弥散加权成像在CT引导下肺肿块穿刺活检的临床应用  

Clinical application of diffusion-weighted imaging in CT-guided lung mass aspiration biopsy

作　　者：徐龙 李鑫 党珊 马光明 韩冬 于勇 于楠 段海峰 XU Long;LI Xin;DANG Shan;MA Guangming;HAN Dong;YU Yong;YU Nan;DUAN Haifeng(School of Medical Technology,Shaanxi University of Chinese Medicine,Xianyang 712046,China;Department of Medical Imaging,Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,China;PET-CT Center,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]陕西中医药大学医学技术学院,陕西咸阳712046 [2]陕西中医药大学附属医院医学影像科,陕西咸阳712000 [3]西安交通大学第一附属医院PET-CT中心,陕西西安710061

出　　处：《分子影像学杂志》2024年第2期151-156,共6页Journal of Molecular Imaging

基　　金：陕西科技厅基础研究项目(2022JM-453)。

摘　　要：目的 探讨磁共振弥散加权成像(DWI)在CT引导下肺肿块穿刺活检术的应用价值。方法 回顾性分析2022年10月~2023年10月在陕西中医药大学附属医院行CT引导下肺肿块穿刺的152例患者,根据术前有无胸部DWI检查分为A组(无DWI检查,n=85),B组(有DWI检查,n=67)。比较两组患者的一般资料、病理阳性率、调针次数、靶皮距、套管针在肺内长度和并发症。结果 A组病理诊断为恶性肿瘤65例,良性病变9例,未明确诊断11例;B组病理诊断为恶性肿瘤57例,良性病变8例,未明确诊断2例;A组和B组病理阳性率分别为87.06%和97.01%,差异有统计学意义(P=0.029)。2组总体并发症发生率及气胸发生率的差异无统计学意义(P>0.05),但A、B组出血发生率分别为30.59%、13.43%,差异有统计学意义(P<0.05)。结论 CT引导下肺肿块穿刺活检前行胸部DWI检查,有助于指导穿刺靶点的选择,提高病理诊断阳性率,减少穿刺相关出血事件发生,具有较好临床实用价值。Objective To explore the application value of magnetic resonance diffusion-weighted imaging(DWI)in CT-guided lung mass aspiration biopsy.Methods We retrospectively analyzed 152 patients who had undergone CT-guided lung mass puncture at the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from October 2022 to October 2023 and divide them into group A(without DWI,n=85)and group B(with DWI,n=67)based on the presence of preoperative chest DWI examination,then compared the baseline data,pathologic positivity rate,number of needle adjustments,target skin distance,length of trocar in the lung,and complications between the two groups.Results The pathological diagnosis of group A was malignant tumors in 65 cases,benign lesions in 9 cases,and unspecified diagnosis in 11 cases,while the pathological diagnosis of group B was malignant tumors in 57 cases,benign lesions in 8 cases,and unspecified diagnosis in 2 cases;and the pathology-positive rates in group A and group B were respectively 87.06%and 97.01%,which were statistically significant(P=0.029).The difference between the total complication rate and pneumothorax rate of the 2 groups was not statistically significant,but the hemorrhage rate of group A and B was successively 30.59%and 13.43%,with statistical significance(P<0.05).Conclusion Chest DWI examination before CT-guided lung mass puncture biopsy,with good clinical practical value,can contribute to guiding the selection of the puncture target point,improving the positive rate of pathological diagnosis,and reducing the occurrence of puncture-related bleeding.

关 键 词：肺肿瘤 穿刺活检 弥散加权成像 计算机体层成像 

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