University Clinic of Respiratory and Allergic Diseases Colnik, Colnik, Slovenia.
Respir Med. 2011 Oct;105 Suppl 1:S74-7. doi: 10.1016/S0954-6111(11)70015-4.
Bronchoscopic lung biopsy using fluoroscopic guidance is the standard procedure for the diagnosis of peripheral pulmonary lesions. Peripheral lesions can also be biopsied using endobronchial ultrasound (EBUS) guidance, which is equally effective and does not expose the patient or staff to radiation.
We determined the diagnostic yield of EBUS- and fluoroscopic-guided bronchoscopic lung biopsy (BLB) under everyday, clinical conditions, and compared our results to published data.
A total of 304 consecutive patients with peripheral pulmonary lesions who underwent EBUS- or fluoroscopy-guided BLB were included in this study. We compared the diagnostic yield of EBUS- and fluoroscopy-guided bronchoscopic lung biopsy (BLB) to determine which method is more sensitive for the diagnosis of peripheral pulmonary lesions.
EBUS-guided BLB was performed in 116 patients, and fluoroscopy-guided BLB was used in 188. The median diameter of the peripheral pulmonary lesions in the EBUS group was 31.5 mm (9-125) compared with 34.5 mm (6-100) in the fluoroscopy group. Diagnostic biopsy samples were obtained from 89 (77%) patients using EBUS and from 139 (74%) patients using fluoroscopy-guided BLB. The difference in the diagnostic outcome between these methods was not statistically significant.
The results of our study showed that the diagnostic yield was similar between EBUS- and fluoroscopy-guided BLB, although our findings suggest that more positive outcomes are expected with EBUS. The EBUS procedure is safer because it does not involve exposure of the patient or medical staff to radiation.
透视引导下经支气管镜肺活检是诊断周围性肺部病变的标准程序。周围性病变也可以通过支气管内超声（EBUS）引导进行活检，其同样有效，且不会使患者或医护人员暴露于辐射之下。
我们在日常临床条件下确定了 EBUS 和透视引导下经支气管镜肺活检（BLB）的诊断率，并将我们的结果与已发表的数据进行了比较。
共纳入 304 例接受 EBUS 或透视引导下 BLB 的周围性肺部病变患者。我们比较了 EBUS 和透视引导下 BLB 的诊断率，以确定哪种方法对周围性肺部病变的诊断更敏感。
116 例患者接受了 EBUS 引导下 BLB，188 例患者接受了透视引导下 BLB。EBUS 组的外周肺部病变的中位直径为 31.5mm（9-125），而透视组为 34.5mm（6-100）。89 例（77%）患者通过 EBUS 获得了诊断性活检样本，139 例（74%）患者通过透视引导下 BLB 获得了诊断性活检样本。这两种方法的诊断结果差异无统计学意义。
我们的研究结果表明，EBUS 和透视引导下 BLB 的诊断率相似，尽管我们的研究结果表明 EBUS 更有可能获得阳性结果。EBUS 操作更安全，因为它不会使患者或医护人员暴露于辐射之下。
