计算机X线断层扫描引导细针穿刺活检诊断肺部小病灶  

Computed tomography-guided percutaneous transthoracic fine-needle aspiration biopsy of small pulmonary nodules

作　　者：张月莉[1] 严德钧[1] 

机构地区：[1]华东医院呼吸科,上海200040

出　　处：《上海医学》2005年第10期850-852,共3页Shanghai Medical Journal

摘　　要：目的探讨计算机X线断层扫描(CT)引导下经皮细针穿刺活检诊断肺部周边小病灶的准确度和安全性。方法2000年6月至2003年11月共45例患者行CT引导下经皮肺部周边小病灶穿刺,男34例,女11例,年龄31～81岁,平均为(61.8±13.7)岁。病灶直径7～20mm,平均为(16.3±4.5)mm。孤立病灶39例,多发病灶6例。结果恶性病变19例(42.2%);良性病变17例(37.8%);组织学检查阴性6例,其中1例为假阴性;无诊断价值3例。其准确度为91.1%(41/45例),灵敏度为95%(19/20例)。并发气胸4例(8.9%)。2例(4.4%)患者合并病灶周围少量出血。讨论CT引导下细针穿刺肺部良、恶性病灶是相当安全和准确的诊断方法,其准确度和安全性与病灶大小和进针深度有关,小病灶准确度低于大病灶。该方法除气胸外无其他严重并发症,值得临床广泛推广。Objective To appraise the diagnostic accuracy and safety of computed tomography （CT）-guided percutaneous transthoracic fine needle aspiration biopsy of small pulmonary nodules. Methods Fourty-five patients （34 men and 11 women）, 31-82 years old （mean age, 61.8 years ） with small solitary pulmonary nodules underwent CT guided transthoracic fine needle aspiration biopsy. The overall diagnostic accuracy, sensitivity and complication rates were analysed. Factors influencing the diagnostic accuracy and pneumothorax rate were statis- tically evaluated. Results 42. 2% （n=19） were malignant and 37. 8% （n= 17） were benign. Histologically, there were 5 true-negative, one false-negative, and no false-positive. The overall sensitivity was 95 % （19/20）; and the diagnostic accuracy rate was 91.1 % （41/45）. Four （8.9%） patients had pneumothorax and two（4.4%） patients complicated with perifocal mild hemorrhage. Patient older than 60 showed a significant increase in occurrence of pneumothorax in comparison with their younger counterparts （P〈0.01）. Conclusion CT-guided percutaneous needle aspiration biopsy is an useful diagnostic tool for solitary pulmonary nodule smaller than 2 cm in diameter. （Shanghai Med J, 2005, 28：850-852）

关 键 词：肺肿瘤/诊断 活组织检查 计算机X线断层扫描 

分 类 号：R814.42[医药卫生—影像医学与核医学]