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Copyright ©ERS Journals Ltd 2004
Endobronchial ultrasonography with guide-sheath for peripheral pulmonary lesions
1 First Dept of Medicine, Hokkaido University School of Medicine, Sapporo, 2 Dept of Medicine, Iwamizawa Municipal General Hospital, Iwamizawa, and 3 Dept of Radiology, Hokkaido University School of Medicine, and 4 Dept of Surgery, National Hiroshima Hospital, Higashi-Hiroshima, Japan.
CORRESPONDENCE: K. Yamazaki, First Dept of Medicine, Hokkaido University School of Medicine, North 15, West 7, Kitaku, Sapporo, 060-8638, Japan. Fax: 81 117067899. E-mail: kyamazak@med.hokudai.ac.jp
Keywords: Bronchial brushing cytology, endobronchial ultrasonography, guide-sheath, peripheral pulmonary lesion, primary lung cancer, transbronchial biopsy
Received: December 15, 2003
Accepted June 23, 2004
The usefulness of endobronchial ultrasonography (EBUS) with guide-sheath (GS) as a guide for transbronchial biopsy (TBB) for diagnosing peripheral pulmonary lesions (PPL)s and for improving diagnostic accuracy was evaluated in this study.
EBUS-GS-guided TBB was performed in 24 patients with 24 PPLs of
Nineteen peripheral lesions (79.2%) were visualised by EBUS. All patients whose PPLs were visible on EBUS images subsequently underwent an EBUS-GS-guided diagnostic procedure. A total of 14 lesions (58.3%) were diagnosed. Even when restricted to PPLs <20 mm in diameter, the diagnostic sensitivity was 53%.
In conclusion, endobronchial ultrasonography with guide sheath-guided transbronchial biopsy was feasible and effective for diagnosing peripheral pulmonary lesions.
30 mm in diameter (average diameter=18.4 mm). A 20-MHz radial-type ultrasound probe, covered with GS was inserted via a working bronchoscope channel and advanced to the PPL in order to produce an EBUS image. The probe with the GS was confirmed to reach the lesion by EBUS imaging and X-ray fluoroscopy. When the lesion was not identified on the EBUS image, the probe was removed and a curette was used to lead the GS to the lesion. After localising the lesion, the probe was removed, and TBB and bronchial brushing were performed via the GS.
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