Lesser Thomas Günter, Petersen Iver, Pölzing Frank, Wolfram Frank
Department of Thoracic and Vascular Surgery, SRH Wald-Klinikum Gera, Teaching Hospital of Friedrich-Schiller University of Jena, Gera, Germany.
Institute of Pathology, SRH Wald-Klinikum Gera, Teaching Hospital of Friedrich-Schiller University of Jena, Gera, Germany.
Ultrasound Med Biol. 2018 Jul;44(7):1556-1562. doi: 10.1016/j.ultrasmedbio.2018.03.003. Epub 2018 Apr 4.
Ultrasound-guided transthoracic needle biopsy (USgTTNB) can only be used for peripheral tumours that contact the pleura. Sonographic accessibility of the entire lung can be achieved using one-lung flooding. In this study, feasibility, sensitivity and complication rate of USgTTNB of lung nodules after one-lung flooding in an ex vivo and in vivo lung tumour model were assessed. USgTTNB was performed ex vivo after one-lung flooding in 10 resected human lung lobes containing carcinoma or metastasis. USgTTNB after one-lung flooding and simulation of a lung nodule was conducted in vivo in 5 animals. Transthoracic sonography and chest X-ray were obtained 30 min after reventilation. The lungs were examined macroscopically and histopathologically. The pathologic diagnosis was confirmed in 85.7% and 100% of tumours after first and second puncture attempts, respectively. The successful puncture rate in vivo was 90%. Neither pneumothorax nor bleeding was observed. One-lung flooding enables USgTTNB of lung nodules with a high sensitivity and minimal risk of complications in a pre-clinical model.
超声引导下经胸针吸活检（USgTTNB）仅适用于与胸膜接触的周围型肿瘤。采用单肺灌洗可实现对整个肺的超声检查。本研究评估了在离体和活体肺肿瘤模型中，单肺灌洗后对肺结节进行USgTTNB的可行性、敏感性和并发症发生率。对10个含有癌或转移灶的切除人肺叶进行单肺灌洗后，在离体状态下进行USgTTNB。对5只动物在活体状态下进行单肺灌洗并模拟肺结节后进行USgTTNB。复通气30分钟后进行经胸超声检查和胸部X线检查。对肺进行大体和组织病理学检查。首次和第二次穿刺尝试后，分别有85.7%和100%的肿瘤得到病理诊断证实。活体状态下的成功穿刺率为90%。未观察到气胸或出血情况。在临床前模型中，单肺灌洗可使对肺结节进行USgTTNB具有高敏感性和最低并发症风险。
