CT引导下经皮肺穿刺活检对肺部毛玻璃样病变良恶性的诊断价值  

Diagnostic Value of Percutaneous Lung Biopsy under CT Guidance for Ground-glass Opacity Pulmonary Lesions

作　　者：严高武 严高文 孙清泉[1] 周瑜[3] 李利发 曾浩[5] 张川[1] 李兵[1] 徐晓雪[1] 杨汉丰[1] 杜勇[1] 

机构地区：[1]川北医学院附属医院放射科,四川南充637000 [2]遂宁市第一人民医院放射科,四川遂宁629000 [3]川北医学院附属医院胸心外科,四川南充637000 [4]川北医学院附属医院胃肠外科,四川南充637000 [5]遂宁市中心医院放射科,四川遂宁629000

出　　处：《中国循证医学杂志》2016年第4期378-382,共5页Chinese Journal of Evidence-based Medicine

摘　　要：目的探讨CT引导下经皮肺穿刺活检（PTNB）对肺部毛玻璃样病变（GGO）的诊断价值。方法回顾性分析2009年1月至2015年1月在川北医学院附属医院肺部GGO行CT引导下PTNB的患者资料。根据病变大小（≤10 mm,10~20 mm,≥20 mm）、针道距离（≤5 cm,5~9 cm,≥9 cm）及GGO成分的比例（50%~90%,〉90%）对患者进行分组。计算CT引导下PTNB对GGO总的及各组的敏感性、特异性及准确性,并采用Fisher’s确切概率法比较各组间的差异。统计分析采用SPSS 17.0软件。结果共纳入60例患者,包括恶性病变48例,良性病变12例。CT引导下PTNB对肺部GGO的敏感性、特异性、准确性分别为87.5%、100%、90%。对于不同大小、针道距离及GGO比例的病变,诊断价值差异均无统计学意义（P均〉0.05）。结论对于肺部GGO的诊断,CT引导下PTNB具有较高的诊断价值,可作为其重要的诊断方法之一。Objective To explore the diagnostic value of CT-guided percutaneous needle aspiration biopsy（PTNB） for ground-glass opacity（GGO） pulmonary lesions. Methods A retrospective design was used to collect clinical data of patients with GGO lesions admitted in the Affiliated Hospital of North Sichuan Medical College between Jan. 2009 to Jan 2015. Patients were divided into groups according the lesion size（≤10 mm, 10-20 mm, ≥20 mm）, length of needle path（≤5 cm, 5-9 cm, ≥9 cm） and percentage of GGO component（50%-90%, 90%）, respectively. The total and subgroups of sensitivity, specificity, and diagnostic accuracy of CT guided PTNB for diagnosing GGO were calculated and the differences among subgroups were compared using Fisher＇s exact test. Statistical analysis was conducted by using SPSS 17.0 software. Results A total of 60 patients involving 48 malignant and 12 benign lesions were included. The total sensitivity, specificity, and accuracy of CT guided PTNB for diagnosing GGO were 87.5%, 100% and 90%, respectively. There were no significant differences among the subgroups based on the lesion size, length of needle path, and percentage of GGO component（all P values 0.05）. Conclusion CT-guided PTNB can be used as one of the diagnostic modalities for lung GGO lesions with a moderate diagnostic value.

关 键 词：肺 穿刺活检 毛玻璃样病变 体层摄影术 X线计算机 

分 类 号：R563[医药卫生—呼吸系统] R734.2[医药卫生—内科学] R730.44[医药卫生—临床医学]