胸部大血管旁直径≤3cm病灶CT引导穿刺活检技术的应用  

Clinical Application of CT-guided Percutaneous Biopsy of Pulmonary Nodules Smaller than 3.0cm and Adjacent to Large Vessels

作　　者：李平[1] 王蕴[1] 宋广学[1] 张辉[1] 万淑红[1] 顾涛[1] 付占昭[1] 

机构地区：[1]秦皇岛市第一医院放射科,河北066000

出　　处：《放射学实践》2008年第3期307-309,共3页Radiologic Practice

摘　　要：目的:评价CT引导经皮穿刺活检术对邻近胸部大血管旁直径≤3cm病灶的临床应用价值。方法:采用CT引导经皮穿刺术对206例邻近胸部大血管的直径≤3cm病灶进行活检,并与手术或临床随访诊断结果进行对比,分析其敏感性、特异性、准确性及并发症情况。结果:本组中该方法对恶性肿瘤的诊断敏感度为82.7%(124/150),阳性预测值100%;对良性病变的诊断特异度为100%,阴性预测值68.3%(56/82);总诊断符合率为87.4%(180/206)。气胸发生率8.3%(17/206),肺内出血发生率9.2%(19/206),均未作特殊处理而自愈;病灶周围有肺气肿是气胸及肺内出血的危险因素(χ2分别为27.56和30.45,P<0.01),而病灶大小及深度与并发症无明显相关性(P>0.05)。结论:CT引导经皮穿刺活检术对邻近胸部大血管旁直径≤3cm病灶的诊断准确性较高且并发症少。Objective：To evaluate the clinical value of CT-guided percutaneous biopsy of pulmonary nodules smaller than 3.0cm and adjacent to large vessels. Methods：206 patients underwent CT-guided biopsy nodules,which were 43.0cm in diameter and located adjacent to large vessels. The diagnosis were correlated with that of surgery or clinical following-up. Sensitivity, specificity and accuracy were calculated, and the incidence and cause of complications were analyzed. Results： The sensitivity and positive prediction value for the diagnosis of malignant neoplasm were 82.7% and 100%respectively. The specificity and negative prediction value for the diagnosis of benign lesion were 100% and 68.3% respectively. The total diagnosis accuracy was 87.4%. The incidence of complicated pneumothorax and pulmonary hemorrhage were 8.3% and 9.2% respectively,which were self-limited without special treatment. Emphysema adjacent to the lesion was a significant risk factor related to the occurrence of complicated pneumothorax and pulmonary hemorrhage. No significant statistical difference was existed between the incidence rate of complication with the size and depth of the lesion （P〉0.05）. Conclusion： CT- guided percutaneous biopsy of pulmonary nodules ≤3.0cm in diameter and adjacent to large vessels showed high diagnostic accuracy and low incidence rate of complication.

关 键 词：活组织检查 体层摄影术 X线计算机 放射学 介入性 肺肿瘤 

分 类 号：R814.42[医药卫生—影像医学与核医学] R814.47[医药卫生—放射医学]