支气管内超声引导针吸活检术在单纯纵隔病变诊断中的应用价值

目的:探讨支气管内超声引导针吸活检术(endobronchial ultrasound-guided transbronchial needle aspiration,EBUS-TBNA)在单纯纵隔病变诊断及鉴别诊断中的应用价值。方法:回顾性分析总结2009年9月至2011年4月在北京大学人民医院胸外科接受EBUS-TBNA检查的73例不伴肺内异常的单纯纵隔病变患者的临床资料,对于EBUS-TBNA未能明确诊断的患者,进一步行外科手术活检或至少6个月以上的临床及影像学随诊。结果:本组73例患者,经EBUS-TBNA检查后60例获得明确诊断,其中恶性病变23例,良性病变37例,确诊率82.2%(60/73)。EBUS-TBNA在单纯纵隔病变良恶性诊断和鉴别诊断方面的敏感性、特异性和准确性分别为95.8%(23/24),100%(49/49)和98.6%(72/73)。所有患者检查耐受良好,无任何相关并发症发生。结论:对于单纯纵隔病变,EBUS-TBNA是一种安全、有效的诊断及鉴别诊断方法。

Application of endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of isolated mediastinal lesions

Objective: To evaluate the role of endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA) in the diagnosis of isolated mediastinal lesions.Methods: A retrospective study was conducted of 73 consecutive patients with isolated mediastinal lesions of unknown origin without parenchymal lung abnormalities,who underwent EBUS-TBNA from September 2009 to April 2011.The patients who were nondiagnostic with EBUS-TBNA subsequently underwent surgical biopsies and a minimum of 6 months’clinical and radiologic follow-up.Results: EBUS-TBNA achieved definitive diagnoses in 60 patients of the 73 patients(82.2%,60/73).Malignancies were diagnosed in 23 patients and benignancies in 37.The sensitivity,specificity,and accuracy of EBUS-TBNA in distinguishing malignant mediastinal lesions were 95.8%(23/24),100%(49/49) and 98.6%(72/73),respectively.EBUS was well tolerated by all of the patients with no complications.Conclusion: EBUS-TBNA of isolated mediastinal lesions is a minimally invasive and safe diagnostic technique with high yield.