Nambu Y, Mouri M, Matsui M, Okada T, Kobayashi Y, Kishimoto N, Noguchi T, Matsuda M, Sakurai S, Ohya N
Department of Internal Medicine, Kanazawa Medical University, Ishikawa, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1993 Jan;31(1):37-44.
Bronchography is essential for evaluation of morphological changes in the bronchial tree. However, conventional bronchography using Propyliodone (Dionosil) is extremely invasive, especially to those with pulmonary infections. In the present study, we developed a new less invasive method of bronchography with the aid of digital subtraction technique (DSBG), and evaluated its clinical benefits. Bronchography was performed by injecting contrast medium (Iopamidol: Iopamiron 300) via the lumen of the bronchoscope (Olympus Type 20), and image processing of the respiratory tract was performed using digital subtraction technique. From 1991 to 1992, DSBG was performed in 15 cases (8 bronchiectasis, 1 diffuse panbronchiolitis, 1 lung cancer, 1 pulmonary emphysema, and 4 others). DSBG clearly demonstrated the morphological changes of large and segmental bronchial lesions in cases of bronchiectasis and lung cancer, as well as conventional bronchography using Dionosil. In addition, it was possible to image the morphological changes of bronchiolar lesions in diffuse panbronchiolitis and pulmonary emphysema to the same detail as obtained using classical selective alveolo-bronchography (SAB). Since DSBG can provide enhanced images the bronchial tree without being affected by cardiac and respiratory movements, we could obtain detailed information on bronchial and/or bronchiolar lesions. With respect to side effects, Iopamiron was quickly drained and/or absorbed within 2 hours after injection. Pulmonary infection and bronchial bleeding, which are well known primary complications of classical bronchography using Dionosil, were not observed. We conclude that 1) DSBG is useful new technique for examining morphological changes of the respiratory tract, and 2) DSBG is less invasive than conventional bronchography.
支气管造影对于评估支气管树的形态变化至关重要。然而，使用丙碘酮（碘司特）的传统支气管造影具有极高的侵入性，尤其对于肺部感染患者。在本研究中，我们借助数字减法技术开发了一种新的侵入性较小的支气管造影方法（数字减法支气管造影，DSBG），并评估了其临床益处。通过支气管镜（奥林巴斯20型）管腔注入造影剂（碘帕醇：碘必乐300）进行支气管造影，并使用数字减法技术对呼吸道进行图像处理。1991年至1992年，对15例患者进行了DSBG（8例支气管扩张、1例弥漫性泛细支气管炎、1例肺癌、1例肺气肿和4例其他疾病）。DSBG清晰地显示了支气管扩张和肺癌病例中大支气管和段支气管病变的形态变化，与使用碘司特的传统支气管造影效果相同。此外，对于弥漫性泛细支气管炎和肺气肿中小支气管病变的形态变化，其成像细节与经典选择性肺泡支气管造影（SAB）相同。由于DSBG能够提供增强的支气管树图像，且不受心脏和呼吸运动的影响，我们能够获得有关支气管和/或细支气管病变的详细信息。关于副作用，碘必乐在注射后2小时内迅速排出和/或吸收。未观察到使用碘司特的经典支气管造影常见的主要并发症肺部感染和支气管出血。我们得出结论：1）DSBG是一种用于检查呼吸道形态变化的有用新技术；2）DSBG的侵入性比传统支气管造影小。
