低剂量CT引导肺小结节活检的应用  

Low-dose CT-guided Needle Biopsy of Small Pulmonary Nodules

作　　者：王臣[1] 嵇鸣[1] 叶春涛[1] 

机构地区：[1]复旦大学附属华东医院放射科,上海200040

出　　处：《中国医学影像学杂志》2014年第4期297-299,304,共4页Chinese Journal of Medical Imaging

摘　　要：目的探讨低剂量CT扫描对直径<1.5 cm的肺内结节穿刺活检的效果及安全性,在保证穿刺准确性及安全性的前提下,最大限度地降低辐射剂量。资料与方法回顾性分析92例行肺部小结节活检的患者,随机分为常规剂量组52例和低剂量组40例,常规剂量组管电流200 mA,管电压120 kV;低剂量组管电流10 mA,管电压120 kV。比较两组CT吸收剂量加权指数(CTDIw)、剂量长度乘积(DLP)、穿刺并发症发生率及穿刺成功率。结果低剂量组CTDIw和DLP分别为(25.16±3.21)mGy和(1.53±0.15)mGy?cm,显著低于常规剂量组的(186.32±22.13)mGy和(9.13±0.51)mGy?cm,差异有统计学意义(t=50.56、46.46,P<0.01);常规剂量组及低剂量组穿刺成功率分别为92.31%、92.50%,差异无统计学意义(χ2=0.13,P>0.05);常规剂量组7例(13.46%)发生气胸、6例(11.54%)咯血,低剂量组4例(10.00%)发生气胸、5例(12.50%)咯血,两组咯血及气胸发生率比较,差异无统计学意义(χ2=0.85、0.84,P>0.05)。结论低剂量CT扫描对于直径<1.5 cm的肺内结节活检较常规剂量CT扫描具有相同的准确性及安全性,同时能有效减少患者的辐射剂量。Purpose To discuss the efficacy and security of low-dose CT in guiding biopsy of pulmonary nodules smaller than 1.5 cm. Materials and Methods A retrospective study of 92 patients who underwent CT guided biopsy of lung nodules were carried out. The patients were randomly divided into normal dose group （52 patients, 200 mA, 120 kV） and low dose group （40 patients, 10 mA, 120 kV）. Factors like weighted CT dose index （CTDlw）, dose- length product （DLP）, biopsy success rate and complication rate in each group were compared respectively. Results The low dose group was significantly lower than the normal dose group in CTDIw and DLP [（25.16±3.21） mGy and （1.53±0.15） mGy-cm versus （186.32±22.13） mGy and （9.13 ±0.51） mGy.cm]; differences with statistic significance： t=-50.56 and 46.46, P〈0.01）. The biopsy success rate in the normal group was 92.31% and that in the low dose group was 92.50%, and it showed no statistic difference （χ2=0.13, P〉0.05）. In the normal group, seven patients suffered from pneumothorax （13.46%）, six patients with hemoptysis （11.54%）; while in the low dose group, four patients suffered from pneumothorax （10.00%） and five with hemoptysis （12.50%）. The incidence rate of pneumothorax and hemoptysis in the two groups had no statistic difference （χ2=0.85 and 0.84,P〉0.05）. Conclusion Low-dose CT- guided needle biopsy of pulmonary nodules smaller than 1.5 cm is feasible and safe, and can effectively reduce radiation dosage of patients in clinical practice.

关 键 词：结节病  肺 肺肿瘤 体层摄影术  螺旋计算机 辐射剂量 活组织检查  针吸 

分 类 号：R734.2[医药卫生—肿瘤] R730.42[医药卫生—临床医学]