摘要
目的探讨CT穿刺角度定位仪(CT定位仪)在CT引导经皮肺部肿块穿刺活检(percutaneous puncture biopsy,PPB)的应用价值。方法根据电脑数字表随机分配原则对126例肺部肿块患者进行分组,研究组使用CT定位仪,对照组不使用该仪器,两者均进行CT引导下PPB检查,比较两组一次穿刺成功率,穿刺诊断的正确率,穿刺次数和并发症发生率。结果研究组借助CT定位仪独有导向针的指向作用,大大提高了一次穿刺的成功率,两组一次穿刺的成功率分别为95%和82%(P=0.023),在肿块直径≤2cm患者尤其明显(P=0.026);提高了穿刺诊断的正确率:两组分别是95.2%和84.1%(P=0.04);两组气胸发生率分别为4.8%和15.8%,两组间差异有统计学意义(P=0.0404)。结论使用CT定位仪行经皮肺肿块穿刺活检术,尤其在病灶小且远离胸壁时,可以准确把握穿刺方向,提高穿刺的准确度,减少手术盲目性及危险性,从而提高穿刺成功率,减少气胸发生。同时,CT定位仪具有使用简便,适用于各种螺旋与非螺旋CT机等优点,具有良好的临床应用前景。
Objective TO evaluate the clinical application value with CT-orientator stereotactic percutaneous puncture biopsy for pulmonary masses. Methods 126 cases of pulmonary masses with puncture biopsy were randomly divided into two group （each of 63）： Research group （group A）with CT- Orientator and Contral group（group B）without CT-Orientator. One time successful puncture rate, the diagnostic accuracy, times of puncture biopsy and complication rate were comparatively studied between group A and group B in performing PPB test under CT guidance. Results The puncture biopsy under CT-Orientator guidance for group A showed highly one time successful rate of 95%（60/63）, but only 82.5%（52/63 ）in group B（P = 0.023）. The diagnostic accuracy of group A was superior to that of group B（95.2% versus 84.1%, P = 0.04）. Decrease of times for puncture biopsy reduced the incidence of pneumothorax, resulting the better outcome in incidence of pneumothorax 4.8% （3/63）in group A than that of 15.8% （10/63）in group B （P = 0.040 4）（especially in patients with lesions D ≤ 2 cm）with statistically significant difference. Condusions Application of CT-orientator for percutaneous puncture biopsy of pulmonary masses, especially for those small and far away form chest wall, would have increased the accuracies both in localization and correctness; decreased the aimless and risk of surgical approach, with less complication. Furthermore, the utilization of CT-orientator is simple and beneficial for spiral and non-spiral CT sets, ought to have good clinical prospect.
出处
《介入放射学杂志》
CSCD
2007年第8期557-560,共4页
Journal of Interventional Radiology
基金
课题属广州铁路集团公司局级课题(广铁校2001
3-38)。
