Endobronchial ultrasonography (EBUS) using a radial ultrasound miniature probe for peripheral pulmonary lesions: tips and techniques

Background When bronchoscopy is performed for peripheral pulmonary lesions (PPLs), a radial ultrasound mini-probe can be inserted from the working channel of the bronchoscope to reach the PPL. Objectives This paper discussed the technique and advantages of diagnosing PPLs using mini-probe. Mini-probe scanning from within a bronchial lumen provides a short-axis image of a PPL. Results Internal structures within PPLs that can be identified by endobronchial ultrasonography (EBUS) include patent blood vessels, patent bronchi, hemorrhage, calcifications, bronchi filled with sputum, necrosis, and small amounts of air in pulmonary alveoli. PPLs are classified as type I if the internal echoes are homogeneous, type III if the internal echoes are heterogeneous, and type II if there are mainly hyperechoic lines and dots near the probe. About 92% of type I lesions were benign, whereas 99 % of type II and type III lesions were malignant. Conclusion There are several techniques of EBUS using a guide sheath (EBUS-GS) for getting adequate specimens of PPLs.