Usefulness of Endobronchial Ultrasonography With a Guide Sheath and Virtual Bronchoscopic Navigation for Ground-Glass Opacity Lesions

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• 作者：Yasuyuki Ikezawa ; MD ; PhD^a ; Naofumi Shinagawa ; MD ; PhD^a ; ^{naofu@med.hokudai.ac.jp} ; Noriaki Sukoh ; MD ; PhD^b ; Megumi Morimoto ; MD^a ; Hajime Kikuchi ; MD ; PhD^a ; Masahiro Watanabe ; MD^b ; Kosuke Nakano ; MD^b ; Satoshi Oizumi ; MD ; PhD^a ; Masaharu Nishimura ; MD ; PhD^a
• 刊名：The Annals of Thoracic Surgery
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：103
• 期：2
• 页码：470-475
• 全文大小：611 K
• 卷排序：103

文摘

Endobronchial ultrasonography with guide sheath (EBUS-GS) could be useful for diagnosing ground-glass opacity (GGO) predominant-type lesions in the peripheral lung. Furthermore, several studies have reported that transbronchial biopsy using EBUS-GS and virtual bronchoscopic navigation (VBN) was safe and effective for diagnosing small peripheral lung lesions. Our objectives were to diagnose solitary peripheral GGO predominant-type lesions by transbronchial biopsy using EBUS-GS and VBN under radiographic fluoroscopic guidance, and to evaluate the clinical factors associated with diagnostic yield.MethodsThe medical records of 169 patients with GGO predominant-type lesions who underwent transbronchial biopsy using EBUS-GS and VBN under radiographic fluoroscopic guidance were retrospectively reviewed.ResultsEndobronchial ultrasonography images could be obtained for 156 (92%) of 169 GGO predominant-type lesions, and 116 (69%) were successfully diagnosed by this method (20 of 31 pure GGO lesions [65%]; 96 of 138 mixed GGO predominant-type lesions [70%]). The mean size of diagnosed lesions was significantly larger than that of nondiagnosed lesions (22 mm versus 18 mm, p < 0.01). Regarding diagnostic yield based on computed tomography sign, cases with presence of a bronchus leading directly to a lesion had significantly higher diagnostic yield than the other lesions (p < 0.01).ConclusionsThe addition of VBN to EBUS-GS could be useful in clinical practice for diagnosing GGO predominant-type lesions in the peripheral lung.