Editor: Ian Penman
2. EUS equipment and technique
Anne Marie Lennon & Koji Matsuda
Fig. 1 (A) Olympus GF-UM2000 mechanical radial echoendoscope (distal tip). Note the transducer is distal to the oblique-forward viewing
optics. (B) Proximal end of the same instrument (left)in comparison to earlier models (right) the motor has been removed from the proximal end to make the instrument lighter.
Fig. 2 Wire-guided, 6.9 mm non-optical radial mechanical instrument (Olympus MH-908). This is particularly useful for traversing
stenotic esophageal lesions.
Fig. 3 (A) Radial mechanical EUS processor for the instruments shown in Figs 1 and 2 (Olympus UM2000). (B) Hitachi processor for
all available PentaxHitachi echoendoscopes (model EUB-6500).
Fig. 4 Electronic radial echoendoscopes. (A) PentaxHitachi EG3630UR has forward-viewing video optics and provides a 270° radial image. (B) Olympus GF-UE260-AL5. This has forward-oblique optics but provides a 360° radial image.
Fig. 5 Curved linear array echoendoscopes. (A) Olympus GF-UC240P. (B) PentaxHitachi FG-38X. This provides a linear array view parallel with the instrument shaft, allowing real-time imaging of a needle
for interventional procedures. This model has a 3.7 mm instrument channel capable of taking 7 Fr stents for pseudocyst drainage.
Fig. 6 Examples of commonly available instruments for EUS. See  for further details.
Fig. 7 High-frequency catheter probes ('miniprobes') for EUS. (A) A variety of probes is available with varying imaging frequencies, diameters, and need for balloon sheaths.
Wire-guided probes for pancreatico-biliary ductal imaging are also available. (B) Drive motor for Olympus catheter probes
Fig. 8 Catheter probes for EUS.
Fig. 9 A 2.8 mm wire-guided catheter probe for imaging in the biliary and pancreatic ducts (Olympus UM-G20-29R).
Fig. 10 Needles available for EUS.
Fig. 11 Needles for EUS. Handle of Echotip Ultra needle (Cook Endoscopy) showing adjustable guard to prevent excessive insertion of
Fig. 12 Distal tips of several EUS needles (Cook Endoscopy). From left to right: 19 G 'Quickcore' core biopsy needle (EUSN-19-QC), 22 G FNA needle (EUSN-3), and 20 G spray needle for celiac plexus neurolysis (EUSN-20-CPN).
Fig. 13 19 G 'Quickcore' needle after extension of tissue tray into target lesion. Upon fully depressing the plunger the spring-loaded outer sheath
closes rapidly over the tray, trapping a tissue core in the tray.
Fig. 14 Low-power view of EUS-guided 19 G core ('Quickcore') biopsy from mediastinal lymph nodes in a patient with non-small cell lung cancer.
Fig. 15 Sonelastography. A developing technique which attempts to differentiate benign from malignant masses, especially in the pancreas,
by differences in elasticity and deformity when gently compressed.
Fig. 16 'Virtual sonography' (Hitachi). Software developments may allow linkage of real-time EUS with CT data from the same patient, allowing scrolling
images of the corresponding CT to be displayed as the ultrasound probe is moved.
Fig. 17 Endobronchial ultrasound. This echoendoscope has an outer diameter of 6.9 mm and a 2.0 mm instrument channel for FNA of transbronchial
EBUS-FNA (Olympus BF-UC160F).
Copyright © Blackwell Publishing, 2006