3. How to Perform Endobronchial Ultrasonography

  1. Noriaki Kurimoto MD, PhD Professor of Chest Surgery1,
  2. David I. K. Fielding MB, BS, FRACP, MD Director of Bronchology2 and
  3. Ali I. Musani MD, FCCP, FACP Associate Professor Director3,4

Published Online: 25 NOV 2010

DOI: 10.1002/9781444314366.ch3

Endobronchial Ultrasonography

Endobronchial Ultrasonography

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

Author Information

  1. 1

    Department of Surgery, St Marianna University, Kawasaki City, Kanagawa Prefecture, Japan

  2. 2

    Department of Thoracic Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia

  3. 3

    Interventional Pulmonology, National Jewish Health, USA

  4. 4

    University of Colorado School of Medicine, Denver, CO, USA

Publication History

  1. Published Online: 25 NOV 2010
  2. Published Print: 7 JAN 2011

ISBN Information

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Once the site of a lesion has been identified precisely using EBUS, the probe is withdrawn, leaving the guide sheath in place.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.