Peripheral Pulmonary Disease Research Articles

Predictive Factors of Nonmalignant Pathological Diagnosis and Final Diagnosis of Ultrasound-Guided Cutting Biopsy for Peripheral Pulmonary Diseases.

This study aimed to explore the predictive factors of nonmalignant pathological diagnosis and final diagnosis of ultrasound-guided cutting biopsy for peripheral pulmonary diseases. A total of 470 patients with peripheral lung disease diagnosed as nonmalignant by ultrasound-guided cutting biopsy in the First Affiliated Hospital of Guangxi Medical University from January 2017 to May 2020 were included. Ultrasound biopsy was performed to determine the correctness of pathological diagnosis. Independent risk factors of malignant tumor were predicted by multivariate logistic regression analysis. Pathological biopsy results showed that 162 (34.47%) of the 470 biopsy data were specifically benign, and 308 (65.53%; malignant lesions: 25.3%, benign lesions: 74.7%) were nondiagnostic findings. The final diagnoses were benign in 387 cases and malignant in 83 cases. In the nondiagnostic biopsy malignant risk prediction analysis, lesion size (OR = 1.025, P = 0.005), partial solid lesions (OR = 2.321, P = 0.035), insufficiency (OR = 6.837, P < 0.001), and presence of typical cells (OR = 34.421, P = 0.001) are the final important independent risk factors for malignant tumors. In addition, 30.1% (25/83) of patients with nonmalignant lesions who were finally diagnosed with malignant tumors underwent repeated biopsy, and 92.0% (23/25) were diagnosed during the second repeated biopsy. 59.0% (49/83) received additional invasive examination. Nondiagnostic biopsy predictors of malignant risk include lesion size, partial solid lesions, insufficiency, and presence of atypical cells. When a nonmalignant result is obtained for the first time, the size of the lesion, whether the lesion is subsolid, and the type of pathology obtained should be reviewed.

Advances of Electromagnetic Navigation Bronchoscopy for Peripheral Pulmonary Lesions

随着计算机断层扫描的筛查应用普及，越来越多的外周肺部病变被发现，外周肺病变的诊断和治疗是目前临床较为棘手的问题之一。电磁导航支气管镜以电磁定位技术为基础，经支气管到达外周肺部病变进行活检或治疗，为肺部可疑病灶提供了新的微创诊治方法。本文将综述电磁导航支气管镜在外周肺病变诊治中的临床应用现状及进展。

Diagnostic Value of Non-Real-Time Radial Probe Endobronchial Ultrasound (RP-EBUS) Guided Positioning Method for Peripheral Pulmonary Lesions.

BackgroundThe aim of this study was to analyze the diagnostic value of thin bronchoscopy lung biopsy for peripheral pulmonary lesions under non-real-time guidance of radial ultrasound (RP-EBUS).Material/MethodsWe used a retrospective analysis of ultrasound images of 165 patients with peripheral pulmonary disease admitted to Suzhou Municipal Hospital Affiliated to Nanjing Medical University from February 2016 to December 2018 who were given RP-EBUS examination. Ultrasound images were obtained for all patients. There were 76 patients treated using traditional positioning method as the control group; 89 patients were treated by probe combined with bronchoscopy positioning method as the research group where the biopsy of the lesion along the path of the ultrasound probe was taken. The positive rate of the 2 methods was observed, and the factors affecting the quality of ultra-thin bronchoscopy under RP-EBUS non-real-time guidance were analyzed.ResultsThe detection rate of the study group was 77.64%, which was significantly higher than that in control group, which was 63.16% (χ2=5.238, P<0.05). The number of biopsies in the study group was 6±1.25, which was significantly lower than that of the control group which was 9±1.87 (t=4.116, P<0.05). The diagnostic positive rate of the RP-EBUS probe was significantly higher than that of the RP-EBUS probe (χ2=5.081, P<0.05).ConclusionsThe diagnostic positive rate of RP-EBUS non-real-time guided subtotal bronchoscopy lung biopsy for peripheral lung disease using probe combined with bronchoscopy positioning method was higher than the traditional positioning method, and the number of biopsies in the study group was significantly lower than that in the control group, which was related to the size, location, whether the probe was wrapped, or the characteristics of the ultrasound image.

Radiofrequency spectral analysis of EBUS for peripheral pulmonary lesions.

We previously reported that histogram-based quantitative evaluation for endobronchial ultrasonography (EBUS) B-mode images could differentiate between benign and malignant lesions. However, these images were generated from reconstructed raw radiofrequency (RF) signals and had some limitations. Currently, there are no reports on raw RF signal data to quantitatively differentiate ultrasound information for peripheral pulmonary lesions. We prospectively hypothesized that RF spectral analysis from EBUS images could reveal sonographic features of peripheral pulmonary diseases. RF data were imported into a frequency spectral analysis software programme, comparing four parameters: mean frequency (MHz); slope; mid-band fit (dB); and y-intercept (dB), to differentiate between benign and malignant lesions. Furthermore, we compared subgroup analysis within benign and malignant lesions. RF data from EBUS images were obtained in 146 cases, of which, 106 lung cancers and 40 inflammatory diseases were present. Significant differences were observed for three parameters in benign and malignant lesions (mean frequency: P < 0.05, slope: P < 0.05, y-intercept: P < 0.01) with diagnostic accuracy of 61%, 57.5%, 63%, respectively. In subgroup analysis, the acute pneumonia group showed higher mean frequency, higher slope and lower y-intercept patterns compared to mycobacterial and fibrotic diseases (P < 0.05). In malignant lesions, small cell carcinoma showed higher mean frequency, higher slope and lower y-intercept pattern compared to other histopathological lung cancers (P < 0.01). RF analysis might be capable of demonstrating aspects of the lesion's pathological heterogeneity rather than precisely differentiating between benign and malignant lesions.

Endobronchial ultrasound.

Endobronchial ultrasound (EBUS) has emerged as a routinely performed procedure in diagnostic bronchoscopy. Extending the view beyond the airway wall, EBUS provides evaluation of tumor involvement of tracheobronchial wall and mediastinum and plays an essential role as a guidance technique for peripheral pulmonary diseases. The latest development is the EBUS-transbronchial needle aspiration (TBNA) scope that allows performing real-time EBUS-TBNA of enlargerd hilar and mediastinal lymph nodes.

Ultrasound of the Thorax (Noncardiac)

Ultrasound examination of the thorax is an extremely valuable adjunct imaging modality in chest wall, pleural, mediastinal, and pulmonary disease. While air-filled lungs will obscure some deeper pulmonary lesions, ultrasound can evaluate peripheral pulmonary disease, mediastinal masses, and the extent and character of pleural effusions. Ultrasound guidance of needle biopsies and thoracocentesis provides safe and accurate lesion sampling.

Sonography Of The Lungs And Pleura

The role of Transthoracic Sonography in the evaluation of chest diseases has already been accepted throughout the world. Though Ultrasound (US) is not widely established as a routine method, but the advantages of low-cost, bedside availability and lack of ionizing radiation exposure has made it an indispensable diagnostic tool in the modern pulmonary medicine. US supplements the conventional chest X-ray and computed tomography and closes the gap between them. Besides, it is invaluable in the interventional procedures of chest and pleural space and it is suited to critically ill patients in need of bedside investigations. This article reviews the sonographic morphology of the pleural and peripheral pulmonary diseases.

Sonography Of The Lungs And Pleura

The role of Transthoracic Sonography in the evaluation of chest diseases has already been accepted throughout the world. Though Ultrasound (US) is not widely established as a routine method, but the advantages of low-cost, bedside availability and lack of ionizing radiation exposure has made it an indispensable diagnostic tool in the modern pulmonary medicine. US supplements the conventional chest X-ray and computed tomography and closes the gap between them. Besides, it is invaluable in the interventional procedures of chest and pleural space and it is suited to critically ill patients in need of bedside investigations. This article reviews the sonographic morphology of the pleural and peripheral pulmonary diseases.

3331: The usefulness of ultrasound guided core needle biopsy in peripheral pulmonary diseases

3331: The usefulness of ultrasound guided core needle biopsy in peripheral pulmonary diseases

Peripheral pulmonary diseases: evaluation with endobronchial US initial experience.

Endobronchial ultrasonography (US) with 4.5-F small-caliber US probes, combined with bronchoalveolar lavage technique, was evaluated in autopsied lungs and 22 patients with various pulmonary interstitial or alveolar diseases. Several different echoic patterns were found that may reflect changes due to pathologic alteration of lung parenchyma. This technique may have potential for evaluation and diagnosis of peripheral lung diseases.