Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Interventional Pulmonology, Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Clin Respir J. 2020 May;14(5):488-494. doi: 10.1111/crj.13159. Epub 2020 Feb 19.
Ultrasound elastography, is a pioneer sonographic modality that is conducted during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in order to increase the accuracy of sampling location. The current study aims to evaluate the usefulness of elastography during EBUS-TBNA in a population with a high prevalence of anthracosis.
This prospective single-blinded study was performed on 69 lymph nodes (LNs) of patients with mediastinal lymphadenopathy undergoing EBUS-TBNA and EBUS-elastography from October 2017 to July 2018. The stiffness level of the tissue was translated into a color to demonstrate the hardness of tissue. Blue and total areas of each section were measured to calculate the hardness of each LN.
Sixty-nine LNs were evaluated by elastography. Twenty percent of LNs were malignant. There was a statistical difference between malignant and non-malignant nodes based on color dominancy (P = 0.032). However, with the exclusion of anthracosis nodes from the analysis, the difference was more significant (P < 0.001). Moreover, when the blue dominancy was used as the predictor of malignancy or anthracosis, the results showed a significant correlation (P < 001).
The usefulness of elastography in selecting the hardest area of tissue that is appropriate for diagnosing diseases has been proven previously. Since in countries with a high prevalence of anthracosis, blue color achieved using elastography predicts either malignancy or anthracosis so, cases with blue dominancy of LNs in elastography and the white color in the EBUS-TBNA indicate anthracosis-caused calcification should be reconsidered.
超声弹性成像是一种超声模态，在支气管内超声引导下经支气管针吸活检术（EBUS-TBNA）期间进行，以提高采样位置的准确性。本研究旨在评估在煤尘沉着症高发人群中，弹性成像在 EBUS-TBNA 中的作用。
本前瞻性单盲研究于 2017 年 10 月至 2018 年 7 月期间对 69 例纵隔淋巴结肿大患者进行了 EBUS-TBNA 和 EBUS 弹性成像，共检测 69 个淋巴结。组织的硬度水平被转化为颜色以显示组织的硬度。测量每个节段的蓝色和总面积，以计算每个 LN 的硬度。
弹性成像评估了 69 个 LN。20%的 LN 为恶性。根据颜色优势，恶性和非恶性淋巴结之间存在统计学差异（P=0.032）。然而，排除煤尘沉着症的 LN 后，差异更显著（P<0.001）。此外，当蓝色优势被用作恶性或煤尘沉着症的预测因子时，结果显示出显著相关性（P<0.001）。
弹性成像在选择最硬的组织区域以诊断疾病的作用已得到证实。由于在煤尘沉着症高发的国家，弹性成像中使用的蓝色预测恶性或煤尘沉着症，因此在弹性成像中 LN 具有蓝色优势，而 EBUS-TBNA 中为白色的情况下，应重新考虑由煤尘沉着症引起的钙化。
