胸腔镜手术中肺部小结节定位方法进展-《中国医学物理学杂志》

文章信息/Info

Title:: Advances in the methods for localization of small pulmonary nodules in thoracoscopic surgery

Author(s):: HAN Xin1; ZHANG Peigang2; 1. Department of Cardiothoracic Surgery, Fenyang Hospital, Shanxi Medical University, Fenyang 032200, China 2. Office of the President, the Peoples Hospital of Lüliang, Lishi 033000, China

Keywords:: Keywords: small pulmonary nodule video-assisted thoracoscopy localization method review

摘要:: 随着高分辨率、低辐射剂量计算机断层扫描（CT）的广泛应用，尤其是随着参加肺癌筛查项目或健康体检人群的增加，肺部小结节的检出越来越多。对于高度怀疑恶性结节者，电视胸腔镜下手术是当前首选的诊疗方法。但在胸腔镜手术过程中术者很难通过手指去触摸、定位肺结节，因此需要使用肺结节定位技术辅助术者在术中准确找到肺结节并切除。根据定位与手术的顺序可分为术前定位及术中定位，前者主要有CT引导下经皮穿刺辅助定位、CT引导下液体材料定位、虚拟支气管镜导航定位等；后者有电磁导航支气管镜引导定位、术中超声定位、利用射频识别系统定位等。本文就以上定位技术及近年来肺结节定位的研究进展进行综述。

Abstract:: With the widespread use of high-resolution, low-radiation-dose computed tomography (CT) scans, especially with the increase in the number of people participating in lung cancer screening programs or health checkups, small lung nodules are increasingly being detected. Video-assisted thoracoscopic surgery is currently preferred treatment and diagnosis choice for those with a high suspicion of malignant nodules. However, during video-assisted thoracoscopic surgery, it is difficult for the operator to touch and localize the pulmonary nodules with his/her fingers, so the use of pulmonary nodule localization techniques is needed to assist the operator to accurately locate and resect the pulmonary nodules. According to the order of localization and surgery, it can be divided into preoperative localization and intraoperative localization, the former mainly includes CT-guided percutaneous puncture-assisted localization, CT-guided liquid material localization, and virtual bronchoscopic navigation localization while the latter includes electromagnetic navigation bronchoscopy-guided localization, intraoperative ultrasound localization, and localization using radiofrequency identification system. The review elaborates on the above-mentioned localization techniques and the research advances in lung nodule localization.