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Diagnostic endoscopic ultrasonography:Assessment of safety and prevention of complications

World Journal of Gastroenterology 2012年第34期18卷 4659-4676页

作者： christian jenssen Maria Victoria Alvarez-Sánchez Bertrand Napoléon Siegbert Faiss Department of Internal Medicine Krankenhaus M rkisch-Oderland GmbHD15344 StrausbergGermany Department of Gastroenterology and Hepatology Hopital Privé Jean MermozF69008 LyonFrance Department of Gastroenterology and Hepatology Asklepios Klinik BarmbekD22291 HamburgGermany

Endoscopic ultrasonography (EUS) has gained wide acceptance as an important, minimally invasive diagnostic tool in gastroenterology, pulmonology, visceral surgery and oncology. This review focuses on data regarding risks and complications of non-interventional diagnostic EUS and EUS-guided fine-needle biopsy (EUS-FNB). Measures to improve the safety of EUS und EUS-FNB will be discussed. Due to the specific mechanical properties of echoendoscopes in EUS, there is a low but noteworthy risk of perforation. To minimize this risk, endoscopists should be familiar with the specific features of their equipment and their patients' specific anatomical situations (e.g., tumor stenosis, diverticula). Most diagnostic EUS complications occur during EUS-FNB. Pain, acute pancreatitis, infection and bleeding are the primary adverse effects, occurring in 1% to 2% ofpatients. Only a few cases of needle tract seeding and peritoneal dissemination have been reported. The mortality associated with EUS and EUS-FNB is 0.02%. The risks associated with EUS-FNB are affected by endoscopist experience and target lesion. EUS-FNB of cystic lesions is associated with an increased risk of infection and hemorrhage. Peri-interventional antibiotics are recommended to prevent cyst infection. Adequate education and training, as well consideration of contraindications, are essential to minimize the risks of EUS and EUS-FNB. Restricting EUS-FNB only to patients in whom the cytopathological results may be expected to change the course of management is the best way of reducing the number of complications.

关键词：内视镜的 ultrasonography 内视镜的指导 ultrasonography 的好针的活体检视复杂并发症禁止徵候风险安全穿孔流血感染尖锐胰腺炎

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Serous pancreatic neoplasia, data and review

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World Journal of Gastroenterology 2017年第30期23卷 5567-5578页

作者： Christoph F Dietrich Yi Dong christian jenssen Valentina Ciaravino Michael Hocke Wen-Ping Wang Eike Burmester Kathleen Moeller Nathan SS Atkinson Paola Capelli Mirko D’Onofrio Medizinische Klinik 2 Caritas-Krankenhaus Bad Mergentheim Ultrasound Department First Affiliated Hospital of Zhengzhou University Department of Ultrasound Zhongshan HospitalFudan University Department of Internal Medicine Krankenhaus Markisch Oderland Strausberg/Wriezen Department of Radiology G.B Rossi University HospitalUniversity of Verona Department of Internal Medicine 2 Helios Hospital Meiningen GmbH Department of Internal Medicine I Sana Klinikum Lichtenberg Translational Gastroenterology Unit Oxford University Hospitals NHS Foundation Trust Department of Pathology G.B Rossi University HospitalUniversity of Verona Department of Radiology GB Rossi University HospitalUniversity of Verona

AIM To describe the imaging features of serous neoplasms of the pancreas using ultrasound, endoscopic ultrasound, computed tomography and magnetic resonance imaging.METHODS This multicenter international collaboration enhances a literature review to date, reporting features of 287 histologically confirmed cases of serous pancreatic cystic neoplasms(SPN). RESULTS Female predominance is seen with most SPN presenting asymptomatically in the 5th through 7th decade. Mean lesion size was 38.7 mm, 98% were single, 44.2% cystic, 46% mixed cystic and solid, and 94% hypoechoic on B-mode ultrasound. Vascular patterns and contrast-enhancement profiles are described as hypervascular and hyperenhancing.CONCLUSION The described ultrasound features can aid differentiation of SPN from other neoplastic lesions under most circumstances.

关键词： Guideline Cancer Ultrasound Endoscopic ultrasound Elastography

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New ultrasound techniques for lymph node evaluation

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World Journal of Gastroenterology 2013年第30期19卷 4850-4860页

作者： Xin-Wu Cui christian jenssen Adrian Saftoiu Andre Ignee Christoph F Dietrich Med.Klinik 2 Caritas-Krankenhaus97980 Bad MergentheimGermany Klinik für Innere Medizin Krankenhaus M rkisch Oderland15334 StrausbergGermany Department of Gastroenterology Research Center of Gastroenterology and HepatologyUniversity of Medicine and Pharmacy Craiova200349 CraiovaRomania

Conventional ultrasound(US)is the recommended imaging method for lymph node(LN)diseases with the advantages of high resolution,real time evaluation and relative low costs.Current indications of transcutaneous ultrasound and endoscopic ultrasound include the detection and characterization of lymph nodes and the guidance for LN biopsy.Recent advances in US technology,such as contrast enhanced ultrasound(CEUS),contrast enhanced endoscopic ultrasound(CE-EUS),and real time elastography show potential to improve the accuracy of US for the differential diagnosis of benign and malignant lymph nodes.In addition,CEUS and CE-EUS have been also used for the guidance of fine needle aspiration and assessment of treatment response.Complementary to size criteria,CEUS could also be used to evaluate response of tumor angiogenesis to anti-angiogenic therapies.In this paper we review current literature regarding evaluation of lymphadenopathy by new and innovative US techniques.

关键词： Lymph nodes Ultrasound Endoscopic ultrasound Lymph node metastasis Lymphoma

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Fortuitously discovered liver lesions

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World Journal of Gastroenterology 2013年第21期19卷 3173-3188页

作者： Christoph F Dietrich Malay Sharma Robert N Gibson Schreiber-Dietrich christian jenssen Department of Internal Medicine Caritas-Krankenhaus Bad Mergentheim97980 Bad MergentheimGermany Department of Gastroenterology Jaswantrai Speciality HospitalOpposite Sports StadiumMeerut UP 250001India Department of Radiology University of MelbourneRoyal Melbourne HospitalVictoria 3050Australia Dagmar Department of Pediatrics Asklepiosklinik St. AugustinAbt. Neonatologie und P diatrische Intensivmedizin52757 AugustinGermany Klinik für Innere Medizin Krankenhaus Mrkisch Oderland15334 StrausbergGermany

The fortuitously discovered liver lesion is a common problem. Consensus might be expected in terms of its work-up, and yet there is none. This stems in part from the fact that there is no preventive campaign involving the early detection of liver tumors other than for patients with known liver cirrhosis and oncological patients. The work-up (detection and differential diagnosis) of liver tumors comprises theoretical considerations, history, physical examination, laboratory tests, standard ultrasound, Doppler ultrasound techniques, contrastenhanced ultrasound (CEUS), computed tomography and magnetic resonance imaging, as well as imageguided biopsy. CEUS techniques have proved to be the most pertinent method; these techniques became part of the clinical routine about 10 years ago in Europe and Asia and are used for a variety of indications in daily clinical practice. CEUS is in many cases the first and also decisive technical intervention for detecting and characterizing liver tumors. This development is reflected in many CEUS guidelines, e.g. , in the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) guidelines 2004, 2008 and 2012 as well as the recently published World Federation for Ultrasound in Medicine and Biology-EFSUMB guidelines 2012. This article sets out considerations for making a structured work-up of incidental liver tumors feasible.

关键词： Contrast-enhanced ultrasound Hepatocellular carcinoma Hemangioma Focal nodular hyperplasia Metastasis Ultrasonography Recommendations Guidelines

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全球气候变化对北极海洋生态系统持久性有机污染物和汞途径及暴露的生态影响研究

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Current Zoology 2015年第4期61卷 617-628页

作者： Melissa A. MCKINNEY Sara PEDRO Rune DIETZ christian SONNE Aaron T. FISK Denis ROY Bjorn M. jenssen Robert J. LETCHER Department of Natural Resources and the Environment University of Connecticut Storrs CT 06269 USA Center for Environmental Sciences and Engineering University of Connecticut Storrs CT 06269 USA Department of Bioscience Arctic Research Centre Aarhus University Roskilde DK-4000 Denmark Great Lakes Institute for Environmental Research University of Windsor Windsor ON N9B 3P4 Canada Department of Biology Norwegian University of Science and Technology Trondheim NO-7491 Norway Wildlife and Landscape Science Directorate Science and Technology Branch Environment Canada National Wildlife Research Centre Carleton University Ottawa ON K1A 0H3 Canada

生物累积性和生物放大污染物，如持久性有机污染物（POPs）和汞（Hg），数十年来一直被公认为在北极海洋生物健康的关注。近年来，全球气候变化（GCC）和北极海冰相关损失已观察到驱动大幅改变北极生态系统。本文综述了研究记录的经验... 详细信息

生物累积性和生物放大污染物，如持久性有机污染物（POPs）和汞（Hg），数十年来一直被公认为在北极海洋生物健康的关注。近年来，全球气候变化（GCC）和北极海冰相关损失已观察到驱动大幅改变北极生态系统。本文综述了研究记录的经验之间的联系GCC诱导的流行和在北极海洋生态系统的汞暴露和通路的生态变化和改变。大多数的研究报道在流行或汞浓度变化与GCC引起的物种营养相互作用的变化组织。这些研究通常集中在阿舞的角色变化，栖息地的范围或接近猎物，尤其是在与海冰变化。然而，生态变化，重新适应污染物的趋势变化往往是不清楚或假定。其他的研究已经成功地使用化学示踪剂，如稳定的氮和碳同位素比值和脂肪酸签名连接这样的生态变化，污染物水平的变化或趋势。较低的海冰与饮食变化/变异与较高的污染水平在一些不同的北极熊，以及相关的环斑海豹，和厚嘴默，但改变营养相互作用影响的流行水平和趋势的大小和方向的变化很大。我们建议在这一新领域的GCC链接ECOTOX -生态学的重点应该放在配套的生态指标与流行和汞的研究常规分析未来的研究，同时考虑了GCC和污染物的相互作用可能发生的多种机制，并有针对性地研究变化的暴露和毒性的物种称为敏感的GCC和污染物[现行生态61（4）：617-628，2015 ]。

关键词：持久性有机污染物海洋生态系统全球气候变化生态影响北极海汞浓度生态变化相互作用

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