CT引导下经肺外通路纵隔结节/肿块粗针穿刺活检术的临床应用  

Clinical application of CT-guided core needle biopsy of mediastinal nodule/mass via extrapleural approach

作　　者：王晔[1] 彭振军[1] 李鹏程[1] 林振宇[1] 邹枕玮[1] 尹中元[1] 

机构地区：[1]华中科技大学附属协和医院肿瘤中心放化疗科,武汉430023

出　　处：《放射学实践》2016年第1期64-67,共4页Radiologic Practice

摘　　要：目的:探讨CT引导下经肺外通路纵隔结节/肿块粗针穿刺切割式活检术的临术应用价值。方法:使用同轴定位系统及18G切割式活检装置,共计80例患者完成CT引导下经肺外通路纵隔结节/肿块穿刺活检术。分析使用该方法完成穿刺活检的纵隔结节/肿块的分布特点、病理诊断以及进针通路选择。结果:80例均穿刺成功,共检出恶性肿瘤72例、胸腺瘤5例、结核1例、慢性炎性病变2例。该方法诊断敏感度为98.6%,特异度为100%,阳性预测值为100%,阴性预测值为87.5%,假阴性率为12.5%。出现少量纵隔内积气1例(1.25%),少量纵隔内出血1例(1.25%),未见气胸及明显纵隔内出血,无致死性并发症出现。结论:CT引导下经肺外通路纵隔结节/肿块粗针穿刺切割式活检术是一项安全、高效的诊断技术。Objective：To study the clinical value of CT guided core needle biopsy of mediastinal nodule/mass via ex- trapleural approach. Methods：Using a co-axial positioning system and 18G cutting type biopsy device, totally 80 patients un- dertaken CT guided biopsy of mediastinal nodule/mass via extrapleural approach. The location of mediastinal nodule/mass, pathology and the puncture pathway were analyzed. Results： All of the 80 patients had the biopsy technically successfully completed. There were malignant tumor （72 cases）, thymoma （5 cases）,pulmonary tuberculosis （I case） and chronic in- flammation lesion （2 cases）. The sensitivity, specificity, positive predictive value, negative predictive value and false negative rate was 98.6%, 100 %, 100 %, 87.5 % and 12.5 % respectively. As for complications, there were mild pneumo-mediastinum （1 case, 1.25%） and mild mediastinal hemorrhage （1 case, 1.23 %）. No evidence of pneumothorax, obvious mediastinal hemorrhage or other lethal complications happened. Conclusions：CT guided core needle cutting biopsy of mediastinal nodule/ mass via extrapleural approach is a safe aM efficient diagnostic technique.

关 键 词：纵隔 活组织检查 体层摄影术 X线计算机 淋巴结 

分 类 号：R564[医药卫生—呼吸系统] R814.42[医药卫生—内科学]