Jun Zhu1, Ye Gu2. 1. Department of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China. 2. Department of Endoscope, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Abstract
INTRODUCTION: Peripheral pulmonary lesions (PPL) are difficult to diagnose. We analysed the diagnostic values and risks of endobronchial ultrasonography with a guide sheath (EBUS-GS) and computed tomography-guided transthoracic needle aspiration (CT-TTNA) in diagnosing PPL. METHODS: We collected 250 cases received EBUS-GS examination, and 279 cases received CT-TTNA examination. We analysed the diagnosis results and the complications of each operation and determined the relevant indications. RESULTS: Biopsy was successful in 239 cases (95.6%) using EBUS-GS and in 279 cases (100%) using CT-TTNA. Lesions were smaller than or equal to 30 mm for biopsy using EBUS-GS in 60.7% of the cases. The distances of lesions from the chest wall were greater than 80 mm for EBUS-GS examination in 89.1% of the cases. The diagnostic rate of EBUS-GS was 78.2%, including 41.8% (100 cases) malignant diseases. EBUS-GS is a highly safe method. The distances of lesions from the chest wall were no greater than 80 mm for CT-TTNA examination in 90.0% of the cases. The diagnosis rate using CT-TTNA was 94.6%, including 90.0% (251 cases) malignant diseases. For CT-TTNA, there is a high chance of complications such as pneumothorax and intrapulmonary hemorrhage. CONCLUSION: EBUS-GS and CT-TTNA each have their own limitations. EBUS-GS has a slightly lower diagnostic rate but higher safety, while CT-TTNA has a higher diagnostic rate but requires attention to complications. For lesions 80 mm more from the chest wall, we recommend EBUS-GS. For lesions 80 mm from or closer to the chest wall, we recommend CT-TTNA.
INTRODUCTION:Peripheral pulmonary lesions (PPL) are difficult to diagnose. We analysed the diagnostic values and risks of endobronchial ultrasonography with a guide sheath (EBUS-GS) and computed tomography-guided transthoracic needle aspiration (CT-TTNA) in diagnosing PPL. METHODS: We collected 250 cases received EBUS-GS examination, and 279 cases received CT-TTNA examination. We analysed the diagnosis results and the complications of each operation and determined the relevant indications. RESULTS: Biopsy was successful in 239 cases (95.6%) using EBUS-GS and in 279 cases (100%) using CT-TTNA. Lesions were smaller than or equal to 30 mm for biopsy using EBUS-GS in 60.7% of the cases. The distances of lesions from the chest wall were greater than 80 mm for EBUS-GS examination in 89.1% of the cases. The diagnostic rate of EBUS-GS was 78.2%, including 41.8% (100 cases) malignant diseases. EBUS-GS is a highly safe method. The distances of lesions from the chest wall were no greater than 80 mm for CT-TTNA examination in 90.0% of the cases. The diagnosis rate using CT-TTNA was 94.6%, including 90.0% (251 cases) malignant diseases. For CT-TTNA, there is a high chance of complications such as pneumothorax and intrapulmonary hemorrhage. CONCLUSION:EBUS-GS and CT-TTNA each have their own limitations. EBUS-GS has a slightly lower diagnostic rate but higher safety, while CT-TTNA has a higher diagnostic rate but requires attention to complications. For lesions 80 mm more from the chest wall, we recommend EBUS-GS. For lesions 80 mm from or closer to the chest wall, we recommend CT-TTNA.