Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
Medicina (Kaunas). 2022 Mar 9;58(3):405. doi: 10.3390/medicina58030405.
: Clinically, a major challenge of multiple nodule localization is puncture-related pneumothorax, which may hamper the successful localization. This study aims to investigate and compare the efficacy and safety of the simultaneous and sequential patent blue dye (PBD) injections for identifying multiple pulmonary nodules during preoperative CT-guided localization. : Sixty-one consecutive patients with multiple pulmonary nodules who underwent preoperative CT-guided localization with PBD injections between January 2020 and December 2020 were retrospectively enrolled. Of these patients, 31 patients with 64 nodules who underwent simultaneous injections were designated as the simultaneous group; the remaining 30 patients with 63 nodules who underwent sequential punctures were designated as the sequential group. The clinical and radiological features, technical information, pathological results, and procedure-related variables and complications of the two groups were reviewed and analyzed. : The localization success rate of the simultaneous group was higher than that of the sequential group (100% [64/64] vs. 93.7% [59/63], = 0.041). The incidences of pneumothorax (32.3 vs. 33.3%, = 0.929) and pulmonary hemorrhage (6.3 vs. 3.0%, = 1) were not significantly different between the two groups, and all cases were minor, which did not require further intervention. Additionally, a significantly lower radiation dose (2.7 vs. 3.5 mSv, = 0.001) and a shorter procedure time (20.95 vs. 25.28 min, = 0.001) were observed in the simultaneous group than in the sequential group. : Compared with the sequential method, simultaneous PBD injections may improve the localization success rate with a shorter procedure time and less radiation exposure if the patient with multiple pulmonary nodules can be approached in a single position. Further prospective studies are needed to validate these results.
临床上，多发结节定位的一个主要挑战是与穿刺相关的气胸，这可能会妨碍定位的成功。本研究旨在探讨和比较同时和顺序注射专利蓝染料（PBD）识别术前 CT 引导下定位的多个肺结节的疗效和安全性。
回顾性纳入 2020 年 1 月至 2020 年 12 月期间因 PBD 注射行术前 CT 引导下定位的 61 例连续多发肺结节患者。其中 31 例 64 个结节行同时注射，设为同时组；其余 30 例 63 个结节行序贯穿刺，设为序贯组。比较两组的临床和影像学特征、技术信息、病理结果及与操作相关的变量和并发症。
同时组的定位成功率高于序贯组（100%[64/64]比 93.7%[59/63]， = 0.041）。两组气胸发生率（32.3%比 33.3%， = 0.929）和肺出血发生率（6.3%比 3.0%， = 1）无显著差异，且均为轻微，无需进一步干预。同时组的辐射剂量（2.7 比 3.5 mSv， = 0.001）和操作时间（20.95 比 25.28 min， = 0.001）均显著短于序贯组。
与序贯法相比，如果能在一个体位接近多个肺结节的患者，同时注射 PBD 可能会提高定位成功率，同时操作时间更短，辐射暴露更少。需要进一步的前瞻性研究来验证这些结果。
