BACKGROUND: Celiac ganglia have not been previously identified by EUS. OBJECTIVE: To assess whether celiac ganglia can be detected by EUS and to define their characteristics. DESIGN: Retrospective review followed by prospective study. METHODS: Retrospective characterization was performed of all celiac ganglia that were incidentally identified by EUS-guided FNA or tru-cut needle biopsy from January 2004 to October 2005. We also prospectively assessed if these structures could be visualized in consecutive patients undergoing curved linear-array EUS. PATIENTS: Seven patients with celiac ganglia diagnosed by EUS-guided FNA (n = 7) and/or tru-cut needle biopsy (n = 1) were reviewed. Twenty-two patients were prospectively evaluated by curved-linear-array EUS. SETTINGS: Division of Gastroenterology and Hepatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA. MAIN OUTCOME MEASUREMENTS: EUS features and detection rate of celiac ganglia. RESULTS: All retrospectively evaluated celiac ganglia were identified anterior to the aorta, slightly to the left, and cephalad to the celiac artery take-off, and medial to the left adrenal gland. The mean distance from the celiac artery take-off was 10 mm (+/-3 mm); mean size was 13 mm (+/-3 mm) by 6 mm (+/-2 mm). They appeared as hypoechoic and multilobulated structures with hyperechoic strands. Celiac ganglia with sonographic features as described above were identified in 16 of 22 prospectively evaluated patients (73%). LIMITATIONS: Small number of patients; no tissue confirmation of prospectively evaluated patients. CONCLUSIONS: Celiac ganglia can be identified with curved linear-array EUS in the majority of patients. Their typical EUS appearance allows distinction from celiac lymph nodes.
BACKGROUND: Celiac ganglia have not been previously identified by EUS. OBJECTIVE: To assess whether celiac ganglia can be detected by EUS and to define their characteristics. DESIGN: Retrospective review followed by prospective study. METHODS: Retrospective characterization was performed of all celiac ganglia that were incidentally identified by EUS-guided FNA or tru-cut needle biopsy from January 2004 to October 2005. We also prospectively assessed if these structures could be visualized in consecutive patients undergoing curved linear-array EUS. PATIENTS: Seven patients with celiac ganglia diagnosed by EUS-guided FNA (n = 7) and/or tru-cut needle biopsy (n = 1) were reviewed. Twenty-two patients were prospectively evaluated by curved-linear-array EUS. SETTINGS: Division of Gastroenterology and Hepatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA. MAIN OUTCOME MEASUREMENTS: EUS features and detection rate of celiac ganglia. RESULTS: All retrospectively evaluated celiac ganglia were identified anterior to the aorta, slightly to the left, and cephalad to the celiac artery take-off, and medial to the left adrenal gland. The mean distance from the celiac artery take-off was 10 mm (+/-3 mm); mean size was 13 mm (+/-3 mm) by 6 mm (+/-2 mm). They appeared as hypoechoic and multilobulated structures with hyperechoic strands. Celiac ganglia with sonographic features as described above were identified in 16 of 22 prospectively evaluated patients (73%). LIMITATIONS: Small number of patients; no tissue confirmation of prospectively evaluated patients. CONCLUSIONS: Celiac ganglia can be identified with curved linear-array EUS in the majority of patients. Their typical EUS appearance allows distinction from celiac lymph nodes.
Authors: Julia K Leblanc; Susan Rawl; Michelle Juan; Cynthia Johnson; Kurt Kroenke; Lee McHenry; Stuart Sherman; Kathy McGreevy; Mohammad Al-Haddad; John Dewitt Journal: Diagn Ther Endosc Date: 2013-01-08