Virtual endobronchial ultrasound for transbronchial needle aspiration
Virtual endobronchial ultrasound for transbronchial needle aspiration
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DOI：
10.1016/j.jtcvs.2013.01.019
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发表时间：
2013-11-01
影响因子：
6
通讯作者：
Date, Hiroshi
中科院分区：
文献类型：
--
作者：
Sato, Masaaki;Chen, Fengshi;Date, Hiroshi
目的：超声引导下经支气管针吸术在计算机准备下能更好地进行。方法：采用三维虚拟支气管镜技术，建立2种基于计算机的“虚拟支气管超声”模式。“虚拟支气管超声标准”采用传统的虚拟支气管镜确定经支气管针吸的位置和角度，再通过虚拟支气管镜进一步评估。“虚拟支气管超声高级”结合虚拟支气管镜对目标病变及相关血管结构进行多层三维成像。通过半透明支气管壁观察病灶及相关血管结构（如肺动脉）。结果：两种方法均需要5 ~ 15分钟的准备时间。虚拟支气管超声标准只需要基本的计算机软件即可进行虚拟支气管镜检查，而虚拟支气管超声高级则需要先进的计算机应用程序。先进的虚拟支气管超声可以更直观地识别目标。这两种方法都有助于评估经支气管针吸的可行性，特别是当目标不在常规纵隔淋巴结时，或靶向位于较高上角的病变（如4L淋巴结）时。由于穿刺点是预先确定的，因此在实际支气管超声引导下经支气管针穿刺时，支气管镜医师不必用超声寻找目标；相反，超声仅用于确认目标位置和经支气管针吸的可视化。结论：两种基于计算机的虚拟支气管超声制备方法均可用于预先确定经支气管吸针穿刺点，提示其对传统的超声引导下经支气管吸针技术具有潜在的补充作用。
Objective: Endobronchial ultrasound-guided transbronchial needle aspiration could be performed better with computer-based preparation.Methods: Three-dimensional virtual bronchoscopy was used to develop 2 modes of computer-based "virtual endobronchial ultrasound." "Virtual endobronchial ultrasound standard" used conventional virtual bronchoscopy to determine the spot and angle for transbronchial needle aspiration, which was further evaluated by virtual bronchoscopy. "Virtual endobronchial ultrasound advanced" used multiple layers of 3-dimensional images of the target lesions and associated vascular structures in combination with virtual bronchoscopy. Target lesions and associated vascular structures (eg, pulmonary artery) were visualized through half-transparent bronchial walls.Results: Both methods required 5 to 15 minutes of preparation per case. Virtual endobronchial ultrasound standard required only basic computer software for virtual bronchoscopy, whereas virtual endobronchial ultrasound advanced required an advanced computer application. Virtual endobronchial ultrasound advanced allowed for a more intuitive recognition of the target. Both methods were useful in evaluating the feasibility of transbronchial needle aspiration, especially when the target was out of regular mediastinal lymph nodes, or in targeting a lesion located at a high upper angle (eg, 4L lymph node). Because the puncture spot was predetermined, bronchoscopists did not have to search for the target using ultrasound at the time of actual endobronchial ultrasound-guided transbronchial needle aspiration; rather, ultrasound was used only for confirmation of the target location and visualization of transbronchial needle aspiration.Conclusions: Both computer-based preparation methods of virtual endobronchial ultrasound were useful in predetermining the puncture spot of transbronchial needle aspiration, suggesting their potential complementary role to the conventional technique of endobronchial ultrasound-guided transbronchial needle aspiration.