胸部结节或肿块的CT导向穿刺活检及治疗的临床应用  

CT-guided needle biopsy and interventional treatment of thoracic nodule or masses

作　　者：莫科 孟家晓 徐绍斌 杨冠英[2] 秦义柳 

机构地区：[1]广东省佛山市南海区第四人民医院,广东528211 [2]广东省佛山市第一人民医院放射科,528000 [3]广东省佛山市禅城区南庄医院,528219

出　　处：《当代医学》2011年第14期52-55,共4页Contemporary Medicine

摘　　要：目的探讨CT导向经皮穿刺对胸部结节或肿块的诊断及介入治疗的临床意义。方法 CT导向下采用18-20G切吸两用穿刺针对25例胸部占位性病变进行穿刺诊断,对穿刺确诊的11例非小细胞肺癌及转移瘤注射无水乙醇及化疗药物,并与同期静脉化疗病例进行对照,观察近期疗效,比较生存率及毒副反应。结果 25例患者穿刺病理诊断为恶性肿瘤12例,良性肿瘤4例,结核3例,淋巴结肿大6例;恶性肿瘤中鳞癌6例,腺癌2例,小细胞癌1例,转移瘤3例。总阳性诊断率达100%,其中细胞学诊断阳性率75.4%,组织学诊断阳性率93.4%。无一例发生严重并发症及针道转移。治疗组较对照组近期疗效、生存率有显著性差异(P<0.05);治疗组毒副反应较对照组轻。结论 CT导向穿刺对胸部结节或肿块的诊断及介入治疗安全有效,值得临床上广泛应用。Objective This study was to investigate the diagnostic and interventional treatment value of CT-guided percutaneous puncture of thoracic nodule or masses.Methods Twenty-five cases with thoracic nodule or masses were performed percutaneous puncture using 18-20 Gauge core-needle and aspiration needle under CT guiding for the diagnosis.Eleven cases of nonsmall-cell lung carcinoma and metastatic tumor were treated with percutaneous ethanol injection or chemotherapeutics under CT guidance,and compared with the same cases of vein chemotherapeutic simultaneously.The shot-term curative effect,survive ratio,toxicity and side effect were observed.Results The specimens were satisfactory obtained in all cases and pathologic diagnosis were made in 25 cases and the positivity was 100%.In those cases,the positivity of cytological diagnosis was 75.4% and positivity of histological diagnosis was 93.4%.Twelve cases were diagnosed malignant tumor,4 cases of benign neoplasm,3 cases of pulmonary tuberculosis and 6 cases of lymphadenectasis in those 25 cases and of those 12 cases of carcinoma included of 6 cases of pulmonary squamous cell carcinoma,2 cases of pulmonary adenocarcinoma,1 cases of pulmonary small-cell lung carcinoma,3 cases of metastatic tumor.None of severe complication and metastasis in needle duct occurred.The shot-term curative effect,survive ratio,toxicity and side effect of curative group were lower than those in control group（P0.05）.Conclusion CT-guided needle biopsy and interventional treatment are of great safe and reliable for thoracic nodule or masses which to be worth wide application in clinical practice.

关 键 词：CT 胸部 活检 诊断 介入治疗 

分 类 号：R734[医药卫生—肿瘤]