Nagai Keisuke, Kuriyama Keiko, Inoue Atsuo, Yoshida Yuriko, Takami Koji
Osaka National Hospital, Osaka, Japan.
Acta Radiol. 2018 Jul;59(7):830-835. doi: 10.1177/0284185117733507. Epub 2017 Oct 3.
Background Small, deep-seated lung nodules and sub-solid nodules are often difficult to locate without marking. Purpose To evaluate the success and complication rates associated with the use of indocyanine green (ICG) to localize pulmonary nodules before resection. Material and Methods This retrospective study was approved by our institutional review board. Informed consent for performing preoperative localization using ICG marking was obtained from all patients. Thirty-seven patients (14 men, 23 women; mean age = 63.1 years; age range = 10-82 years) with small peripheral pulmonary nodules underwent computed tomography (CT)-guided ICG marking immediately before surgery between March 2007 and June 2016. The procedural details and complication rates associated with ICG marking are described. Results The average nodule size and depth were 9.1 mm (range = 2-22 mm) and 9.9 mm (range = 0-33 mm), respectively. Marking was detected at the pleural surface in 35 patients (95%). Three cases of mild pneumothorax (8%), five cases of cough (14%), and one case of mild bloody sputum (3%) with no clinical significance were noted. There were no severe complications. The average duration required to perform the marking was 19.4 min (range = 12-41 min). Conclusion Our results indicate that CT-guided ICG marking is safe and useful for detecting the location of small pulmonary nodules preoperatively.
背景 小的、位于肺深部的结节以及亚实性结节在未进行标记时常常难以定位。目的 评估在肺结节切除术前使用吲哚菁绿（ICG）进行定位的成功率及并发症发生率。材料与方法 本回顾性研究经机构审查委员会批准。所有患者均获得了关于使用ICG标记进行术前定位的知情同意。2007年3月至2016年6月期间，37例（14例男性，23例女性；平均年龄63.1岁；年龄范围10 - 82岁）患有外周小肺结节的患者在手术前即刻接受了计算机断层扫描（CT）引导下的ICG标记。描述了与ICG标记相关的操作细节及并发症发生率。结果 结节平均大小和深度分别为9.1毫米（范围2 - 22毫米）和9.9毫米（范围0 - 33毫米）。35例患者（95%）在胸膜表面检测到标记。记录到3例轻度气胸（8%）、5例咳嗽（14%）和1例轻度血痰（3%），均无临床意义。无严重并发症。标记操作平均所需时间为19.4分钟（范围12 - 41分钟）。结论 我们的结果表明，CT引导下的ICG标记对于术前检测小肺结节的位置是安全且有用的。
