CT引导下软线爪钩定位肺结节准确性的影响因素  

Impact factors of the accuracy of CT-guided localization of pulmonary nodules with soft wire hook-wire

作　　者：孔伟东[1] 荣萍 李茗[1] 杨尚文[1] 马一鸣[1] 陈文倩 董宁宇 辛小燕[1] 韩小伟 KONG Weidong;RONG Ping;LI Ming;YANG Shangwen;MA Yiming;CHEN Wenqian;DONG Ningyu;XIN Xiaoyan;HAN Xiaowei(Department of Radiology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China)

机构地区：[1]南京大学医学院附属鼓楼医院医学影像科,江苏南京210008

出　　处：《中国介入影像与治疗学》2022年第1期26-30,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的分析CT引导下软线爪钩定位肺结节准确性的影响因素。方法回顾性分析214例接受CT引导下软线爪钩定位的单发肺结节患者,均于定位后24 h内接受电视胸腔镜手术(VATS)切除肺结节。于CT图像上测量肺内定位爪钩与结节外缘之间的最短距离,以该距离<1 cm为定位准确性较好,≥1 cm为准确性较差。采用单因素及多因素logistic回归分析观察CT引导下软线爪钩定位肺结节准确性的影响因素。结果214枚肺结节均一次性穿刺定位成功,其中189枚定位准确性较好(较好组)、25枚定位准确性较差(较差组);组间结节深度、(进针处)胸壁厚度、进针深度、穿刺针与水平面的角度及术中针道出血率差异均有统计学意义(P均<0.05)。多因素回归分析结果显示,结节最大径(OR=10.422,P=0.034)、结节深度(OR=0.045,P<0.001)、胸壁厚度(OR=0.635,P=0.029)及穿刺针与水平面的角度(OR=1.044,P=0.009)均为影响准确定位的因素。结论于CT引导下以软线爪钩定位肺结节时,结节径线和深度、胸壁厚度及穿刺针与水平面的角度均影响其准确性。Objective To explore the impact factors of the accuracy of CT-guided localization of pulmonary nodules with soft wire hook-wire.Methods Totally 214 patients with single pulmonary nodule and located by soft wire hook under CT guidance were enrolled.All patients underwent video assisted thoracoscopic surgery(VATS)to remove pulmonary nodules within 24 h after localization.The shortest distance between the positioning hook and the outer edge of nodule was measured on CT images,<1 cm was considered as with good positioning accuracy,while≥1 cm was considered as with poor accuracy.Univariate and multivariate logistic regression analysis were used to observe the impact factors of the accuracy of CT-guided nannies hooks in localization of pulmonary nodules.Results All 214 pulmonary nodules were successfully localized by one-time puncture,including 189 with good accuracy(good group)and 25 with poor accuracy(poor group).There were significant differences of nodule depth,chest wall thickness(insertion point),needle depth,angle between puncture needle and horizontal plane,and needle bleeding between groups(all P<0.05).Multivariate logistic regression analysis showed that the maximum diameter of nodule(OR=10.422,P=0.034),nodule depth(OR=0.045,P<0.001),chest wall thickness(OR=0.635,P=0.029)and the angle between puncture needle and horizontal plane(OR=1.044,P=0.009)were important factors for the accuracy of localization.Conclusion The maximum diameter of nodule,depth of nodule,chest wall thickness,as well as the angle between puncture needle and horizontal plane were impact factors of the accuracy of CT-guided soft wire claw hook localization.

关 键 词：肺肿瘤 体层摄影术 X线计算机 胸腔镜 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]