经支气管超声诊断肺结节性病变

Endobronchial ultrasound in diagnosis of pulmonary nodules

目的探讨经支气管超声(EBUS)诊断肺部结节性病变的价值。方法对CT扫描提示肺部占位的52例肺部结节性病变患者行EBUS检查,观察病灶内部回声、边界、后壁回声及后方回声等超声表现。结果 52例肺部结节性病变患者中,良性病变18例,恶性病变34例。边界清晰和后壁呈线状均匀增强是肺部恶性病变的重要声像图特征,边界不清和后壁带状不均匀增厚是肺部良性病变的声像图特征;在肺部结节性病变中,"彗星尾征"提示肺鳞癌病变。声像图表现中内部回声、后方回声变对肺部结节性病变的诊断价值不大。EBUS检查未发生并发症。结论 EBUS是肺部结节性病变超声诊断的新方法,且安全有效。

Objective To investigate the value of endobronchial ultrasound（EBUS）in the diagnosis of the pulmonary nodules.Methods A total of 52 patients with pulmonary nodules detected on chest CT underwent EBUS.The ultrasound images including internal echo,edge of the state,the back wall echo and posterior echo changes were analyzed.Results In all 52 patients with pulmonary nodules,18 cases were benign lesions,and 34 cases were malignant lesions.The clear boundaries and the linear back wall with homogeneous enhancement were the typical images of malignant lesions.The fuzzy boundaries and unevenly thickened strip back wall were the typical images of benign lesions.Comet tail sign specifically suggested squamous cell carcinoma in pulmonary nodules.The internal echo and posterior echo of pulmonary nodule were meaningless for differential diagnosis.No complications occurred in applications of EBUS.Conclusion EBUS is a new technique of ultrasound in the differential diagnosis of pulmonary nodules which is safe and effective.