摘要
目的探讨CT引导下经皮肺穿刺活检术的临床应用价值。方法连续收集105例肺部病变患者,分为局灶结节组(直径≤3cm)、局灶团块组(直径>3cm)及弥漫性病变组。在CT引导下行活检针穿刺活检,穿刺活检病理结果与手术病理或临床随访结果对照。结果对101例患者完成活检,穿刺活检成功率为96.19%(101/105);其中局灶结节组33例,局灶团块组59例,弥漫性病变组9例。与手术病理或临床随访结果对照,总诊断符合率为92.08%(93/101),3组的诊断符合率分别为87.88%(29/33),93.22%(55/59)及100%(9/9),各组间诊断符合率差异均无统计学意义(P均>0.05);总并发症发生率为12.38%(13/105)。Logistic回归分析显示,病灶大小是出血的影响因素(χ2=7.77,P=0.005),病灶大小和病灶周围有无肺气肿是气胸的影响因素(P<0.001)。结论 CT引导下经皮肺穿刺成功率及诊断符合率较高,并发症少,是一种具有较高实用性和安全性的活检取材方法。病灶直径≤3cm及病灶周围广泛肺气肿可增大并发症风险。
Objective To observe the clinical value of CT-guided percutaneous needle aspiration biopsy for pulmonary dis- eases. Methods Totally 105 patients were enrolled and divided into 3 groups according to the image feature： Focal nodular group （diameter ≤3 cm）, focal clumps group （diameter ≤3 cm） and diffuse lesions group. All patients underwent CT- guided needle lung biopsy, and the results were compared with that of surgical pathology or clinical follow-up. Results A total of 101 patients completed biopsy, and the success rate was 96.19% （101/105）. There were 33 patients in focal nodu- lar group, 59 in focal clumps group, and 9 in diffuse lesions group. Compared with surgical pathology or clinical follow-up, the total diagnostic coincidence rate was 92.08% （93/101）, and diagnostic coincidence rate was 87.88% （29/33） in focal nodular group, 93.22% （55/59） in focal clumps group, and 100%（9/9） in diffuse lesions group. There was no statistical difference among three groups （all P〉0. 05）. The complication rate was 12.38% （13/105）. According to Logistic regres- sion analysis, the size of lesion was impact factor of bleeding （X2 = 7.77, P= 0. 005）, and the size of lesion and emphysema around the lesion were impact factors of pneumothorax （P（0. 001）. Conclusion CT-guided percutaneous needle lung bi- opsy is a practical and safe method, which has high success rate and high diagnostic coincidence rate and fewer complica- tions. The risk of complications will increase when the size of lesions less than or equal to 3 cm and when there are exten- sive emphysema around the lesion.
出处
《中国介入影像与治疗学》
CSCD
2012年第10期711-714,共4页
Chinese Journal of Interventional Imaging and Therapy
