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超声内镜：正常食管的解剖学

Author
Frank G Gress, MD
Section Editor
Douglas A Howell, MD, FASGE, FACG
Deputy Editor
Anne C Travis, MD, MSc, FACG, AGAF
Translators
谭诗云, 主任医师，教授

引言

超声内镜(endoscopic ultrasound, EUS)是一种内镜技术，可提供高度准确的黏膜层、黏膜下层及管腔周围结构的成像。该技术经常用于术前对消化道(gastrointestinal, GI)恶性肿瘤(如食管癌、胃癌、胰腺癌和直肠癌)进行分期；对于这些恶性肿瘤，当由经验丰富的内镜医生进行操作时，EUS的准确率分别可达90%、88%和90%[1-4]。

EUS可区分消化道管壁的组织学分层，通过这种独特的能力，EUS可提供消化道的高分辨率影像[5-9]。最常用的超声内镜工作频率范围很广(5-20MHz)，其穿透深度和分辨率各异。通过这些超声内镜获得的图像可显示出构成消化道管壁的5段或5层结构。有关可显示9层消化道管壁结构的高频EUS(>20MHz)的内容将在别处讨论(参见“High-frequency catheter endoscopic ultrasonography”)。这些层次对应于消化道管壁5层不同的组织学结构：

●管腔内侧的最内层为黏膜浅层

●第二层对应于固有层或黏膜深层

●第三层为黏膜下层

       

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Literature review current through: 2017-06 . | This topic last updated: 2017-05-11.
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References
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  1. Snady H. Role of endoscopic ultrasonography in diagnosis, staging, and outcome of gastrointestinal diseases. Gastroenterologist 1994; 2:91.
  2. Colin-Jones DG, Rösch T, Dittler HJ. Staging of gastric cancer by endoscopy. Endoscopy 1993; 25:34.
  3. Yasuda K, Mukai H, Fujimoto S, et al. The diagnosis of pancreatic cancer by endoscopic ultrasonography. Gastrointest Endosc 1988; 34:1.
  4. Snady H, Bruckner H, Siegel J, et al. Endoscopic ultrasonographic criteria of vascular invasion by potentially resectable pancreatic tumors. Gastrointest Endosc 1994; 40:326.
  5. Kimmey MB, Martin RW, Haggitt RC, et al. Histologic correlates of gastrointestinal ultrasound images. Gastroenterology 1989; 96:433.
  6. Wiersema MJ, Wiersema LM. High-resolution 25-megahertz ultrasonography of the gastrointestinal wall: histologic correlates. Gastrointest Endosc 1993; 39:499.
  7. Tio TL, Tytgat GN. Endoscopic ultrasonography of normal and pathologic upper gastrointestinal wall structure. Comparison of studies in vivo and in vitro with histology. Scand J Gastroenterol Suppl 1986; 123:27.
  8. Bolondi L, Casanova P, Santi V, et al. The sonographic appearance of the normal gastric wall: an in vitro study. Ultrasound Med Biol 1986; 12:991.
  9. Tio TL, Tytgat GN. Endoscopic ultrasonography in analysing peri-intestinal lymph node abnormality. Preliminary results of studies in vitro and in vivo. Scand J Gastroenterol Suppl 1986; 123:158.
  10. Caletti GC, Bolondi L, Zani L, Labò G. Technique of endoscopic ultrasonography investigation: esophagus, stomach and duodenum. Scand J Gastroenterol Suppl 1986; 123:1.
  11. Lux G, Heyder N. Endoscopic ultrasonography of the pancreas. Technical aspects. Scand J Gastroenterol Suppl 1986; 123:112.
  12. Kremkau FW, Taylor KJ. Artifacts in ultrasound imaging. J Ultrasound Med 1986; 5:227.
  13. Snady H. Artifacts and techniques of endoscopic ultrasonography in investigating gastrointestinal pathologies and therapeutic options. In: Methods in Disease: Investigating the Gastrointestinal Tract, Preedy V, Watson R (Eds), Greenwich Med Media, London 1998. p.141.
  14. Grech P. Mirror-image artifact with endoscopic ultrasonography and reappraisal of the fluid-air interface. Gastrointest Endosc 1993; 39:700.
  15. Bolondi L, Caletti G, Casanova P, et al. Problems and variations in the interpretation of the ultrasound feature of the normal upper and lower GI tract wall. Scand J Gastroenterol Suppl 1986; 123:16.
  16. Eloubeidi MA, Tamhane A, Lopes TL, et al. Cervical esophageal perforations at the time of endoscopic ultrasound: a prospective evaluation of frequency, outcomes, and patient management. Am J Gastroenterol 2009; 104:53.