CT引导下细针穿刺活检对肺部空洞性病变的诊断价值  

Diagnostic Value of CT Guided Fine Needle Aspiration Biopsy in Cavitary Pulmonary Lesions

作　　者：王海彦[1] 庄一平[1] 张晋[1] 李旸[1] 张磊[1] 

机构地区：[1]江苏省肿瘤医院放射科,南京210009

出　　处：《临床放射学杂志》2013年第7期1021-1025,共5页Journal of Clinical Radiology

摘　　要：目的探讨CT引导下经皮细针穿刺活检在肺部空洞性肿块中的诊断价值。方法 97例肺内孤立性肿块或结节伴有空洞的患者,进行CT引导下经皮肺穿刺活检,以手术病理或1年随访的最终诊断为标准,计算CT穿刺活检的诊断准确率,比较不同病灶大小及空洞壁厚度下CT穿刺活检的诊断敏感度、特异度及准确率,并采用Lo-gistic回归分析CT穿刺活检并发症的危险因素。结果 CT穿刺活检的敏感度、特异度及准确率分别为97.4%,90.0%及95.9%,不同大小病灶(直径<2 cm或≥2 cm)、不同空洞壁厚度(<5或≥5 mm)其敏感度、特异度及准确率无统计学差异(P>0.05)。9例(9.3%)CT穿刺后出现少量气胸,14例(14.4%)出现少许肺泡出血,穿刺并发症与病灶大小、空洞壁厚度、针道深度及穿刺针大小无相关性(P>0.05)。结论 CT引导下经皮细针穿刺活检安全,对肺部空洞性病变的诊断准确性高。Objective To investigate the diagnostic value of CT guided fine needle aspiration biopsy （FNAB） in cavit- ary pulmonary lesions. Methods 97 consecutive patients with pulmonary cavitary mass or nodule received CT guided FNAB with use of an 18 gauge （ n = 33 ） or 20 gauge （ n = 64） Chiba needle for histological diagnosis. The diagnostic accu- racy of FNAB was calculated compared with the final diagnosis as determined by surgical histology or 1 year clinical follow up. The sensitivity, specificity, and accuracy were compared between patients with different lesion sizes and different cavity wall thickness. The risk factors of associated complications of FNAB were determined by using Logistical regression analy- sis. Results The overall sensitivity, specificity, and accuracy of FNAB were 97.4%, 90.0%, and 95.9%, respective- ly. The sensitivity, specificity, and diagnosis accuracy in different lesion size （ 〈 2 cm VS ≥ 2 cm）, or different cavity wall thickness （ 〈 5 mm VS ≥ 5 mm） were not different （P 〉0.05; O. 235）. Associated complications included pneumo- thorax in 9 （9.3%） patients and alveolar hemorrhage along the needle path or around the target lesions in 14 patients （ 14. 4% ） . The lesion size, wall thickness, length of the needle path and needle size were not risk factors of FNAB complications. Conclusion CT guided FNAB can be effectively ad safely used for patients with pulmonary cavitary lesions.

关 键 词：体层摄影术 X线计算机 肺活检术 细针穿刺活检术空洞性病变 

分 类 号：R816.41[医药卫生—放射医学]