Objective: To evaluate the diagnostic value of thin-slice CT navigation combined with radial endobronchial ultrasound in peripheral lung lesions. Methods: The clinical data of patients with peripheral lung lesions diagnosed by thin-slice CT navigation combined with radial endobronchial ultrasound in National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from November 2015 to August 2018 were retrospectively analyzed. The success rate of thin-slice CT for guiding radial endobronchial ultrasound was statistically analyzed, and the diagnostic rate, sensitivity and specificity of thin-slice CT combined with radial endobronchial ultrasound were analyzed. Results: 140 consecutive patients with 145 lesions were included, 139 lesions in 136 patients were found by thin-layer CT guidance, the success rate was 95.9%; 137 lesions in 135 patients were examined by histology and/or cytology, and 106 lesions were finally diagnosed, the diagnostic rate was 77.37%; and the diagnosis sensitivity and specificity was 88.45% and 99.96%. Histological and cytological diagnostic rate, sensitivity and specificity was 72.18% versus 63.50%, 70.58% versus 66.85%, 100% versus 88.23%, respectively. Factors influencing the diagnostic rate of thin-slice CT navigation combined with radial endobronchial ultrasound include the relationship between the lesion and the target bronchus, the location of the probe and the lesion, and the size of the lesion, and the difference between the farthest generation of bronchoscopy insertion and the bronchial generation of lesions. Five patients had mild bleeding and one ultrasonic probe was damaged. Conclusion: Thin-slice CT has a higher positive rate in guiding peripheral lung lesions with radial ultrasound, and this method has a higher diagnostic value for peripheral lung lesions.
目的： 探讨薄层CT导航联合径向超声在肺外周病变诊断中的价值。 方法： 回顾性分析2015年11月至2018年8月在中国医学科学院北京协和医学院肿瘤医院行薄层CT导航联合径向超声诊断的肺外周病变患者的临床资料。统计薄层CT导航引导径向超声显示病变的成功率，分析薄层CT联合径向超声对肺外周病变的诊断率、诊断敏感度及特异度；分析在诊断过程中对薄层CT联合径向超声诊断率的影响因素，总结并发症发生情况。 结果： 共纳入140例患者145个病变，136例139个病变经薄层CT导航引导发现病变，引导成功率为95.86%；135例患者137个病变进行了病理和（或）细胞学取样，诊断敏感度为88.45%，特异度为99.96%，诊断率为77.37%。其中经活检病理诊断敏感度为70.58%，特异度为100%，诊断率为72.18%；细胞学诊断敏感度为66.85%，特异度为88.23%，诊断率为63.50%；影响薄层CT导航联合径向超声诊断率的因素包括病变与目标支气管的关系、探头与病变的位置关系、病变大小以及病变所在支气管级数与支气管镜进镜最远级数差。取样的135例患者中5例患者出现少量出血，1支超声探头发生损坏。 结论： 薄层CT对径向超声在肺外周病变诊断中的引导成功率高，该方法对肺外周病变具有较高的诊断价值。.
Keywords: Diagnosis; Lung neoplasms; Surgery, computer assistant; Tomography, X-Ray computed; Ultrasonography, intervantional.