摘要
目的尝试在CT引导下能用于肺脏微小病变术前定位的材料,不污染病变组织,能够被术者用手触知,能够适用于胸腔镜手术。方法将明胶和琼脂分别溶于蒸馏水,配制成一定的浓度,加入适量的碘海醇或硫酸钡;将以上材料组成的组合分别注入活体大白兔肺脏。于注射后即刻和更长时间内观察在肺内形成结节的情况。处死大白兔后,肉眼观察和用手触知结节,观察结节的硬度,并对结节周围肺组织进行病理学检查。结果20%明胶和2%、3%的琼脂不易在肺内凝结,不能形成结节或形成的结节硬度不够和局限性不好。5%的琼脂+硫酸钡,可在肺内形成形态固定,边界清晰,位置固定,质地坚硬的高密度结节,并能够在肺内长期存留,病理学检查提示对肺组织无明显影响。结论在CT引导下用5%的琼脂混合适量的硫酸钡粉末用于肺内微小病变的术前定位,在术中能被触知,在透视下能被观察到,并可以长时间(≤6天)在肺内存留。
Objective To search for a locating-material and method guided by CT which can help localize and resect nonpalpahle and invisible small pulmonary lesions, such as solitary pulmonary nodule（SPN）, ground glass opacity（GGO）, either in thoracooperation or fluoroscopy-assisted thoracoscopic resection. Methods Powdered agar was dissolved in distilled water at concentrations of 2%, 3%, 5% and kept at 〉50℃ to maintain its liquid form. So did gelatin at concentration of 20%. Every material above mixed with contrast media and 0.5ml of mixture was injected into lung of rabbits respectively before liquid form became a hard gel. Results Gelatin, 2% agar and 3% agar could not form hard enough palpable nodules for some of them disappeared in the lung. 5% agar could be detected as a hard nodule by manual palpation and is visible under fluoroscopy for it contained barium sulfate. Moreover, pathologic exam showed that it was harmless to the lung parenchyma around. Conclusion 5% agar mixed with barium sulfate marking may represent a feasible alternative technique either in thoracooperation or fluoroscopy-assisted thoracoscopic resection for localizing nonpalpable occult lesions located away from the pleural surface.
出处
《当代医学》
2009年第8期21-24,共4页
Contemporary Medicine
基金
上海市"登山计划"重大项目:肺癌早期诊断和早期治疗的基础和临床研究。上海市科委
项目编号:06DZ19503
上海人才发展资金资助项目:肺癌早期诊断和早期治疗的基础和临床研究。编号:026
上海市科委基础处重点项目:cRGD-USPIO纳米微粒的制备及其在肿瘤早期诊断中的应用。项目编号:08JC1407500
上海市科委纳米促进中心重大项目:肺癌早期诊断的MRI纳米造影剂的应用研究。项目编号:0852nm03700
关键词
CT穿刺
肺部微小病变
术前定位
动物实验
CT-guided Percutaneous puncture
Lung small lesion
Preoperative localization
Animal study
