2018 年 26 巻 1 号 p. 11-16
Background: Ultrasound guidance in bronchofiberscope has been used in endobronchial approach and body-surface ultrasound in transcutaneous approach. We attempted to combine the two methods, creating the body-surface ultrasound-guided bronchofiberscope (BSUS-BF) method, and evaluated its utility in diagnosing peripheral lung lesions.
Methods: The patients with lesions visible in body-surface ultrasound and ≤5 cm in longer axis in CT scan were selected for the study. The forceps were controlled under the fluoroscopy and checked by the ultrasound for real-time visualization of the forceps in the lesions. Statistical analyses used Pearson’s chi-squared test.
Results: The forceps were visualized in 68.7% cases (79/115). The diagnostic rate was 59.1% overall and 67.1% when the forceps were visualized. For malignant lesions; the diagnostic rate was 72.6% overall and 78.6% when the forceps were visualized. For lesions ≤3 cm in malignant lesions; the diagnostic rate was 62.7% (18/29) overall and 73.7% (14/19) when the forceps were visualized. The diagnostic rate was 74.0% (37/50) when the forceps were located within the lesions and 48.3% (14/29) when the forceps were located adjacent to them.
Conclusions: BSUS-BF offers real-time confirmation of the positioning of forceps in lesions, giving a higher diagnostic rate when the forceps are visualized. This study is registered in the University Hospital Medical Information Network (UMIN) clinical trials registry with registration number UMIN000013227.
