Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taipei, Taiwan.
Ultrasound Med Biol. 2011 Nov;37(11):1755-61. doi: 10.1016/j.ultrasmedbio.2011.07.007.
The endobronchial ultrasound (EBUS) features of peripheral pulmonary lesions (PPLs) are associated with histopathologic presentation. Certain histologic and radiologic characteristics of peripheral pulmonary lesions affect the diagnostic yield of transbronchial lung biopsies (TBLB). This study aimed to assess the feasibility of EBUS echoic features as predictors of diagnostic yield of TBLB. Four hundred and eight patients with PPLs underwent TBLB. The yields of TBLB in lesions with characteristic EBUS features were compared with those without such features. The overall diagnostic yield of TBLB was 64.2%. Lesion diameter (≥3 cm vs. <3 cm; 69.1% vs. 58.5%, p < 0.05), location of the EBUS probe (within vs. adjacent to lesions; 73.2% vs. 46.3%, p < 0.01) and lesion echogenicity (heterogeneous vs. homogeneous; 76.7% vs. 52.0%, p < 0.01) were associated with higher TBLB yields. In malignant PPLs, the echoic features associated with higher TBLB yields were lesion diameter (≥3 cm vs. <3 cm; 74.4% vs. 62.5%, p < 0.05), location of the EBUS probe (within vs. adjacent to lesions; 78.7% vs. 47.4%, p < 0.01), echoic feature of the margin (noncontinuous vs. continuous; 77.0% vs. 62.4%, p < 0.01) and lesion echogenicity (heterogeneous vs. homogeneous; 77.7% vs. 53.9%, p < 0.01). EBUS probe location, echoic feature of the margin and lesion echogenicity were independent predictors according to the results of multivariate analysis. In conclusion, EBUS features are feasible predictors of diagnostic yield of TBLB in peripheral lung lesions.
支气管内超声（EBUS）在肺外周病变（PPL）中的特征与组织病理学表现有关。某些肺外周病变的组织学和影像学特征会影响经支气管肺活检（TBLB）的诊断率。本研究旨在评估 EBUS 回波特征作为 TBLB 诊断率预测指标的可行性。408 例肺外周病变患者接受了 TBLB。比较了具有特征性 EBUS 特征的病变与不具有此类特征的病变的 TBLB 获得率。TBLB 的总体诊断率为 64.2%。病变直径（≥3cm 与<3cm；69.1%与 58.5%，p<0.05）、EBUS 探头位置（位于病变内与邻近病变；73.2%与 46.3%，p<0.01）和病变回声特征（异质性与均质性；76.7%与 52.0%，p<0.01）与较高的 TBLB 获得率相关。在恶性 PPL 中，与较高 TBLB 获得率相关的回声特征包括病变直径（≥3cm 与<3cm；74.4%与 62.5%，p<0.05）、EBUS 探头位置（位于病变内与邻近病变；78.7%与 47.4%，p<0.01）、边缘回声特征（不连续与连续；77.0%与 62.4%，p<0.01）和病变回声特征（异质性与均质性；77.7%与 53.9%，p<0.01）。根据多变量分析的结果，EBUS 探头位置、边缘回声特征和病变回声特征是独立的预测指标。总之，EBUS 特征是肺外周病变 TBLB 诊断率的可行预测指标。
