计算机辅助CT引导经皮肺结节穿刺活检临床应用

目的评价CT引导下肺结节病变经皮穿刺术的技术要点及临床应用价值。方法本组78例CT诊断肺结节患者,病灶直径为1～3 cm,平均(1.9±0.7)cm。采用计算机辅助多平面重组精确三维定位后,行经皮肺穿刺术,所取组织同时作细胞学和组织学检查。病例经手术病理证实或经临床随访而明确结果。结果 78例中恶性49例,良性病变29例,总穿刺敏感性94.2%,特异性100%,符合率96.1%,阳性预测值100%,阴性预测值89.6%。9例并发气胸,11例肺内少量渗血,1例咯血,1例胸腔大量出血,并发症发生率28.21%(22/78),经处理后均治愈。结论计算机辅助CT引导肺结节病变经皮穿刺术活检对肺结节的定性有重要价值。

Clinical application of CT-guided percutaneous needle biopsy of pulmonary nodules by computer-assisted multiplanar

Objective To evaluate the technique and clinical application of CT-guided percutaneous pneu-mocentesis in patients with pulmonary nodules.Methods 78 cases with pulmonary nodules proved by cytopathologic and histopathologic examination or clinic follow-up were collected.The nodules were 1~3 cm mean（1.9±0.7）cm in diameter,each positioned in three diamensions by computer-assisted multiplanar reconstruction image.Each case was reviewed for complications after the operations for 7 days.Results Of the 78 cases studied,49 cases were proved to be malignant and 29 cases benign lesion,with the total sensibility rate of 94.2%,specificity rate of 100% and coincidence rate of 96.1%.The positive predictive value was 100% and negative predictive value 89.6%.9 cases were complicated with pneumothorax and 11cases with capillary hemorrhage in lung.There was one case of emptysis and another case of bleeding in thoracic cavity.The incidence rate of complication was 28.21%（22/78）.All were cured after treatment.Conclusion CT-guided percutaneous needle biopsy for the diagnosis of small pulmonary nodules showed high accuracy and low incidence of complication.