Yasufuku Kazuhiro, Chhajed Prashant N, Sekine Yasuo, Nakajima Takahiro, Chiyo Masako, Iyoda Akira, Yoshida Shigetoshi, Otsuji Mizuto, Shibuya Kiyoshi, Iizasa Toshihiko, Saitoh Yukio, Fujisawa Takehiko
Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
Oncol Rep. 2004 Feb;11(2):293-6.
The radial endobronchial ultrasound (EBUS) probe is conventionally inserted through the working channel of the flexible bronchoscope and limits interventional diagnostics and therapeutics under direct ultrasound control. The aim of this study was to assess the new convex probe EBUS (CP-EBUS) in the visualization of the hilar lymph nodes in surgically resected specimens and explore its feasibility to perform transbronchial needle aspiration (TBNA) under direct EBUS guidance prior to its clinical use. Fourteen surgically resected specimens from lung cancer (n=12) and metastatic lung cancer (n=2) patients were included in the study. The resected specimens included eight right upper lobes, one right middle lobe, and five left lower lobes. The EBUS examination was performed with a flexible bronchoscope equipped with a 7.5 MHz convex probe (CP) that scans parallel to the insertion direction of the bronchoscope. The appearance of the hilar lymph nodes using this CP-EBUS was noted. The size of hilar lymph nodes was measured at CP-EBUS and compared with the actual size of the lymph nodes, which was measured with a Vernier's caliper. Hilar lymph nodes could be clearly visualized with CP-EBUS. There was a good correlation between the actual size of the lymph node and that measured using CP-EBUS (R(2)=0.950). A dedicated transbronchial aspiration needle could be inserted into the hilar lymph node under direct ultrasonic control. There is a possibility in the underestimation of the size of large lymph nodes due to the scanning nature of the convex probe. The CP-EBUS was successfully used to visualize the hilar lymph node and perform TBNA in surgical resected lung specimens. This technique has an excellent potential to perform direct ultrasound guided TBNA of mediastinal and hilar lymph nodes.
传统的径向支气管内超声（EBUS）探头是通过可弯曲支气管镜的工作通道插入的，这限制了在直接超声控制下的介入诊断和治疗。本研究的目的是评估新型凸阵探头EBUS（CP-EBUS）在手术切除标本中对肺门淋巴结的可视化效果，并在其临床应用前探索在EBUS直接引导下进行经支气管针吸活检（TBNA）的可行性。本研究纳入了14例来自肺癌患者（n = 12）和转移性肺癌患者（n = 2）的手术切除标本。切除的标本包括8个右上叶、1个右中叶和5个左下叶。使用配备7.5 MHz凸阵探头（CP）的可弯曲支气管镜进行EBUS检查，该探头与支气管镜的插入方向平行扫描。记录使用这种CP-EBUS时肺门淋巴结的外观。在CP-EBUS下测量肺门淋巴结的大小，并与用游标卡尺测量的淋巴结实际大小进行比较。使用CP-EBUS可以清晰地看到肺门淋巴结。淋巴结的实际大小与使用CP-EBUS测量的大小之间具有良好的相关性（R(2)=0.950）。在直接超声控制下，可以将专用的经支气管穿刺针插入肺门淋巴结。由于凸阵探头的扫描特性，有可能低估大淋巴结的大小。CP-EBUS已成功用于在手术切除的肺标本中可视化肺门淋巴结并进行TBNA。这项技术在对纵隔和肺门淋巴结进行直接超声引导下的TBNA方面具有巨大潜力。
