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首页> 美国卫生研究院文献>Journal of Thoracic Disease >Ultrasound techniques in the evaluation of the mediastinum part 2: mediastinal lymph node anatomy and diagnostic reach of ultrasound techniques clinical work up of neoplastic and inflammatory mediastinal lymphadenopathy using ultrasound techniques and how to learn mediastinal endosonography
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Ultrasound techniques in the evaluation of the mediastinum part 2: mediastinal lymph node anatomy and diagnostic reach of ultrasound techniques clinical work up of neoplastic and inflammatory mediastinal lymphadenopathy using ultrasound techniques and how to learn mediastinal endosonography

机译：超声技术在纵隔评估中的应用第2部分：纵隔淋巴结的解剖和超声技术的诊断范围利用超声技术进行的肿瘤性和炎症性纵隔淋巴结肿大的临床检查以及如何学习纵隔内镜

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Ultrasound imaging has gained importance in pulmonary medicine over the last decades including conventional transcutaneous ultrasound (TUS), endoscopic ultrasound (EUS), and endobronchial ultrasound (EBUS). Mediastinal lymph node (MLN) staging affects the management of patients with both operable and inoperable lung cancer (e.g., surgery vs. combined chemoradiation therapy). Tissue sampling is often indicated for accurate nodal staging. Recent international lung cancer staging guidelines clearly state that endosonography should be the initial tissue sampling test over surgical staging. Mediastinal nodes can be sampled from the airways [endobronchial ultrasound combined with transbronchial needle aspiration (EBUS-TBNA)] or the esophagus [endoscopic ultrasound fine needle aspiration (EUS-FNA)]. EBUS and EUS have a complementary diagnostic yield and in combination virtually all MLNs can be biopsied. Additionally endosonography has an excellent yield in assessing granulomas in patients suspected of sarcoidosis. The aim of this review in two integrative parts is to discuss the current role and future perspectives of all ultrasound techniques available for the evaluation of mediastinal lymphadenopathy and mediastinal staging of lung cancer. A specific emphasis will be on learning mediastinal endosonography. Part 1 deals with an introduction into ultrasound techniques, MLN anatomy and diagnostic reach of ultrasound techniques and part 2 with the clinical work up of neoplastic and inflammatory mediastinal lymphadenopathy using ultrasound techniques and how to learn mediastinal endosonography.
机译：在过去的几十年中，超声成像在肺部医学中已变得越来越重要，包括常规的经皮超声（TUS），内窥镜超声（EUS）和支气管内超声（EBUS）。纵隔淋巴结分期（MLN）影响可手术和不可手术的肺癌患者的治疗（例如手术与联合化学放疗）。通常需要进行组织取样以准确进行淋巴结分期。最近的国际肺癌分期指南明确指出，超声检查应作为外科分期的初始组织取样测试。可从气道[支气管内超声联合经支气管针抽吸术（EBUS-TBNA）]或食道[内镜超声细针抽吸术（EUS-FNA）]取样纵隔淋巴结。 EBUS和EUS的诊断率互补，几乎所有MLN都可以进行活检。另外，在怀疑结节病的患者中，超声检查在评估肉芽肿方面具有极好的效果。这篇综述的目的是在两个整合的部分中讨论可用于评估纵隔淋巴结病和肺癌纵隔分期的所有超声技术的当前作用和未来前景。具体重点将放在学习纵隔内镜检查上。第1部分介绍超声技术，MLN解剖学和超声技术的诊断范围，第2部分介绍使用超声技术对赘生性和炎性纵隔淋巴结肿大进行临床检查以及如何学习纵隔内超声。

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