Diagnostic Utility of Electromagnetic Navigation Bronchoscopy Combined with Radial Probe Endobronchial Ultrasound in Peripheral Pulmonary Lesions

: 背景与目的 随着高分辨计算机断层扫描（computed tomography, CT）的广泛应用和健康体检的普遍开展，大量周围型肺部病灶被发现，对临床诊断治疗提出了新的挑战。电磁导航支气管镜（electromagnetic navigation bronchoscope, ENB）和径向探头支气管内超声（radial probe bronchoscopy ultrasound, R-EBUS）是用于周围型肺部病灶诊断的新兴技术，本研究旨在探讨ENB联合R-EBUS对肺周围型病灶诊断中的应用价值。方法 2016年9月-2017年11月苏州大学附属第一医院胸外科应用ENB技术对18例患者的30处肺部周围型病灶进行了检查，术前制定导航计划，术中导航成功到达预定位置后使用R-EBUS确认病灶，依次使用穿刺针、细胞刷、活检钳进行病灶组织活检。结果 30处肺部周围型病灶，导航成功率为100%（30/30），阳性诊断率为90%（27/30）。手术时间为（95.61±28.74）min，每处病灶导航时间为（25.90±11.29）min，发生气胸1例，未见其他严重并发症。结论 利用ENB联合R-EBUS技术诊断肺周围型病灶具有较高的导航成功率和诊断阳性率，安全有效，值得进行临床推广。. METHODS: From September 2016 to November 2017, eighteen patients with thirty peripheral pulmonary lesions in the First Affiliated Hospital of Soochow University were enrolled. The ENB was performed on these patients who were detected peripheral lung lesions by chest HR-CT. After successful navigation, the lesion's location was confirmed by R-EBUS, and specimens were acquired by needle aspiration, endoscopic cell brush and biopsy forceps. RESULTS: A total of eighteen patients with thirty lesions were enrolled in this study, the navigation success rate was 100%, the positive rate was 90%. The mean operation time was (95.61±28.74) min, and navigation time for each lesion was (25.90±11.29) min, and pneumothorax was observed in 1 case. CONCLUSIONS: ENB combined with R-EBUS for the diagnosis of peripheral pulmonary lesions is safe and effective. This technique is worth promoting.