Advantages and drawbacks associated with the use of endosonography in sarcoidosis.

IF 2.9 3区医学 Q2 RESPIRATORY SYSTEM Expert Review of Respiratory Medicine Pub Date : 2023-04-01 DOI:10.1080/17476348.2023.2201439

Kuruswamy Thurai Prasad, Sahajal Dhooria, Valliappan Muthu, Inderpaul Singh Sehgal, Ashutosh Nath Aggarwal, Ritesh Agarwal

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Abstract

Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a real-time, minimally invasive procedure for sampling intrathoracic lymph nodes. Herein, we discuss EBUS-guided procedures, their benefits, and drawbacks in diagnosing sarcoidosis.

Areas covered: We first describe the utility of various endosonographic imaging techniques like B-mode, elastography, and doppler imaging. We then review the diagnostic yield and safety of EBUS-TBNA and compare it with the other available diagnostic modalities. Subsequently, we discuss the technical aspects of EBUS-TBNA influencing the diagnostic yield. Recent advances in EBUS-guided diagnostics like EBUS-guided intranodal forceps biopsy (EBUS-IFB) and EBUS-guided transbronchial mediastinal cryobiopsy (EBMC) are reviewed. Finally, we summarize the advantages and disadvantages associated with EBUS-TBNA in sarcoidosis and provide an expert opinion on the optimal use of this procedure in patients with suspected sarcoidosis.

Expert opinion: EBUS-TBNA is a minimally invasive, safe procedure with a good diagnostic yield, and should be the preferred diagnostic modality for sampling intrathoracic lymph nodes in patients with suspected sarcoidosis. For optimal diagnostic yield, EBUS-TBNA should be combined with endobronchial biopsy (EBB) and transbronchial lung biopsy (TBLB). Newer endosonographic techniques like EBUS-IFB and EBMC might obviate the need for EBB and TBLB due to their superior diagnostic yield.

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在结节病中使用超声检查的利弊。

支气管超声引导下经支气管穿刺(EBUS-TBNA)是一种实时、微创的胸内淋巴结取样方法。在这里，我们讨论ebus指导的程序，他们的好处，以及在结节病诊断的缺点。涵盖的领域:我们首先描述了各种内声成像技术的应用，如b型、弹性成像和多普勒成像。然后，我们回顾了EBUS-TBNA的诊断率和安全性，并将其与其他可用的诊断方式进行了比较。随后，我们讨论了影响诊断良率的EBUS-TBNA技术方面。本文综述了ebus引导下诊断的最新进展，如ebus引导的结内钳活检(EBUS-IFB)和ebus引导的经支气管纵隔低温活检(EBMC)。最后，我们总结了与EBUS-TBNA治疗结节病相关的优点和缺点，并就该手术在疑似结节病患者中的最佳应用提供了专家意见。专家意见:EBUS-TBNA是一种微创、安全的手术，具有良好的诊出率，应作为疑似结节病患者胸内淋巴结取样的首选诊断方式。为获得最佳诊断率，EBUS-TBNA应联合支气管内活检(EBB)和经支气管肺活检(TBLB)。较新的超声技术，如EBUS-IFB和EBMC，由于其更高的诊断率，可能会消除对EBB和TBLB的需要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Respiratory Medicine RESPIRATORY SYSTEM-

CiteScore

6.80

自引率

2.60%

发文量

期刊介绍： Coverage will include the following key areas: - Prospects for new and emerging therapeutics - Epidemiology of disease - Preventive strategies - All aspects of COPD, from patient self-management to systemic effects of the disease and comorbidities - Improved diagnostic methods, including imaging techniques, biomarkers and physiological tests. - Advances in the treatment of respiratory infections and drug resistance issues - Occupational and environmental factors - Progress in smoking intervention and cessation methods - Disease and treatment issues for defined populations, such as children and the elderly - Respiratory intensive and critical care - Updates on the status and advances of specific disease areas, including asthma, HIV/AIDS-related disease, cystic fibrosis, COPD and sleep-disordered breathing morbidity