CT引导下穿刺活检在孤立性肺结节的诊断价值  

The diagnostic value of CT-guided percutaneous needle biopsy for solitary pulmonary nodules

作　　者：王海彦[1] 庄一平[1] 陈梅[2] 张晋[3] 冯勇[3] 张晓[1] 许林[4] 

机构地区：[1]江苏省肿瘤医院放射科,210009 [2]江苏省肿瘤医院CT室,210009 [3]江苏省肿瘤医院胸外科,210009 [4]中山大学附属第二医院检验科,510120

出　　处：《岭南现代临床外科》2007年第5期375-378,共4页Lingnan Modern Clinics in Surgery

基　　金：江苏省科技发展计划项目资助(BS2006005)

摘　　要：目的探讨CT引导下肺穿刺活检在诊断孤立性肺结节中的价值。材料和方法对56例孤立性肺结节CT引导下进行穿刺活检,观察CT平扫上结节的形态学特点,对穿刺活检术的诊断正确率与病灶的大小、位置、进针深度进行Logistic回归分析,并分析并发症情况。结果56例孤立性肺结节中,41例为恶性,7例为良性,8例活检未获明确诊断。恶性结节较良性结节多见,CT恶性结节表现有空泡征、分叶征、短细毛刺、嵴突征、血管集束征及胸膜凹陷征。CT引导下肺穿刺活检诊断孤立性肺结节的正确率为86%,气胸的发生率为3.6%。Logistic回归发现,病灶的大小是影响穿刺活检正确率的主要因素(Wald=2.903,P=0.038,OR=0.935)。结论CT引导下肺穿刺活检病灶诊断孤立性肺结节临床价值大,准确率较高,而病灶的大小影响穿刺活检的正确率。Objective To investigate the diagnostic value of CT-guided percutaneous needle biopsy for solitary pulmonary nodules, Methods CT-guided percutaneous transthoracic needle biopsy was performed in 56 patients with solitary pulmonary noude. All cases had proved by surgical pathology or clinical follow-up. The morphological features of the nodules on plain CT scans were observed. The diagnostic accuracy of the CT-guided percutaneous transthoracic lung biopsy and its complications were analyzed. A logistic regression analysis was used to investigate the relationship between the location and size of the lesions and insertion depth of biopsy needles and the diagnostic accuracy of CT-guided percutaneous needle biopsy. Resluts In 56 cases of solitary pulmonary nodules, the malignant and benign and indeterminated diagnosis of biopsy were 41 and 7 and 8 cases respectively. The manifestations of malignant nodules in CT scan were vacuole sign, lobulated sign, short spicule sign, spine sign, vessel convergence and pleural indentation sign. The diagnostic accurate rate of CT-guided percutaneous needle biopsy was 86% and the incidence of pneumothorax was 3.6%. Logistic regression analysis revealed that size of nodules were principal factors to effect diagnostic accurate rate of needle biopsy. （Wald=2.903,P=0.038,0R=0.935）. Conclusion CT- guided percutaneous needle biopsy is a clinically valuable diagnostic means for solitary pulmonary nodules with regard to its high diagnostic accurate rate. The lesion size has significant effect on the diagnostic accurate rate.

关 键 词：孤立性肺结节 活检 CT引导 诊断正确率 并发症 

分 类 号：R445.3[医药卫生—影像医学与核医学] R561[医药卫生—诊断学]