Gomez Mario, Silvestri Gerard A
Department of Internal Medicine, Allergy and Sleep Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
Proc Am Thorac Soc. 2009 Apr 15;6(2):180-6. doi: 10.1513/pats.200808-081LC.
The diagnosis of indeterminate mediastinal lymph nodes, masses, and peripheral pulmonary nodules constitutes a significant challenge. Options for tissue diagnoses include computed tomography-guided percutaneous biopsy, transbronchial fine-needle aspiration, mediastinoscopy, left anterior mediastinotomy, or video-assisted thoracoscopic surgery; however, these approaches have both advantages and limitations in terms of tissue yield, safety profile, and cost. Endobronchial ultrasound (EBUS) is a new minimally invasive technique that expands the view of the bronchoscopist beyond the lumen of the airway. There are two EBUS systems currently available. The radial probe EBUS allows for evaluation of central airways, accurate definition of airway invasion, and facilitates the diagnosis of peripheral lung lesions. Linear EBUS guides transbronchial needle aspiration of hilar and mediastinal lymph nodes, improving diagnostic yield. This article will review the principles and clinical applications of EBUS, and will highlight the role of this new technology in the diagnosis and staging of lung cancer.
纵隔淋巴结、肿块及周围肺结节的诊断具有不确定性，是一项重大挑战。组织诊断的方法包括计算机断层扫描引导下经皮活检、经支气管细针抽吸、纵隔镜检查、左前纵隔切开术或电视辅助胸腔镜手术；然而，这些方法在组织获取量、安全性和成本方面都有各自的优缺点。支气管内超声（EBUS）是一种新的微创技术，它能使支气管镜检查医生的视野超越气道管腔。目前有两种EBUS系统。径向探头EBUS可用于评估中央气道、准确界定气道侵犯情况，并有助于诊断周围肺部病变。线性EBUS可引导对肺门和纵隔淋巴结进行经支气管针吸活检，提高诊断率。本文将综述EBUS的原理及临床应用，并着重介绍这项新技术在肺癌诊断和分期中的作用。
