目的 评估胸腔镜手术(VATS)中超声定位肺部磨玻璃结节的临床价值.方法 前瞻性对14例行VATS的患者(慢性阻塞性肺部疾病 、 哮喘病史等影响术中肺萎陷者除外)共18枚磨玻璃结节(≤3 cm)进行术中超声定位,并将结节超声特征与CT及病理结果比较分析.结果 18枚结节超声全部给予明确定位(100％),其中13枚结节处于完全不张的肺组织中.术中超声显示结节大小与术前CT及术后病理测值差异无统计学意义(P>0.05).术中超声所呈现的高回声与低回声间肺萎陷的程度 、CT值以及病灶与胸膜的距离差异有统计学意义(P<0.05).超声定位平均用时(4.2±2.7)min.结论 术中超声在VATS中可以安全 、 有效地定位肺部磨玻璃结节及明确手术切除边界,可以辅助胸外科医生完成微创的肺部切除术.%Objective To evaluate the clinical significance of video-assisted thoracic surgery ( VATS) in localization of pulmonary ground-glass opacities( GGOs) by intraoperative ultrasound ( IU ) . Methods An intraoperative ultrasonographic procedure was prospectively performed on 14 patients harboring GGOs of no more than 3 cm in diameter to localize these lesions and achieve adequate margins . Patients were excluded with both asthma and chronic obstructive pulmonary disease from this study inasmuch as the intraoperative ultrasonographic procedure was more difficult to interpret when residual air is present in the lung . The sonographic characteristics of nodules were compared with those from CT and pathology . Results A total of 18 GGOs were successfully identified by intraoperative ultrasonography without any complications .In all instances 13 GGOs were localized in the lung of complet collapse ,and high-quality echo images were obtained . Additionally ,the IU showed that the nodule sizes were similar to those of CT and postoperative pathological specimens( P < 0 .05) . There was significant difference in lung collapse degree , the maximum diameter of CT and the distance from the lesion to the pleura between echo types ( P <0 .05) . The mean operation time was ( 4 .2 ± 2 .7) min . Conclusions Intraoperative ultrasonography can both safely and effectively localize pulmonary GGO in a completely deflated lung . Hence ,ultrasonography may assist surgeons to perform minimally invasive lung resections with clear surgical margins during the treatment of lung GGO .
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