Nishimura Yoshihiko, Osugi Harushi, Inoue Kiyotoshi, Takada Nobuyasu, Takamura Masashi, Kinosita Hiroaki
Second Department of Surgery, Osaka City University Medical School, Osaka, Japan.
J Ultrasound Med. 2002 Jan;21(1):49-58. doi: 10.7863/jum.2002.21.1.49.
To study the usefulness of bronchoscopic ultrasonography in diagnosing tracheobronchial invasion of esophageal cancer and to compare it with endoscopic ultrasonography, bronchoscopy, and computed tomography.
We prospectively investigated 59 patients with newly diagnosed esophageal cancer located at or above the level of the tracheal bifurcation. A 20-MHz ultrasonic probe covered by a sheath with a balloon inflated with water was used for bronchoscopic ultrasonography. The presence of tracheobronchial invasion was diagnosed on the basis of an interruption in the most external hyperechoic layer of the tracheal bronchus.
Bronchoscopic ultrasonography was completed without complications in all patients, but endoscopic ultrasonography was performed completely in only 44% of them. The overall accuracy rates for diagnosis of tracheobronchial invasion on the basis of bronchoscopy, bronchoscopic ultrasonography, endoscopic ultrasonography, and computed tomography were 78%, 91%, 85%, and 58%, respectively. Statistical examination showed that the accuracy of bronchoscopic ultrasonography and bronchoscopy was significantly greater than that of computed tomography, and the accuracy of bronchoscopic ultrasonography was greater than that of bronchoscopy.
Bronchoscopic ultrasonography is useful for evaluating cancer invasion into the tracheal bronchus. It is more accurate than the other methods and could be used to visualize the layered structure of the tracheal bronchus in all patients.
研究支气管超声在诊断食管癌气管支气管侵犯中的作用，并将其与内镜超声、支气管镜检查和计算机断层扫描进行比较。
我们前瞻性地调查了59例新诊断的位于气管隆突水平或以上的食管癌患者。使用覆盖有鞘且鞘内充水球囊的20兆赫超声探头进行支气管超声检查。根据气管支气管最外层高回声层的中断来诊断气管支气管侵犯的存在。
所有患者均顺利完成支气管超声检查，无并发症发生，但仅44%的患者完成了内镜超声检查。基于支气管镜检查、支气管超声、内镜超声和计算机断层扫描诊断气管支气管侵犯的总体准确率分别为78%、91%、85%和58%。统计学检验表明，支气管超声和支气管镜检查的准确率显著高于计算机断层扫描，且支气管超声的准确率高于支气管镜检查。
支气管超声有助于评估癌症对气管支气管的侵犯。它比其他方法更准确，可用于观察所有患者气管支气管的分层结构。
