Herth Felix J F, Ernst Armin
Department of Pneumology and Critical Care Medicine, Thoraxklinik University of Heidelberg, Germany.
Curr Opin Pulm Med. 2005 Jul;11(4):278-81. doi: 10.1097/01.mcp.0000166492.69788.e3.
Bronchoscopy is a minimally invasive method for diagnosing lung diseases, but the technique has some limitations. In case of parabronchial lesions, the view is limited to the inner surface. Therefore, endobronchial ultrasound systems were developed. For obtaining biopsies of peripheral lung lesions, a new real-time guidance system shows promising results. In this review the authors assess the most important and interesting articles in both fields.
In a trial it was shown that with the help of endobronchial ultrasound the diagnosing and staging of lung cancer and other pathologies could be improved. It is a safe technique and it has proved extremely useful during diagnostic and interventional procedures. With the navigation conclusive, biopsies were obtained in nearly 70% of the patients without any severe side effects.
Endobronchial ultrasound proved to be useful in high-resolution imaging of the multilayer structures of the bronchial wall and the adjacent mediastinal structures at a distance of as much as 4 cm. Lymph nodes could be easily localized for transbronchial needle aspiration. In many instances it was superior for staging lung cancer and other pathologies. Real-time electromagnetic-guided bronchoscopy, coupled with computed tomography is a feasible and safe method for obtaining biopsies from peripheral lung lesions.
支气管镜检查是诊断肺部疾病的一种微创方法，但该技术存在一些局限性。对于支气管旁病变，视野仅限于内表面。因此，开发了支气管内超声系统。对于获取周围性肺病变的活检样本，一种新的实时引导系统显示出了有前景的结果。在本综述中，作者评估了这两个领域中最重要和最有趣的文章。
一项试验表明，借助支气管内超声可改善肺癌及其他病变的诊断和分期。这是一种安全的技术，已证明在诊断和介入操作中极为有用。在导航确定的情况下，近70%的患者获得了活检样本，且无任何严重副作用。
支气管内超声在对支气管壁多层结构以及距离达4厘米的相邻纵隔结构进行高分辨率成像方面被证明是有用的。淋巴结可轻松定位以便进行经支气管针吸活检。在许多情况下，它在肺癌及其他病变的分期方面更具优势。实时电磁导航支气管镜检查结合计算机断层扫描是从周围性肺病变获取活检样本的一种可行且安全的方法。
