PET/CT图像辅助CT引导下肺部病变穿刺活检  

PET/CT-aided CT-guided percutaneous biopsy of lung lesions

作　　者：丁勇生[1] 夏淦林[1] 李洪江[1] 王汉杰[1] 司海峰[1] 沈爱军[1] 

机构地区：[1]南通市肿瘤医院影像科,江苏南通226361

出　　处：《中国介入影像与治疗学》2013年第12期730-733,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：南通市科技计划项目(HS2011008)

摘　　要：目的评价PET/CT图像辅助CT引导下肺部病变穿刺活检技术的临床应用价值。方法回顾性分析38例接受18F-FDG PET/CT全身显像,并在15日内接受PET/CT图像辅助CT引导下穿刺活检的肺部病变患者的资料,探讨肺部病变的PET/CT图像特点,并以术后病理或临床随访结果为标准,计算活检诊断的准确率、敏感度、特异度、假阴性率及主要并发症发生情况。结果 PET/CT示22例病灶代谢均匀,16例不均匀。PET/CT图像辅助CT引导下穿刺活检取材成功率为94.74%(36/38),真阳性35例,真阴性1例,假阴性2例,无假阳性病例;诊断准确率为94.74%(36/38)、敏感度为94.59%(35/37)、特异度为100%(1/1)、假阴性率为5.41%(2/37)。穿刺后主要并发症包括气胸3例,咯少量鲜血1例,针道出血4例,胸部疼痛4例。结论 PET/CT图像辅助CT引导下肺部病变穿刺活检术能降低假阴性率,相对安全、高效。Objective To observe clinical value of percutaneous biopsy of lung lesions under CT guidance combined with previously acquired 18 F-FDG PET/CT images. Methods Data of 38 patients who underwent PET/CT and CT-guided per- cutaneous biopsy of lung lesions within 15 days after PET/CT were retrospectively analyzed. The characteristics of lesions on PET/CT images were observed. Final diagnosis was established on the basis of histopathology after operation or clinical follow-up. The accuracy rate, sensitivity, specificity, false-negative rate and primary complication rate of biopsy were cal- culated. Results Uniform metabolic focal lesions on PET/CT images were found in 22 cases, while uneven lesions were detected in 16 cases. The success rate of biopsy was 94.74% （36/38）. Biopsy tissues of 35 patients were proved positive, 1 was negative, 2 were false-negative, while none was false-positive. The diagnostic accuracy rate of biopsy was 94.74% （36/38）, the sensitivity was 94.59% （35/37）, and specificity rate was 100% （1/1）, false-negative rate was 5.41% （2/ 37）. Pneumothorax occurred in 3 cases, slight hemoptysis occurred in 1 case, while pulmonary hemorrhage and chest pain occurred in 4 cases, respectively. Conclusion PET/CT-aided CT-guided percutaneous biopsy can reduce false-negative, which is relatively safe and effective in diagnosis of lung lesions.

关 键 词：体层摄影术 X线计算机 肺肿瘤 活组织检查 

分 类 号：R814.42[医药卫生—影像医学与核医学] R734.2[医药卫生—放射医学]