Iwasaki Yoshinobu, Nagata Kazuhiro, Yuba Tatsuya, Hosogi Shigekuni, Kohno Kenji, Ohsugi Shuji, Kuwahara Hiroomi, Takemura Yoshizumi, Yokomura Ichiro
Department of Medicine, Division of Pulmonary Medicine, Kyoto Prefectural University of Medicine, 465 Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602, Japan.
Respir Med. 2005 Mar;99(3):285-9. doi: 10.1016/j.rmed.2004.07.015.
To evaluate the effectiveness of fluoroscopy-guided barium marking for localization of small peripheral pulmonary lesions before video-assisted thoracic surgery (VATS) resection.
MATERIAL & METHODS: Twenty-one patients with peripheral pulmonary lesions 15 mm or less in diameter who were scheduled to undergo VATS resection were studied. A catheter was inserted bronchoscopically into the target segment and guided to a presumed lesion. The tip of the catheter was confirmed fluoroscopically to be at the exact spot determined beforehand. A 50% (weight/volume) barium sulfate suspension was instilled into the bronchus through the catheter, and the site of barium marking was ascertained by CT scanning.
The average instilled volume of barium was 0.42+/-0.07 ml. On CT scans, barium spots were superimposed on the target lesions in 19 of the 21 patients and were only 6-7 mm from the lesions in the other 2. Barium was well preserved in all patients at the time of VATS resection. A mild cough persisted for about 1 week in one patient, but the other patients had no specific complications.
Fluoroscopy-guided barium marking is a safe, convenient, and reliable method for localization of small pulmonary lesions before VATS resection.
评估在电视辅助胸腔镜手术（VATS）切除术前，透视引导下钡剂标记对小的外周肺部病变进行定位的有效性。
对21例计划接受VATS切除、直径15mm或更小的外周肺部病变患者进行研究。通过支气管镜将导管插入目标节段并引导至推测的病变处。通过透视确认导管尖端位于预先确定的精确位置。通过导管将50%（重量/体积）硫酸钡混悬液注入支气管，并通过CT扫描确定钡剂标记的部位。
钡剂的平均注入量为0.42±0.07ml。在CT扫描中，21例患者中有19例钡剂点叠加在目标病变上，另外2例距离病变仅6 - 7mm。在VATS切除时，所有患者的钡剂均保存良好。1例患者轻度咳嗽持续约1周，但其他患者无特殊并发症。
透视引导下钡剂标记是VATS切除术前对小的肺部病变进行定位的一种安全、方便且可靠的方法。
