Endobronchial ultrasound (EBUS) has evolved beyond conventional applications in mediastinal staging and central pulmonary tumor diagnosis. It encompasses the assessment of pulmonary vasculature in patients with thoracic malignancies. EBUS can visualize major vessels and allow assessment of pulmonary embolism, differential diagnosis of endovascular lesions, and T staging. Additionally, EBUS-guided transvascular needle aspiration (TVNA) has proven valuable for sampling lesions behind vessels and diagnosing conditions such as pulmonary artery sarcoma and tumor embolism, with low complication rates reported. The PubMed and SCOPUS databases were searched up to November 2024 for articles in the English language reporting the use of EBUS for pulmonary vasculature assessment. References were also searched for relevant articles. The integration of EBUS with other modalities enhances staging and diagnostic capabilities in thoracic malignancies. Despite promising findings, limitations include suboptimal image quality and challenges in extensively assessing all the vasculature. Safety concerns, particularly with transvascular biopsy, remain minimal with expert handling, although further studies are needed to assess specific risks like hematogenous tumor seeding. EBUS continues to evolve, suggesting its potential to become the cornerstone in advanced thoracic diagnostics and treatment planning. This review systematically explores the feasibility, safety, and diagnostic utility of EBUS in pulmonary vasculature assessment, highlighting its potential as an indispensable tool in thoracic diagnostics and treatment planning.
支气管内超声（EBUS）的应用已超越纵隔分期和中央型肺部肿瘤诊断的传统范畴，扩展至胸部恶性肿瘤患者的肺血管系统评估。EBUS能够清晰显示主要血管结构，可用于肺栓塞评估、血管内病变的鉴别诊断以及肿瘤T分期。此外，EBUS引导下的经血管针吸活检（TVNA）已被证实对血管后方病变取样及诊断肺动脉肉瘤、肿瘤栓塞等疾病具有重要价值，且报道的并发症发生率较低。本研究检索了截至2024年11月PubMed和SCOPUS数据库中关于EBUS用于肺血管评估的英文文献，并通过参考文献追溯补充相关研究。EBUS与其他影像技术的融合显著提升了胸部恶性肿瘤的分期与诊断能力。尽管前景广阔，其局限性包括图像质量有待优化以及全面评估所有血管结构的挑战。在专业操作下，经血管活检的安全性风险极低，但仍需进一步研究评估肿瘤血行播散等特定风险。EBUS技术持续发展，有望成为胸部高级诊断与治疗规划的核心手段。本综述系统探讨了EBUS在肺血管评估中的可行性、安全性及诊断效用，强调其作为胸部疾病诊断与治疗规划不可或缺工具的潜力。
Endobronchial Ultrasound Access to Pulmonary Vasculature in Thoracic Malignancy
肿瘤(癌症)患者之家