Application Of Endobronchial Ultrasonography(EBUS) In Pulmonary Peripheral Nodule

Objective To evaluate the value of bronchoscopy using endobronchial ultrasonography(EBUS)for diagnosing peripheral pulmonary nodule(PPN).Method The clinical data of 73 patients undergoing bronchoscopy using radial EBUS for PPN were retrospectively analyzed between January 1st and December 31 st 2015.All patients with Computer Tomography(CT)examination showed pulmonary nodules <3cm and routine bronchoscopy showed no significant abnormalities.Biopsy and brushing guided by EBUS were employed.For people who couldn't be diagnosed with EBUS,invasive operation or more then 6 months follow-up after treatment was carried out.Calculated the diagnostic coincidence rate of EBUS,and compared diagnostic rate in different location relationship between the lesion and the ultrasonic probe,using or not a guide sheath(GS),and nodules in different lobes.At the same time,the relationship between the characteristics of ultrasound images and benign or malignant lesions was analyzed.Result 1.73 patients were confirmed malignant diseases in 50 patients and benign diseases in 23 patients.The visualization yield of PPN in bronchoscopy using EBUS was 80.8%(59/73),the diagnostic coincidence rate was 64.4%(47/73),with the malignant rate of 54%(27/50).2.The diagnostic yield(78.7%,37/47)when the EBUS probe was located within the lesion was significantly higher compared with if the probe was located adjacent(41.7%,5/12)to or outside the lesion(35.7%,5/1413)(P=0.003).3.Among the 59 cases detected by EBUS,there were 16 cases of homogeneous type,25% of malignant lesions,75% of benign lesions,43 cases of heterogeneous lesions,81.4% of malignant lesions,Lesions accounted for 18.6%,the difference was statistically significant(P <0.05).4.The diagnostic yield using a GS or not for PPN was 66.7%(4/6)and 64.2%(43/67)respectively,the difference was not statistically significant(P >0.05).5.The diagnostic rate of PPN in middle lobe of the right lung was the highest,the lowest was the upper lobe of the left lung.The diagnostic rate between different lobes was not statistically significant(P >0.05).6.Complications: there were 2 patients(2.7%,2/73)with a small amount of bleeding during bronchoscopy,no complications associated with EBUS directly.Conclusion Bronchoscopy using EBUS is effective and safe for diagnosing PPN,and is worthy of clinical promotion.Ultrasound probe and the location of the lesion can affect the accuracy of the diagnosis,ultrasound image can help determine benign and malignant lesions.