Ultrasound-guided pathological sampling of cadaver lung tissue in cases of COVID-19

Objective: To investigate the method and application of ultrasound-guided post-mortem lung tissue sampling in cases of COVID-19 Methods: Ultrasound-guided post-mortem lung tissue sampling was performed with 14G biopsy needles in 17 confirmed COVID-19 cases in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from Feb to Mar 2020 ①Ten conventional puncture points were designed according to the anatomy of human lung lobes and the projections on the body surface The 3rd and 6th intercostal spaces in the left midclavicular line were the puncture points for the tissues of the medial areas of the upper and lower lobes of the left lung, and the 3rd, 4th, and 6th intercostal spaces in the right midclavicular line were the puncture points of the lung tissues taken from the medial areas of the upper, middle, and lower lobes of the right lung The 4th and 7th intercostal spaces in the left midaxillary line were the puncture points of the lung tissues from the upper and lower lateral lobes, and the 4th, 5th, and 7th intercostal spaces in the right midaxillary line were the puncture points of the lung tissues from the lateral areas of the upper, middle and lower lobes of the right lung ②According to the sonographic findings of the lung tissues at each puncture point, it was divided into three types: air-containing lung, consolidated lung and compressed lung And the corresponding sampling methods were designed to complete multiple points of the medial and lateral areas of the left and right lung lobes ③The time required for each lung sampling was recorded, and the sizes of the specimens were measured The success rates of all puncture points were compared and the success rates of various type lung tissues were compared Results: ①In 17 COVID-19 death cases, 174 puncture points were selected for bilateral lung tissues, and 288 lung tissue specimens were obtained by puncture ②There were differences in the success rates of the puncture points, and the success rate of the 6th intercostal puncture points on the left and right midclavicular lines were lower than those of the other puncture points(P<0 05) ③There were differences in the success rate of corpse lung sampling with different types of ultrasonographic performance The success rates of gas-containing lung sampling was 74 4%, which was lower than that of consolidation lung (86 8%)and compressed lung(84 1%)(P<0 05) ④The length of the compressed lung specimen was 11 4(10 6, 12 3)mm, which was lower than that of gas-containing lung and consolidation lung[14 6(12 5, 15 2)mm, 13 5(12 5, 15 0)mm] (P<0 05) Conclusions: This study introduces an ultrasound-guided minimally invasive puncture method for cadaver lung tissue sampling, and itmay be a reliable method for collecting lung tissues in COVID-19 cases © 2020 Chinese Medical Association