Department of Medicine 1, University of Erlangen-Nuremberg, Erlangen, Germany.
Respiration. 2011;81(1):32-8. doi: 10.1159/000320365. Epub 2010 Aug 21.
There are only few reports about confocal laser endomicroscopy (CLE) for pulmonary imaging. In these studies, in contrast to gastrointestinal endoscopy, CLE was performed without fluorescein.
The aim of the present study was to evaluate the value of fluorescein usage for CLE of the lung.
Fluorescein-aided CLE was performed in 15 consecutively recruited patients and in 4 young healthy volunteers with a miniprobe during flexible bronchoscopy. Before and after intravenous administration of fluorescein, central airways and alveolar structures were evaluated.
Fluorescein administration did not permit imaging of epithelial cells in the central airways. In the lung periphery, alveolar walls and partially macrophages could be seen in native imaging, as expected. After administration of fluorescein, alveoli were almost filled with foam in areas with normal lung tissue. The origin of this foam was shown to be artificial. Furthermore, in patients with pathologies of the lung parenchyma, dark neoplastic and inflammatory cells adjacent to the alveolar walls were identified. No relevant side effects of fluorescein administration could be observed.
Fluorescein-aided CLE of the lung appeared to be safe and well tolerated. While the lack of staining of cells in the central airways was a major limitation, it permitted analysis of the lung interstitium and alveolar space and thus emerges as a new approach for the in vivo analysis of interstitial lung diseases.
关于肺部的共聚焦激光内镜检查（CLE）仅有少数报道。在这些研究中，与胃肠内镜不同，CLE 并未使用荧光素进行。
本研究旨在评估荧光素在肺部 CLE 中的应用价值。
在 15 名连续招募的患者和 4 名年轻健康志愿者的支气管镜检查中，使用微型探头进行荧光素辅助的 CLE。在静脉注射荧光素前后，评估中央气道和肺泡结构。
荧光素给药不能使中央气道中的上皮细胞成像。在肺外周，如预期的那样，在原生成像中可以看到肺泡壁和部分巨噬细胞。给予荧光素后，在正常肺组织区域，肺泡几乎充满了泡沫。该泡沫的来源表明是人为的。此外，在肺实质病变的患者中，可以识别到与肺泡壁相邻的黑色肿瘤和炎性细胞。未观察到荧光素给药的相关不良反应。
荧光素辅助的肺部 CLE 似乎是安全且耐受良好的。虽然中央气道中细胞缺乏染色是一个主要限制，但它允许对肺间质和肺泡空间进行分析，因此成为一种分析间质性肺疾病的新方法。
