CT引导经皮肺穿刺切割活检对肺内疑难病变诊断的研究  

The study of diagnosis on difficult pulmonary pathological changes by percutaneous biopsy under CT guided

作　　者：刘志仁[1] 纪志英[1] 刘静[1] 

机构地区：[1]山东省德州市人民医院放射科,山东德州253014

出　　处：《医学影像学杂志》2005年第4期282-285,共4页Journal of Medical Imaging

摘　　要：目的:探讨CT导引下经皮肺穿刺切割活检技术及临床应用价值。方法:在CT定位导引下使用槽式切割活检针进行病理组织学检查。结果:110例病变中,12例肺内弥漫性病变,98例肺内局灶性病变。在局灶性病变中,邻近胸膜的病灶36例,邻近肺门的病灶6例,距穿刺点胸膜最远8. 5cm。病灶靶区刺中率98. 18% (10. 8/110 ) ,切割取材成功率92 . 72 % (10 2 /110 ) ,病理确诊率96 . 36 % (10. 6 /110 ) ,并发症19.0 9(2 1/110 )。结论:①让患者保持相对固定的呼吸屏气相位,精确控制进针深度、角度及穿刺路径是刺中病灶靶区、减少并发症的关键;②CT导引下经皮肺穿刺切割活检技术是肺内疑难病变定性诊断的理想方法。Objective:To explore the technique of pulmonary percutaneous biopsy under CT guided and the clinical application.To resolve the qualitative diagnosis of difficult pulmonary pathological changes.Methods:The pathological diagnosis was performed after getting the tissue by the groovy needle punctured the lesion.Results:The 110 focuses included 12 diffuse pulmonary diseases and 98 focal pulmonary diseases,There are 36 cases near pleura and 6 cases near hilum of lung in the focal pulmonary disease.The biggest distance between the lesion and pleura was 8.5cm.The successful rate of puncture was 98.18%(108/110),the successful rate of incising tissue was 92.72%(102/110),the defined pathologcal diagnostic rate was 96.36%(106/110),and complication presented in 19.09%(21/110).Conclusion:①Let the patients do their best to keep holding their breath immovably during puncture,accurately measure the depth of lesion and regulate the angle of puncture out of pleura,that is the key for successful puncture.It's the key for reducing complications that the needle avoid interlobar pleura and thicker veins and then reach the edge of the lesion quickly through visceral pleura.It's the key for patholoical qualitative diagnosis to get enough patholoic tissue;②The technique of pulmonary percutaneous biopsy under CT guided is the perfect method for qualitative diagnosis of difficult pulmonary pathological changes:it is of great clinical application.

关 键 词：肺内病变 切割活检 CT引导 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]