First experience of three-dimensional mini-probe endoscopic ultrasonography in digestive tract

Aim: to evaluate advantages and difficulties of performing three-dimensional endoscopic ultrasonography (3D-EUS).

Materials and methods: from XI.2004 to II.2006 3D-EUS was performed in 37 patients: m –14, f –23, mean age –55.4±14.1 (26–81) years. Mini-probe 3D-EUS was performed for suspected lesions less than 2cm in size in esophagus (5), stomach (22), duodenum (2), colon (4) and 3D intraductal ultrasonography (IDUS) for pancreatobiliary pathology in 4 cases. We used 3D-ultrasound probe UM-DP20–25R (20MHz), 3D-IDUS probe UM-DG20–31R (20MHz), probe unit MAJ-935, EUS center Exera EU-M60, 3D-IDUS system (Olympus Co). EUS was performed while the EUS probe in the outer sheath was withdrawn automatically.

Results: 3D-EUS was successfully performed in all 37 patients. Pathological lesions were rejected in 6 cases. In the other 31 patients following lesions were revealed: neoplastic lesions including early cancer – in 15 cases, submucosal tumors –9 (leyomioma-3, lipoma-2, aberrant pancreas-3, carcinoid-1), stomach and duodenal ulcers –2, peptic esophageal stricture –1; 3D-IDUS revealed bile duct tumors in 3 patients, Mirizzi syndrome in one. 3D-EUS enables to evaluate in details volumetric (three-dimensional) form, size of lesions and its extent in the gastrointestinal wall. 3D-EUS also facilitates revealing these changes in gastrointestinal wall due to automatically withdrawn scanning system on the distal end of the probe for the space of 4cm.

Conclusion: 3D-EUS training requires to pay particular attention to imaging and manual dexterity without unnecessary scope and probe movements. 3D reconstruction enables to detect anatomical topography of internals and pathological lesions which is especially important at the early stage of EUS training.