支气管内超声引导下经血管针吸活检诊断肺门和纵隔病变的安全性和有效性

Safety and efficacy of EBUS-TVNA technology in diagnosis of hilum of lung and mediastinal lesions

摘要:

目的 探讨支气管内超声引导下经血管针吸活检（EBUS-TVNA）在肺门和纵隔病变中的诊断价值。方法 回顾性分析2021年6月－2023年1月该院接受超声支气管镜检查，因病变和气道间隔血管，行EBUS-TVNA的10例患者的临床资料。分析EBUS-TVNA诊断阳性率和并发症发生情况。结果 10例患者中，8例穿过肺动脉和分支，2例分别穿过主动脉和上腔静脉。所有患者均成功获取标本。有8例患者明确诊断，恶性病变6例，良性病变2例，EBUS-TVNA诊断肺门和纵隔疾病的总体阳性率为80.0%（8/10），诊断恶性疾病的敏感度为85.7%（6/7），特异度为100.0%（3/3）；有2例患者未能明确诊断，1例行经皮肺穿刺确诊为膀胱尿路上皮癌肺转移，1例随访6个月，病灶缩小归为良性。入组患者检查耐受性较好，均未发生严重并发症。结论 EBUS-TVNA诊断肺门和纵隔病变，是一种安全有效的技术，可作为传统超声内镜技术的有效辅助手段。

Abstract:

Objective To evaluate the diagnostic value of endobronchial ultrasound-transvascular needle aspiration (EBUS-TVNA) in hilum of lung and mediastinal lesions.Methods 10 cases of hilum of lung and mediastinal lesions who underwent EBUS-TVNA because vessels pass between the airway and lesions were selected from June 2021 to January 2023, the diagnostic rate and complications were retrospectively analyzed.Results Of the 10 patients, 8 traversed the pulmonary artery or its branches, 2 traversed aorta or superior vena cava. Specimens were successfully obtained from all patients and 8 of them got definitive diagnosis, including 6 malignancy and 2 benign lesions. The overall yield of EBUS-TVNA for hilum of lung and mediastinal lesions was 80.0% (8/10), the diagnostic sensitivity for malignancy was 85.7% (6/7), and the diagnostic specificity was 100.0% (3/3). The other 2 cases were not diagnosed,1 was diagnosed as bladder urothelial carcinoma by percutaneous lung puncture biopsy, and the other was classified as benign due to the reduced lesion after 6 months of follow-up. All of them had good tolerance to the operation, and no serious complications occurred.Conclusion EBUS-TVNA is a safe and effective technique for the diagnosis of hilum of lung and mediastinal lesions, it can be used as an effective auxiliary method to traditional ultrasound bronchoscopy techniques.