Endoscopic ultrasound in chronic liver disease

Abstract

Endoscopic ultrasound (EUS) is a minimally invasive diagnostic and therapeutic modality with a number of established as well as evolving uses in patients with chronic liver disease. Compared to other diagnostic tools such as cross-sectional imaging or conventional endoscopy, EUS has been shown to increase diagnostic sensitivity and therapeutic success for many clinical scenarios and applications with a low rate of adverse events. In this review, we discuss and focus on the current and growing role of EUS in the evaluation and/or treatment of hepatobiliary masses, hepatic parenchymal disease, portal hypertension, esophageal and other varices, and indeterminate biliary strictures.

The value of platelet parameters and related scoring system in predicting esophageal varices and collateral veins in patients with liver cirrhosis

“…18,19 In addition, endoscopic ultrasonography can also predict the recurrence of esophageal varices after EVL by observing the degree of veins around the esophagus and the collateral veins of the esophagus. 20 In this study, it was found that the more serious the degree of esophageal varices, the wider the diameter of esophageal collateral veins, and there was a significant positive correlation between them. Therefore, when esophageal varices were detected, esophageal collateral veins should be injected at the same time to guide the next step of diagnosis and treatment.…”

“…Gao et al 24 bleeding. 27,28 In addition, studies have shown that the diameter of para-esophageal veins is related to a higher recurrence rate of varices. 29,30 However, at present, there are few studies on the prediction of esophageal collateral veins.…”

Role of Endoscopic Ultrasound in Liver Disease: Where Do We Stand?

“…Generally, the reduced elastic rebound is highly suggestive for stiffer tissue. This finding, in the context of CLD, indicates liver fibrosis and/or cirrhosis or some other pathological process, such as malignant focal lesions [5][6][7][8]. Elastography modalities currently in use are transient elastography (FibroScan), 2-dimensional shearwave elastography (SWE), acoustic radiation force impulse (ARFI) imaging, real-time elastography (RTE), and magnetic resonance (MR) imaging elastography.…”

“…Elastography modalities currently in use are transient elastography (FibroScan), 2-dimensional shearwave elastography (SWE), acoustic radiation force impulse (ARFI) imaging, real-time elastography (RTE), and magnetic resonance (MR) imaging elastography. RTE is different from other ultrasound elastography techniques because it can measure heartbeat-induced strain, which allows relatively objective qualitative and semiquantitative results [5][6][7][8][9][10].…”

“…Elastographic methods, such as FibroScan, have shown a good correlation to histological findings [5][6][7][8][9]. However, there are some limitations in terms of FibroScan use, such as the applicability of its measurements with a transabdominal approach in obese patients, those with ascites, or in those with narrow intercostal spaces.…”