Zhao Zhen-Long, Peng Li-Li, Wei Ying, Li Yan, Wang Ge-Meng, Yu Ming-An
Department of Interventional Ultrasound Center, China-Japan Friendship Hospital, Beijing 100029, China.
J Thorac Dis. 2020 Mar;12(3):858-865. doi: 10.21037/jtd.2019.12.92.
Ultrasound-guided lung biopsy (USLB) is a minimally invasive, real-time, safe and effective way to diagnose peripheral lung lesions. USLB is now widely used in clinical practice. However, the accuracy of USLB lacks large sample studies, and specimens from USLB are seldom used for microbial cultures. In this study, the efficiency of diagnosing tumours and infectious diseases with USLB is investigated, and the safety of USLB is evaluated.
From September 2015 to August 2018, a total of 507 cases of USLB were retrospectively reviewed, including the pathological results, microbial culture results and complications. The final diagnosis was confirmed by clinical diagnosis and follow-up. The technical success rate and accuracy of USLB were calculated.
Six patients were excluded because they were lost to follow-up. A total of 501 patients were finally included (335 males and 166 females). The diagnostic accuracy of USLB was 82.0%. The accuracy of USLB in diagnosing lung tumours was 88.5% and that for diagnosing special infections was 55.2%. The positive rate of USLB lung tissue cultures was 18.3%. USLB can diagnose some microbial infections with high accuracy, such as mycobacterial infections, and , and infections.
USLB is a safe and effective method for diagnosing peripheral lung lesions with high accuracy and a low complication rate. Lung tissue pathology and cultures have good diagnostic value for tuberculosis and fungi infections. Lung tissue cultures can also diagnose bacterial infections and can contribute to the selection of antibiotics.
超声引导下肺活检（USLB）是诊断周围型肺病变的一种微创、实时、安全有效的方法。USLB目前在临床实践中广泛应用。然而，USLB的准确性缺乏大样本研究，且USLB获取的标本很少用于微生物培养。本研究探讨了USLB诊断肿瘤和感染性疾病的效率，并评估了USLB的安全性。
回顾性分析2015年9月至2018年8月共507例USLB病例，包括病理结果、微生物培养结果及并发症情况。最终诊断经临床诊断及随访证实。计算USLB的技术成功率和准确性。
6例患者因失访被排除。最终纳入501例患者（男性335例，女性166例）。USLB的诊断准确性为82.0%。USLB诊断肺部肿瘤的准确性为88.5%，诊断特殊感染的准确性为55.2%。USLB肺组织培养阳性率为18.3%。USLB能高精度诊断某些微生物感染，如分枝杆菌感染，以及 、 和 感染。
USLB是诊断周围型肺病变的一种安全有效的方法，准确性高，并发症发生率低。肺组织病理学及培养对结核和真菌感染具有良好的诊断价值。肺组织培养也能诊断细菌感染，并有助于抗生素的选择。
