圆束计算机断层扫描指导支气管检查对周边肺病变的有效性和安全性:系统性审查和元分析
Ziling Li1,2, Shuyun Xu1,2, Yong Zhang3
1Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Journal of thoracic disease
|March 14, 2025
概括
形束计算断层扫描 (CBCT) 导向的支气管检查是一种安全有效的方法来诊断周围肺病变 (PPLs),实现高诊断产量. 这种技术在识别和采样小或难以定位的肺部异常方面具有显著的优势.
科学领域:
- 肺部病理学 肺部病理学
- 医疗成像医学成像
- 诊断程序 诊断程序 诊断程序
背景情况:
- 周围肺病变 (PPLs) 带来了诊断方面的挑战.
- 形束计算机断层扫描 (CBCT) 引导的支气管镜正在成为PPL诊断的关键工具.
研究的目的:
- 通过元分析评估CBCT指导式支气管镜诊断PPL的疗效和安全性.
- 确定影响诊断产量 (DY) 和不良事件的因素.
主要方法:
- 使用QUADAS-2进行系统的文献搜索和质量评估.
- 综合诊断收益率 (DY) 和不良事件率的元分析.
- 小组分析探索导航技术,损伤特征和采样方法.
主要成果:
- 包括23项涉及1769名患者和1863名PPL的研究.
- 整体聚合的DY为80.2% (95%CI:76.0-84.1%).
- 在机器人辅助导航中观察到的最高DY (87.5%);病变大小>20毫米,支气管征兆和固体病变改善了诊断几率. 聚合不良事件发生率为2.3%.
结论:
- 通过CBCT指导的支气管镜检查显示了PPL的高诊断产量.
- 该程序是安全的,具有较低的不良事件率.
- 机器人辅助导航和特定的损伤特征提高了诊断的成功.
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