CT引导下注射吲哚菁绿在肺磨玻璃结节术前定位中的应用  

The application of CT-guided intrapulmonary injection of indocyanine green in preoperative localization of pulmonary ground-glass nodules

作　　者：林佳 王龙飞 吴安乐[1] 滕飞[1] 咸玉涛 韩瑞 LIN Jia;WANG Longfei;WU Anle;TENG Fei;XIAN Yutao;HAN Rui(Department of Interventional Radiology,Ningbo First Hospital,Ningbo,Zhejiang Province 315010,China)

机构地区：[1]宁波市第一医院介入放射科,浙江宁波315010 [2]宁波市第一医院胸外科,浙江宁波315010

出　　处：《介入放射学杂志》2023年第6期556-559,共4页Journal of Interventional Radiology

摘　　要：目的探讨CT引导下肺内注射吲哚菁绿(ICG)在肺磨玻璃结节(GGN)术前定位中的安全性和可行性。方法回顾性分析2021年10月至2021年12月因发现肺结节就诊于宁波市第一医院胸外科,同时行CT引导下肺内注射ICG定位和电视胸腔镜(VATS)肺结节切除术患者的临床资料。记录结节定位、手术及病理等信息。评价定位成功率和并发症发生率。结果共纳入64例患者(69枚GGN)。病灶直径为(0.7±0.3)cm,其中纯GGN 52个,混和GGN 17个。ICG定位时间为(9.3±4.1)min。并发症发生率为15.6%(10/64),5例少量气胸,5例少量肺内出血,均无特殊处理。术中所有结节均见荧光显影,2例见ICG弥散,但仍能找到病灶,定位成功率和手术切除成功率均达100%,无转开胸者,手术时间为(68.1±26.2)min,术中出血量为(12.0±5.2)mL。术后无严重并发症发生,术后住院时间(3.0±1.0)d,术后病理示肺腺癌91%(63/69)。结论CT引导下肺内注射ICG定位肺GGN是安全有效的。Objective To investigate the safety and feasibility of CT-guided intrapulmonary injection of indocyanine green(ICG)in the preoperative localization of pulmonary ground-glass nodule(GGN).Methods The clinical data of the patients,who were admitted to the Department of Thoracic Surgery of Ningbo First Hospital of China due to the discovery of pulmonary nodules between October 2021 and December 2021 and received preoperative localization of lung nodules by using CT-guided intrapulmonary injection of ICG together with video-assisted thoracoscopic(VATS)pulmonary nodule resection,were retrospectively analyzed.The information of nodule location,operation and pathology were recorded.The success rate of lesion localization and the incidence of complications were mainly evaluated.Results A total of 64 patients(69 GGNs in total)were enrolled in this study.The mean diameter of the lesions was(0.7±0.3)cm,including 52 pure GGNs and 17 mixed GGNs.The mean time spent for ICG localization was(9.3±4.1)min.The incidence of complications was 15.6%(10/64),including small amount of pneumothorax(n=5)and small amount of intrapulmonary hemorrhage(n=5),for which no special treatment was adopted.During the operation,ICG fluorescence visualization was observed in all GGNs,which displayed as a diffuse pattern in 2 patients but the lesions could still be demonstrated.Both the success rates of lesion localization and surgical resection were 100%,no thoracotomy was needed.The mean time spent for operation was(68.1±26.2)min and the mean amount of intraoperative blood loss was(12.0±5.2)mL.There were no serious complications after operation.The mean postoperative hospital stay was(3.0±1.0)days.The postoperative pathological diagnosis showed that 91%(63/69)of GGNs was lung adenocarcinoma.Conclusion For the preoperative localization of GGNs,CT-guided intrapulmonary injection of ICG is clinically safe and effective.

关 键 词：吲哚菁绿 肺磨玻璃结节 定位 胸腔镜 

分 类 号：R734.2[医药卫生—肿瘤]