改进的定位技术在胸部肿瘤穿刺活检中的应用  

Practical value of improved localization processes for conducting chest tumor core biopsy

作　　者：付秀根[1] 石磊[1] 郑祖安[1] 姜永生[1] 袁响林[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院肿瘤科,武汉430030

出　　处：《放射学实践》2011年第9期992-995,共4页Radiologic Practice

摘　　要：目的:探索CT-SIM三维定位系统、体模固定技术和PET-CT融合影像导引定位技术在胸部肿瘤经皮穿刺活检中的应用价值。方法:对380例胸部肿瘤患者行改进的CT定位技术下的经皮穿刺活检术。根据肿瘤的大小、深度、毗邻关系、活动度以及患者的心肺功能状态,综合运用CT-SIM系统、体模固定技术和PET-CT融合影像导引技术,为患者进行穿刺前定位。统计穿刺定位时间长度、成功率、确诊率、并发症发生情况,并与210例采用传统铅栅定位下胸部肿瘤穿刺活检的相应资料进行比较。结果:采用改进的CT定位技术的380例患者穿刺定位精确,平均定位时间(9.5 min)较传统方法(16.8 min)缩短7.3 min,活检成功率和确诊率分别是98.7%和95.3%,高于传统定位方法的93.3%和83.3%,两者差异均具有统计学意义(P<0.05)。穿刺并发症发生率相似,气胸发生率分别为2.8%和2.9%,咯血发生率分别为11%和12.8%。结论:根据患者状态及肿瘤特点,在CT-SIM系统快速精确定位技术的基础上,综合运用体模固定技术和PET-CT融合影像导引技术,能显著缩短经皮穿刺活检的定位时间,提高活检成功率。Objective：To evaluate the improved localizing processes of percutanous core biopsy by applying the CT-SIM three-dimension localizing system、the mould immobilizing technique and PET-CT fusion image guiding technique.Methods：There were 590 patients who had been conducted CT-guided core biopsys for chest tumors from January,2008 to January,2011.The improved positioning processes were used in 380 cases during October,2009 to January,2011,while other 210 cases were punctured by using the lead grid.Data had been collected including the time span for positioning,rates of completing the biopsies and positive pathological results,and the complications.Results：All the 380 cases were precisely localized.The average time span of procedure by the CT-SIM system was 7.3min shorter than the group using the lead grid.The rates of completing the biopsies and positive pathological results were 98.7%（P0.05） and 95.3%（P0.05） when localizing the lesions by the CT-SIM system,while the rates of lead grid group were 93.3% and 83.3%.The incidences of pneumothorax and hemoptysis were similar in the two groups.Conclusion：The improved localizing processes of percutanous core biopsy by applying the CT-SIM three-dimension localizing system、the mould Immobilizing technique and PET-CT fusion image guiding technique can be helpful to conduct the core biopsy faster and more accurate.

关 键 词：定位 体模 显象术 体层摄影术 X线计算机 正电子发射断层显像术 活组织检查 针吸 

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