Journal of Korean Society of Medical Ultrasound 1996;15(2): 197-207.
Usefulness of the Miniature Ultrasonic Probe for the Diagnosis of Gastroenterologic Diseases
Chan Sup Shim, Chang Beom Ryu, Yong Deok Cho, Jin Oh Kim, Hyung Keun Bong, Joo Young Cho, Yun Soo Kim, Joon Seong Lee, Moon Sung Lee, and Seong Hwang
Department of Internal Medicine, Institute for Dgestive Research, Soonchunhyang University College of Medicine
PURPOSE : To evaluate and establish the indications of miniature ultrasonic probe examination for the variousgastroenterologic diseases according to the ultrasonic frequency, the invasion depth of the diseases and scanningmethods, and to discover the technical and mechanical problems of miniature ultrasonic probe. MATERIAL & METHODS :Clinical studies were performed with the miniature ultrasonic probe (UM-2R/3R ; 12/20 MHz ; Olympus Co., MP-PNseries ; 15/20 MHz ; Aloka Co.), during the routine endoscopic examination in 61 patients with variousgastro-enterologic diseases. These cases were also examined by conventional endoscopic ultrasonography (EUS), andinterpreted by three gastroenterologists. Final diagnoses of these cases were confimed by histopathologicexamination of the biopsy, polypectomy, endoscopic mucosal resection, or surgery, and other clinicalexamina-tions. RESULTS : All but 10 cases (83.6%) were adequately visualized by the miniature ultrasonic probe,whereas conventional EUS failed to completely visualize 18 cases (70.5%). The causes of technically inadequateinvestigation by conventional EUS were gastrointestinal strictures (not traversable), cardiac lesions (no optimaldocking), very small lesions and small esophageal varices (compressed by balloon). The causes of inadequateinvestigation by miniature ultrasonic probe were severe esophageal stenoses, antral and stomal lesions (impossiblewater filling), and very large lesions (not visualized posterior margin). Conventional EUS was superior tominiature ultrasonic probe for the detection of lymph node enlargement (nine cases vs. seven cases). CONCLUSION :A miniature ultrasonic probe scanning can be well indicated to the tight gastrointestinal stenosis, relativelysmall and flat lesion, small intramural lesion, and early gastric cancer. Frequency of 20 MHz will be adequate formucosal lesion, but in case with deeper and larger lesions such as submucosal tumor or advanced cancer will beadequately examined by 12 or 15 MHz probes. For the scanning using miniature ultrasonic probe, water filling ofstomach should be achieved, whereas in the antrum or esophagus, continuous suction has to be applied afterinstillation of water. In the near futrue, the development of more durable miniature ultrasonic probe with balloonattached to the tip and a greater depth penetration would be desirable.
Keywords: Miniature ultrasonic probe, Conventional EUS, Depth of penetration
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