冯靖--Radial_EBUS-径向超声及其杂交技术.pdfVIP

Radial Endobronchial Ultrasound (Radial-EBUS) 径向超声 冯 靖 天津医科大学总医院 呼吸与危重症科 主任医师 教授 博士生导师 美国杜克大学医学中心 博士后 美国国立卫生研究院 博士后 客座教授 Radial-EBUS: For What? • Peripheral pulmonary lesions (PPLs) were defined as those that were surrounded by pulmonary parenchyma and not visible by bronchoscopy (no evidence of endobronchial lesion, extrinsic compression, submucosal tumour, or narrowing, inflammation or bleeding of the bronchus). • PPLs are common problems in clinical practice. Clinical data and radiographic finding, such as chest radiography and computed tomography (CT) can provide some clues for diagnosis. However, in some circumstances, definite diagnosis is required before deciding on the appropriate treatment. Therefore, respiratory specimens are needed to identify the etiology of the lesions. • Flexible brochoscopy (FB) can reach into the airway up to the subsegmental bronchi; beyond the visual range, the airway continually divides into many generations before the peripheral target is reached. Without guidance, FB cannot guarantee an accurate sampling at the exact location of the PPL. • Diagnostic yield for routine bronchoscopy for investigation of PPL (i.e. lesions not endobronchially visible) may be ＜20%. • The highest diagnostic yield for bronchoscopic evaluation of PPLs appears to be associated with use of Radial Endobronchial ultrasound (Radial-EBUS). • Radial EBUS has a 20-MHz (12-30 MHz available) rotating transducer that can be inserted together with or without a guide sheath (GS) through the working channel (2.0- 2.8 mm) of a standard flexible bronchoscope. Radial EBUS transducer probes come in different sizes with external diameters of 1.4- 2.6 mm. • EBUS ‘Central’ probes are utilise