Berim Ilya G, Saeed Ali I, Awab Ahmed, Highley Adam, Colanta Agnes, Chaudry Fawad
Departments of *Pulmonary, Critical Care and Sleep Medicine §Pathology, Creighton University, Omaha, NE †Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of New Mexico, Albuquerque, NM ‡Department of Medicine, Section of Pulmonary Diseases and Critical Care, Center for Interventional Pulmonology, University of Oklahoma, Oklahoma City, OK ∥Department of Internal Medicine, Pulmonary, Critical Care and Sleep Medicine, Faith Regional Healthcare System, Norfolk, NE.
J Bronchology Interv Pulmonol. 2017 Apr;24(2):170-173. doi: 10.1097/LBR.0000000000000368.
Fluoroscopy-guided transbronchial forceps biopsy has a low diagnostic yield in patients with radiographic suspicion of interstitial lung disease. Cryobiopsy has a higher diagnostic yield likely due to preserved lung architecture and larger biopsies; however, there is an increased risk of major airway bleeding and pneumothorax. Simultaneous use of endobronchial balloon blocker allows for containment of bleeding after cryobiopsy to the affected lobe. In the current article we describe use of radial ultrasound in identification of a target lung parenchyma without a major blood vessel adjacent to distal bronchi. After fluoroscopic marking of the selected airway a 3 second cryobiopsy was performed after localization of cryoprobe. Simultaneous use of radial ultrasound and fluoroscopy can possibly decrease bleeding complication associated with cryobiopsy in patients with suspected interstitial lung disease.
在影像学怀疑有间质性肺疾病的患者中,透视引导下经支气管钳取活检的诊断率较低。冷冻活检的诊断率较高,可能是由于肺结构得以保留且活检组织较大;然而,大出血和气胸的风险增加。同时使用支气管内球囊封堵器可在冷冻活检后将出血控制在受影响的肺叶。在本文中,我们描述了如何使用径向超声来识别目标肺实质,该肺实质在远端支气管附近无主要血管。在透视下标记选定的气道后,在冷冻探头定位后进行3秒的冷冻活检。对于疑似间质性肺疾病的患者,同时使用径向超声和透视可能会降低与冷冻活检相关的出血并发症。