Zhang L, Li M, He S, Tong R, Zhu J Q, Wang G Q
Department of Endoscopy, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2017 Nov 12;40(11):845-849. doi: 10.3760/cma.j.issn.1001-0939.2017.11.009.
To explore the diagnostic value of endobronchial ultrasonography with a guide sheath (EBUS-GS) for peripheral pulmonary ground glass opacity (GGO). The clinical data of 27 consecutive patients with 27 GGOs diagnosed by EBUS-GS between November 2014 to December 2015 in our Cancer Hospital were retrospectively analyzed. The average age of these 27 patients, including 9 males and 18 females, was 59±11 years. The median lesion size of the 27 GGOs was 2.9±1.2 cm, including 24 mixed GGOs and 3 pure GGOs. EBUS images of all 27 GGOs were evaluated, cytological, histological and combination diagnosis analyzed, and complications observed. Under thin bronchoscope, 2 out of 27 cases showed bronchial stenosis, 1 showed bronchial stenosis with mucosal swelling, and the other 24 did not show abnormalities. Twenty-five out of 27 GGOs were found by EBUS, including 22 cases of mGGO and 3 of pGGO. In these ultrasonic images of 22 mGGOs, 18 showed mixed blizzard sign, 3 showed diffusely heterogeneous acoustic shadow and 1showed blizzard sign. Ultrasonic images of 3 pGGOs all appeared as blizzard sign. Twenty-six cytological specimens were obtained, and 16 were diagnosed clearly. All 27 histological specimens were collected, and 18 were diagnosed clearly. Nineteen of 27 cases were diagnosed by combination of cytological and histological specimens. One complication of EBUS-GS with mild bleeding was observed, and hemorrhage was terminated by conservative treatment. EBUS-GS is valuable for GGO diagnosis with less complications and higher safety. GGO ultrasonic image manifested as mixed blizzard sign, blizzard sign or diffusely heterogeneous acoustic shadow.
探讨经支气管镜超声引导针吸活检术(EBUS-GS)对周围型肺磨玻璃影(GGO)的诊断价值。回顾性分析2014年11月至2015年1 2月我院肿瘤医院连续27例经EBUS-GS诊断的27个GGO患者的临床资料。这27例患者中,男性9例,女性18例,平均年龄59±11岁。27个GGO的中位病变大小为2.9±1.2 cm,其中混合性GGO 24个,纯GGO 3个。对所有27个GGO的EBUS图像进行评估,分析细胞学、组织学及联合诊断情况,并观察并发症。在细支气管镜下,27例中有2例显示支气管狭窄,1例显示支气管狭窄伴黏膜肿胀,其余24例未显示异常。27个GGO中25个通过EBUS发现,其中混合性GGO 22例,纯GGO 3例。在这22例混合性GGO的超声图像中,18例显示混合暴风雪征,3例显示弥漫性不均匀声影,1例显示暴风雪征。3例纯GGO的超声图像均表现为暴风雪征。获取26份细胞学标本,16份诊断明确。收集所有27份组织学标本,18份诊断明确。27例中有19例通过细胞学和组织学标本联合诊断。观察到1例EBUS-GS轻度出血并发症,经保守治疗出血停止。EBUS-GS对GGO诊断有价值,并发症少,安全性高。GGO超声图像表现为混合暴风雪征、暴风雪征或弥漫性不均匀声影。