CT引导下经皮穿刺活检对肺小结节的诊断价值

目的 探讨CT引导下肺小结节经皮穿刺活检的准确性和临床应用价值。方法回顾性分析2015年1月至2017年12月75例在南京医科大学附属肿瘤医院进行CT引导下经皮肺小结节(长径≤1cm)穿刺活检术的患者资料,其中65例使用针吸活检,10例使用切割活检。分析两种方法的诊断敏感度和准确率,以及常见并发症的发生率。结果两组的穿刺成功率均为100%;针吸活检组的敏感度和准确率为71.4%(35/49)和72.3%(47/65),切割活检组为85.7%(6/7)和80.0%(8/10),两种方法之间差异无统计学意义(P>0.05)。切割活检组邻近肺野出血发生率25.0%,高于针吸活检组的4.3%,差异有统计学意义(P<0.05);切割活检组的气胸、针道渗血及胸膜下血肿发生率分别为50.0%、41.7%、16.7%,针吸活检组为24.6%、47.8%、1.4%,两组间差异均无统计学意义(P>0.05)。结论CT引导下肺部小结节经皮穿刺针吸活检和切割活检诊断具有较高的敏感度和准确率,针吸活检邻近肺野出血并发症的发生率低于切割活检。

Diagnostic value of CT guided percutaneous biopsy in small pulmonary nodules

ObjectiveTo evaluate the diagnostic accuracy and clinical value of CT guided percutaneous biopsy for small pulmonary nodules. MethodsSeventy five cases receiving percutaneous biopsy for small(≤1 cm) pulmonary nodules from January 2015 to December 2017 were analyzed retrospectively. Among them, 65 cases were treated with Fine Needle Aspiration, and 10 cases with Core Needle Biopsy. The diagnostic efficacy (sensitivity and accuracy) and the incidence of common complications were compared between the two groups. ResultsThe success rates of puncture technique were 100％ in both groups. There was no difference between the sensitivity and accuracy of two groups (P>005). The incidence of bleeding in the adjacent lung field was 250％ in Core Needle Biopsy group which was significantly higher than that (43％) in Fine Needle Aspiration group (P<005). The incidence of pneumothorax, needle bleeding and subpleural hematoma were 500％, 417％, 167％ in Core Needle Biopsy group, and 246％, 478％, 14％ in Fine Needle Aspiration group where showed no significant difference (P>005). ConclusionsCT guided percutaneous Fine Needle Aspiration and Core Needle Biopsy were sensitive and accurate in diagnosis of small pulmonary nodules. The incidence of bleeding in the adjacent lung field of Fine Needle Aspiration is lower than that of Core Needle Biopsy.