CT引导下经皮胸膜或肺结节穿刺的临床应用  

Clinical application of CT-guided percutaneous puncture for pleural or pulmonary nodules

作　　者：徐才国[1] 张杰华[1] 柯孔良[1] 尹雪君 朱卫峰[1] 牛富业[1] 

机构地区：[1]解放军第413医院放射科,浙江舟山316000

出　　处：《中国医学影像技术》2009年第S1期167-168,共2页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨在普通CT机引导下经皮胸膜或肺结节穿刺的临床应用价值。方法在西门子普通CT机引导下经皮胸膜或肺结节穿刺共35例,其中男23例,年龄35～75岁,中位年龄56岁;女12例,年龄33～65岁,中位年龄52岁,穿刺前充分阅读增强CT片,确定穿刺部位,避开血管或其他重要结构,患者体位根据结节与胸壁距离行仰卧、俯卧或侧卧位;在结节部位先行厚层CT平扫,在CT机下测量经皮结节穿刺角度和进针深度,穿刺1～3针,穿刺针为18、20和22号,对胸膜或靠近胸壁结节用18号针,对远离胸壁或肺气肿明显患者则采用20或22号穿刺针。结果35例患者均穿刺成功,32例获得组织学和细胞学,3例仅获得细胞学,但病理均能明确诊断。结论CT引导下经皮胸膜或肺结节穿刺,对胸膜或肺结节的诊断极有价值,也安全可靠。Objective To investigate the clinical value of percutaneous puncture guided with general CT for pleural or pulmonary nodules.Methods Pleural or pulmonary nodules in 35 cases were percutaneous punctured guided by ordinary Siemens CT machine.Enhanced CT films were full read before puncture to determine the puncture site and avoid blood vessels or other important structure.Patient posture were determined by the distance between the chest and nodules such as supine,prone or lateral position.CT scan nodules,puncture angle and depth were measured in the CT films.Results Thirty-five cases were successfully punctured,tissues and cells were gotten in 32 cases,and only cells in three cases.All patients were diagnosed through the pathological.Conclusion CT-guided percutaneous puncture are valuable,safe and reliable for the diagnosis of pulmonary nodules and pleura.

关 键 词：体层摄影术 X线计算机 穿刺 活检 

分 类 号：R814.42[医药卫生—影像医学与核医学] R56[医药卫生—放射医学]