CT引导下气管前腔静脉后间隙病变穿刺活检术的临床应用  

Clinical application of CT-guided percutaneous puncturing biopsy for the lesions located in the pretracheal retrocaval space

作　　者：梁力嵩 席建东[1] 王显龙[1] 俞志坚[1] 温志波[1] 江永焰[1] 

机构地区：[1]广州南方医科大学珠江医院影像诊断科,510280

出　　处：《介入放射学杂志》2015年第11期974-978,共5页Journal of Interventional Radiology

摘　　要：目的探讨CT引导下气管前腔静脉后间隙结节穿刺活检术的临床可行性和应用。方法回顾性总结2008年1月至2014年7月于南方医科大学珠江医院46例行CT引导下气管前腔静脉后间隙病变穿刺活检术资料,穿刺结束后立即行CT平扫及临床短期随访,了解并发症情况,评估穿刺安全性;行穿刺术所取得标本,均行细胞病理学及组织学检查,以手术标本病理结果或治疗效果作为标准,评估活检术准确性及其临床应用价值。结果本组患者并发症发生率15.6%(1例液气胸,6例少量气胸(肺压缩10%以下),余均未出现明显并发症;46例患者中2例取得的组织较为细碎,未获得确切病理结果,1例穿刺组织病理结果与术后病理结果不相符;43例(93.5%)患者获得病理学诊断。结论 CT引导下气管前腔静脉后间隙病变穿刺活检术,在操作者熟悉气管前腔静脉后解剖的基础上,术前认真阅读患者影像资料,根据实际情况制定合适的穿刺路径,能够安全、准确地取得组织病理结果。这一技术对指导临床医师进一步制定诊疗计划极有帮助。Objective To discuss the clinical feasibility and application of CT-guided percutaneous puncturing biopsy for the lesions located in the pretraeheal retrocaval space. Methods The clinical and biopsy data of 46 patients with lesions in the pretracheal retrocaval space, who had received CT- guided percutaneous puncturing biopsy at Zhujiang Hospital of Southern Medical University during the period from January 2008 to July 2014, were retrospectively analyzed. When the puncture was finished, plain CT scan was immediately performed to check the complication and to evaluate the safety of the procedure; the patients were followed up for a short time. All the specimens obtained by puncture were sent for pathological cytology and histological examination. Taking the pathological results of the surgical specimens or the therapeutic effect as the standard, the diagnostic accuracy of biopsy and its clinical application were evaluated. Results In this series, the complication incidence was 15%, including hydropneumothorax （n=l） and mild pneumothorax （lung compression〈10%,n=6）; and no other obvious complications were observed. In two patients, the specimens obtained by biopsy were broken bits and no exact pathological diagnosis could be made. In one patient, the pathological findings of biopsy specimen were not consistent with the postoperative pathological results. In the remaining 43 patients, pathological diagnosis was successfully obtained. Conclusion The pathological results of the lesions located in the pretracheal retrocaval space can be safely and correctly obtained by CT-guided percutaneous puncturing biopsy when the operator is quite familiar with the anatomy of pretracheal retrocaval space, reads the patient＇s imaging materials before procedure carefully and formulates the puncturing path properly according to the actual situation, This technique is very helpful in guiding clinicians to make a further treatment plan.

关 键 词：穿刺活检 计算机断层成像 引导 纵隔病变 气管前间隙 

分 类 号：R56[医药卫生—呼吸系统]