CT引导下Hook-Wire针肺小结节定位术在胸腔镜肺结节切除术的临床应用  

Clinical application of Hook-wire needle localization of small pulmonary nodules under CT guidance in thoracoscopic pulmonary nodule resection

作　　者：李海飞 孙立国 徐鹏 孙秀梅 刘卫民 李军 LI Haifei;SUN Liguo;XU Peng;SUN Xiumei;LIU Weimin;LI Jun(Department of Radiology,Yantai Affiliated Hospital of Binzhou Medical University,Yantai 264100,China)

机构地区：[1]滨州医学院烟台附属医院医学影像科,山东烟台264100

出　　处：《医学影像学杂志》2022年第10期1698-1701,共4页Journal of Medical Imaging

摘　　要：目的 探讨肺内小结节术前CT引导下Hook-Wire针定位术在胸腔镜切除术的临床应用价值。方法 选取我院胸腔镜术前行CT引导下hook-wire针定位119例患者共128枚结节,其中同步法多针定位6例(同侧肺4例、双侧肺2例)。记录定位成功率、定位操作时间、并发症、术后病理诊断结果。结果 119例128枚结节定位成功率96. 9%,中位定位时间11. 8 min,4枚定位针脱落(3. 1%),其中1例定位针折断于胸壁内,极少量气胸5例(3. 9%),病灶周围及针道出血11枚(8. 6%)。术后病理炎性结节13枚,胸内淋巴结2枚,错构瘤1枚;非典型腺瘤样增生13枚,原位腺癌24枚,微浸润腺癌37枚,浸润性腺癌37枚,子宫内膜癌转移1枚。结论 胸腔镜术前行CT引导下Hook-wire针定位术定位准确,是一项安全、有效、并发症少的技术。Objective To evaluate the clinical value of preoperative Hook-wire needle localization of small pulmonary nodules under CT guidance in thoracoscopic resection.Methods 119 patients with 128 pulmonary nodules were retrospectively analyzed.All patients underwent Hook-wire needle localization under CT guidance before thoracoscopy,including synchronous multi needle localization in 6 cases(Ipsilateral lung for 4 cases and bilateral lung for 2 cases).The success rate,operation time,complications and postoperative pathological diagnosis were recorded.Results The success localization rate of total 128 nodules in 119 cases was 96.8%.The median localization time was 11.8 min.The needle fell off in 4 nodules(3.1%),including broken into chest wall in 1 case and minimal pneumothorax in 5 cases(3.9%).Bleeding around the lesion and needle tract were found in 11 nodules(8.6%).Postoperative pathological results were as follows:13 inflammatory nodules,2 intrathoracic lymph nodes,1 case of hamartoma,13 of adenoid hyperplasia,24 of adenocarcinoma in situ,37 of microinvasive adenocarcinoma,37 of invasive adenocarcinoma,and 1 of endometrial carcinoma metastasis.Conclusion Hook-wire needle localization under CT guidance before thoracoscopy is a safe and effective technique with few complications,which can accurately define position.

关 键 词：体层摄影术 X线计算机 肺小结节 胸腔镜手术 

分 类 号：R814.42[医药卫生—影像医学与核医学] R563[医药卫生—放射医学]