CT引导下肺部微结节(≤1cm)同轴活检术临床分析  

The Clinical Analysis of CT-guided Percutaneous Core Needle Biopsy for Small(1 cm) Pulmonary Lesions

作　　者：邓伟[1] 胡洋[1] 徐亚琼[1] 

机构地区：[1]阆中市人民医院,四川阆中637400

出　　处：《中外医学研究》2014年第33期21-23,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨CT引导下经皮同轴活检术对肺部微结节(≤1 cm)诊断的临床应用价值。方法:采用CT引导下经皮穿刺同轴活检术对78例肺部病灶直径小于1 cm的微结节进行取材活检,穿刺活检结果与手术或临床随访结果进行对比分析。结果:总诊断准确率为92.3%,本组中该方法对恶性结节诊断敏感性为88.5%,对良性结节诊断特异度为100%。阳性预测值和阴性预测值分别为100%、81.3%。气胸发生率为19.2%,出血发生率为17.9%。多因素Logistic回归分析显示,病灶-胸膜距离(P=0.004)和胸膜-穿刺针角度(P=0.012)是气胸发生的危险因素,病灶-胸膜距离是出血发生的危险因素(P=0.019)。结论:CT引导下经皮穿刺同轴活检术对肺部微结节的诊断准确性较高且并发症少。Objective：To assess the clinical application of computed tomography（CT）-guided percutaneous core needle biopsy（CNB） for small（≤1 cm） pulmonary lesions.Method：A retrospective study was undertaken comprising 78 patients who underwent CT-guided CNB for small pulmonary lesions.To assess the accuracy of the procedure,the diagnosis at biopsy was compared with the surgical,pathological and clinical follow-up.Result：The overall diagnostic accuracy was 92.3%.The sensitivity for malignancy and specificity for benign lesions were 88.5% and 100%,respectively.Positive and negative predictive values were 100% and 81.3%,respectively.Fifteen patients（19.2%） had pneumothorax after CT percutaneous CNB of the lung.The significant risk factors affecting the incidence of pneumothorax were lesion-pleural distance（P=0.004） and needle-pleural angle（P=0.012）.Bleeding occurred in 14 patients（17.9%）.The only significant risk factor affecting the incidence of bleeding was lesion-pleural distance（P=0.019）.Conclusion：CT-guided percutaneous CNB of small pulmonary lesions provides high diagnostic accuracy with acceptable complications.

关 键 词：CT断层扫描 同轴穿刺 经皮穿刺活检术 

分 类 号：R816.4[医药卫生—放射医学]