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Standard Imaging Techniques

Summary of scanning routes

The standard convex EUS scanning routes are listed below.

Transgastric approach (aortic route)

Transgastric approach (aortic route)

Transgastric approach (portal vein route)

Transgastric approach (portal vein route)

Transduodenal bulb approach

Transduodenal bulb approach

Transduodenal (descending part) approach

Transduodenal (descending part) approach

Anatomy around the esophagus

Orientation of the endosonographer and the control section and rotation of the endoscope

When imaging a target with convex EUS, torque operation of the endoscope is important. In this handbook, rightward rotation is referred to as “clockwise”, and leftward rotation as “counterclockwise”. When the transducer is pointing to the posterior side, the left side of the abdominal cavity is observed with clockwise rotation and the right side of the abdominal cavity is observed with counterclockwise rotation.

Clockwise rotation

Clockwise rotation

Counterclockwise rotation

Counterclockwise rotation

Relationship between the endoscope and target

As the scope is advanced, the target moves to the right on the ultrasound screen. Moreover, as the transducer is incorporated in the up angulation side of the scope tip, it moves closer to the target when the scope tip is bent upward, while the target moves upward on the ultrasound screen.

Abbreviations used in this handbook

Ao Aorta SMV Superior Mesenteric Vein
IVC Inferior Vena Cava IMA Inferior Mesenteric Artery
PV Portal Vein GDA Gastroduodenal Artery
UP Umbilical Portion Ph Head of the Pancreas
CA Celiac Artery Pn Neck of the Pancreas
SA Splenic Artery Pb Body of the Pancreas
SV Splenic Vein Pt Tail of the Pancreas
CHA Common Hepatic Artery MPD Main Pancreatic Duct
PHA Proper Hepatic Artery BD Bile Duct
RHA Right Hepatic Artery GB Gallbladder
LHV Left Hepatic Vein CHD Common Hepatic Duct
SMA Superior Mesenteric Artery APW Aortopulmonary Window

 

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