调节多层螺旋CT扫描机架角度在经皮肺穿刺活检术中的应用  

The Application of Adjusting the Frame Angle of Multislice Spiral CT Scanning in Percutaneous Lung Biopsy

作　　者：马冬[1] 于韬[1] 郑文恒[1] 王长德[1] 王颖[1] 李森[1] 罗娅红[1] 

机构地区：[1]辽宁省肿瘤医院,辽宁沈阳110042

出　　处：《肿瘤学杂志》2016年第3期222-225,共4页Journal of Chinese Oncology

摘　　要：[目的]探讨在多层螺旋CT引导的经皮肺穿刺活检术中,应用调节CT扫描机架角度的方法来规避骨性遮挡、优化穿刺路径的价值。[方法]21例常规螺旋CT扫描方式预定的穿刺路径遇到骨性遮挡,改用调节CT扫描机架角度方法引导穿刺。[结果]21例病例经调节CT扫描机架角度方法均获取理想的穿刺路径,成功避开骨性遮挡。一次性穿刺结果的阳性率为95.2%(20/21)。其中18例一次进针穿刺成功,其余均两次进针穿刺成功。术后5例发生并发症,发生率为23.8%(5/21),其中轻度气胸4例,肺内少量出血1例,均经临床观察及对症处理后病情缓解;无严重并发症发生。[结论]在多层螺旋CT引导的经皮肺穿刺活检术中,当常规扫描方式预定的穿刺路径遇到骨性遮挡时,可以采用调节扫描机架角度的方法优化穿刺路径,该方法操作简便、安全可行。[Purpose] To investigate the value of adjusting the frame angle of multislice spiral CT（MSCT） scanning to avoid the bony occlusion and to optimize the puncture path in the percutaneous lung biopsy guided by MSCT. [Methods] Bony occlusion was encountered in a predetermined puncture path under conventional MSCT scanning in 21 cases,and the method of adjusting the frame angle of CT scanning to guide the puncture was carried out successfully in 21 cases.[Results] The ideal puncture path was obtained by adjusting the frame angle of the CT scanning,and the bony occlusion was also avoided in all 21 cases. The positive rate of disposable puncture result was 95.2%（20/21）,in which 18 cases were puncture once,the other three cases were punctured twice. Postoperative complications occurred in 5 cases（23.8%,5/21）,among them,4 cases with mild pneumothorax,and 1 case with a small amount of hemorrhage in the lungs. All 5 cases relieved by clinical observation and symptomatic treatment. No serious complication occurred.[Conclusion] In the percutaneous lung biopsy guided by MSCT,the method of adjusting the frame angle of scanning machine is much easier and safer to optimize the puncture path when the conventional scanning encounters with bony occlusion.

关 键 词：肺肿瘤 胸部疾病 体层摄影术 X线计算机 活组织检查 

分 类 号：R730.4[医药卫生—肿瘤] R734.2[医药卫生—临床医学]