磁共振扩散加权成像对CT引导下经皮经胸肺活检术的价值分析  

Analysis of the value of magnetic resonance diffusion-weighted imaging for CT-guided percutaneous transthoracic lung biopsy

作　　者：郝申 严金明 杨静 张晴 李绍东 HAO Shen;YAN Jinming;YANG Jing;ZHANG Qing;LI Shaodong(School of Medical Imaging,Xuzhou Medical University,Xuzhou,Jiangsu 221004,China;Department of Medical Imaging,Xuzhou Hospital of Traditional Chinese Medicine,Xuzhou,Jiangsu 221010;Department of Oncology,Xuzhou Hospital of Traditional Chinese Medicine;Department of Pathology,Xuzhou Hospital of Traditional Chinese Medicine;Department of Medical Imaging,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221002)

机构地区：[1]徐州医科大学医学影像学院,江苏徐州221004 [2]徐州市中医院医学影像科,江苏徐州221010 [3]徐州市中医院肿瘤内科 [4]徐州市中医院病理科 [5]徐州医科大学附属医院医学影像科,江苏徐州221002

出　　处：《徐州医科大学学报》2023年第12期922-925,共4页Journal of Xuzhou Medical University

基　　金：江苏省中医药科技发展计划项目(MS2022064)。

摘　　要：目的评估磁共振扩散加权成像(DWI)在CT引导下的经皮肺穿刺活检(PTLB)过程中对合并阻塞性肺炎或肺不张的肺占位性病变患者的应用价值。方法选取2019年7月1日—2022年12月31日徐州市中医院收治的行PTLB、合并阻塞性肺炎或肺不张的肺占位性病变患者,共269例。按1∶1的比例将患者随机分为DWI+CT引导组和CT引导组。DWI+CT引导组于7 d内先后完成磁共振DWI和CT扫描,CT引导组行CT扫描。以手术切除后病理结果为金标准,比较2组患者PTLB的首次穿刺准确度。结果DWI+CT引导组70例,CT引导组72例。DWI+CT引导组的PTLB准确度为98.57%(69/70),CT引导组为87.50%(63/72),2组比较差异有统计学意义(P=0.010)。结论穿刺前结合DWI序列扫描能够提升CT引导下PTLB首次穿刺的准确度。Objective To evaluate the application of magnetic resonance diffusion-weighted imaging(DWI)for CT-guided percutaneous transthoracic lung biopsy(PTLB)in pulmonary space-occupying lesion patients with obstructive pneumonia or pulmonary atelectasis.Methods A total of 269 pulmonary space-occupying lesions patients with obstruc-tive pneumonia or pulmonary atelectasis who were admitted to Xuzhou Hospital of Traditional Chinese Medicine and un-derwent PTLB from July 1,2019 to December 31,2022 were selected.The patients were randomly divided into two groups in a ratio of 1∶1:a DWI+CT-guided group and a CT-guided group.The DWI+CT-guided group underwent DWI and CT scanning within seven days,while the CT-guided group was subject to CT scanning.Both groups were com-pared for the accuracy of first PTLB puncture,with the pathological results after surgical resection as the golden stand-ards.Results There were 70 patients in the DWI+CT group and 72 patients in the CT group.The accuracy of PTLB was 98.57%(69/70)for the DWI+CT-guided group and 87.50%(63/72)for the CT-guided group,with statistical differ-ences(P=0.010).Conclusions The combined use of DWI before puncture can improve the accuracy of first CT-guided PTLB.

关 键 词：肺占位性病变 活组织检查 磁共振成像 扩散加权成像 精准穿刺 

分 类 号：R446.8[医药卫生—诊断学]