3. How to Perform Endobronchial Ultrasonography
Published Online: 25 NOV 2010
Copyright © 2011 Noriaki Kurimoto, David I. K Fielding and Ali I. Musani
How to Cite
Kurimoto, N., Fielding, D. I. K. and Musani, A. I. (2011) How to Perform Endobronchial Ultrasonography, in Endobronchial Ultrasonography, Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444314366.ch3
- Published Online: 25 NOV 2010
- Published Print: 7 JAN 2011
Print ISBN: 9781405182720
Online ISBN: 9781444314366
- How to Perform Endobronchial Ultrasonography;
- superior vena cava (SVC);
- transbronchial biopsy (TBB);
- Tips for Successful EBUS - GS;
- EBUS Guided Transbronchial Needle Aspiration (EBUS - TBNA);
- How to Perform EBUS - TBNA
Performing endobronchial ultrasonography (EBUS) using a balloon probe Orientation of the 12 o'clock position on the ultrasound monitor does not correspond to the bronchoscopic 12 o'clock orientation. The EBUS image can be rotated to allow matching of orientation of the bronchoscopic image and the EBUS image. Landmarks of peribronchial anatomy and bronchial openings give us the correct angle to rotate the EBUS image. We therefore routinely rotate the EBUS image to give the same orientation as the bronchoscopic image. Keeping the probe in the centre of the balloon allows the ultrasound wave to enter the bronchial wall perpendicularly. The layers of the bronchial wall can be visualized clearly where the 1st layer is a thick hyperechoic layer, with the ultrasound pulse penetrating the bronchial wall perpendicularly.
Performing EBUS using a guide sheath (EBUS-GS)
Once the site of a lesion has been identified precisely using EBUS, the probe is withdrawn, leaving the guide sheath in place.
A biopsy forceps or bronchial brush is then introduced into the sheath.