CT引导经皮肺穿刺活检术对直径≤30mm肺结节诊断价值  

CT-GUIDED PERCUTANEOUS LUNG BIOPSY:ITS VALUE FOR DIAGNOSIS OF NODULE OF≤30 MM IN DIAMETER

作　　者：韩乐乐[1] 张传玉[1] 于华龙[1] 刘世合[1] 张亮[1] 

机构地区：[1]青岛大学附属医院放射科,山东青岛266100

出　　处：《青岛大学医学院学报》2016年第2期232-234,237,共4页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：目的探讨CT引导下经皮肺穿刺活检术对直径≤30 mm肺结节的诊断价值。方法2013年1月—2015年1月,在我院经胸部CT证实患有直径≤30mm肺结节的病人214例,均行CT引导下经皮肺穿刺活检术。计算穿刺活检诊断准确率,并分析影响穿刺活检诊断准确率及并发症的各种因素。结果 214例病人均穿刺取材成功,诊断为恶性病变162例、良性病变42例,坏死组织及正常肺组织10例经手术病理检查、临床治疗或随访观察证实为恶性病变173例、良性病变41例,穿刺诊断准确率为93%。不同大小病灶其穿刺活检诊断准确率差异有统计学意义（χ2=10.350,P〈0.05）。穿刺活检并发症主要为气胸（22.0%）和出血（33.6%）。气胸的发生率与病灶大小、穿刺深度及肺气肿有关（χ2=3.924~10.482,P〈0.05）,出血的发生率与病灶大小、穿刺深度及病灶成分有关（χ2=4.234~43.610,P〈0.05）。结论 CT引导下经皮肺穿刺活检术诊断准确率高,并发症少,操作简单,可用于肺小结节的定性诊断,具有很高的临床价值。Objective To assess the diagnostic value of CT guided percutaneous biopsy for lung nodules of ≤30 mm in diameter. Methods From January 2013 to January 2015, 214 patients, confirmed by CT as having a pulmonary nodule （diame ter ≤30 mm）, underwent CT-guided percutaneous biopsy. The diagnostic accuracy of needle biopsy was calculated, and the factors that impact the accuracy of needle biopsy and complications were analyzed. Results A needle biopsy was succeeded in all the 214 cases, of which, 162 were diagnosed as malignant disease, and 42 were benign. After surgery and pathological examination, clinical therapy or follow-up observation, 173 cases were confirmed as malignancy, and 41 as benign, the accuracy of needle biopsy being 93 %. The difference in the accuracy among different size of the nodule was significant （x^2 = 10.350, P〈0.05）. The major complications included pneumothorax （22.0%） and hemorrhage （33.6%）. Pneumothorax was associated with the lesion size, the depth of puncture and emphysema （x^2=3.924-10.482,P〈0.05）. Hemorrhage was correlated with size of the nodule, depth of puncture and components of the nodule （x^2 =4.234-43.610,P〈0.05）. Conclusion CT-guided pereutaneous lung biopsy has a high aecu racy rate in the diagnosis of small lung nodules, this technique is easy to master with less complications, which has a high clinical value for qualitative diagnosis of small lung nodules.

关 键 词：硬币病变 肺 体层摄影术 X线计算机 活组织检查 针吸 诊断 

分 类 号：R734.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]