Contrast-enhanced harmonic endoscopic ultrasonography for assessment of lymph node metastases in pancreatobiliary carcinoma

Figure 1 Schematic depiction of patient selection and exclusion criteria. pts: Patients; lns: Lymph nodes. CT: Computed tomography; MRI: Magnetic resonance imaging; EUS: Endoscopic ultrasonography; FNA: Fine needle aspiration.

Figure 2 Typical examples of lymph nodes with (A) and without (B) a central intranodal blood vessel on color Doppler endoscopic ultrasonography. An apparently visible lymph node was detected in both A and B (arrowheads). A shows a tubular structure that was ≥ 1 mm in diameter and was located toward the center of the lymph node and demonstrated blood flow on color Doppler endoscopic ultrasonography (arrow).

Figure 3 Contrast-enhanced harmonic endoscopic ultrasonography -determined enhancement patterns of the lymph node.

Figure 4 Typical example of a metastatic lymph node that shows heterogeneous enhancement on contrast-enhanced harmonic endoscopic ultrasonography (left, fundamental B mode; right, contrast harmonic mode).

Figure 5 Typical example of a reactive lymph node that shows homogeneous enhancement on contrast-enhanced harmonic endoscopic ultrasonography (left, fundamental B mode; right, contrast harmonic mode).