page 25 and 26: 2. Postema M, Gilja OH. Ultrasound-
Page 27 and 28: Ultralyd for vurdering av destrukti
Page 29 and 30: Det føtale sentralnervesystemetH-G
Page 32 and 33: CEUS og elastografi av fokale pankr
Page 34 and 35: Effekten av redusert ultralyd energ
Page 36 and 37: Ultralydvurdering og intervensjon i
Page 38 and 39: Ultralyd ved assistert befruktningP
Page 40 and 41: Rutinemessig cervixmålingTorbjørn
Page 44 and 45: Menetriers disease. A thickened lay
Page 46 and 47: Ultralydveiledet behandling av inva
Page 48 and 49: Congenital sublingual cysteKasuisti
Page 50 and 51: Oppfølging etter påvist utvikling
Page 52 and 53: Acrani og holoprocencephalon hos fo
Page 54 and 55: Ultralyd av pankreas ved cystisk fi
Page 56 and 57: Generalforsamling NFUDTorsdag 15. m
Page 58: legers etter-‐ og videreutda

Ultralydsymposium - NORSK FORENING FOR ULTRALYD ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?