CT引导下肺部病变再次穿刺活检的价值

目的探讨CT引导下肺部病变再次穿刺活检的价值。方法 47例因肺部病变住院诊疗的患者行CT引导下肺部病变细针穿刺活检术,首次穿刺病理结果不能明确良恶性或怀疑恶性但难以确定组织学分型,故再次行CT引导下细针穿刺活检术,并分析其再次穿刺的价值。结果 47例病例经穿刺、手术及临床治疗后随访证实恶性病例33例,良性病例14例。其中恶性33例病例中,穿刺明确恶性者27例,另有3例为可疑恶性病变,还有3例穿刺结果未见恶性证据。阳性预测值100.0%(30/30),敏感性90.9%(30/33),假阴性率9.1%(3/33)。良性病例14例中穿刺诊断良性8例,有1例疑癌。假阳性率7.1%(1,14)。穿刺活检对所有病灶的诊断正确率为80.9%(38/47)。结论 CT引导下肺穿刺活检一次成功率及阳性率高,但仍有一定的假阴性存在。对于临床高度怀疑恶性病变患者,再次行肺穿刺活检具有一定的必要性和可行性。重新设计穿刺靶部位和活检靶点可以进一步降低肺部恶性肿瘤的活检假阴性率。

The value of repeated CT-guided needle biopsy of lung lesions

Objective To explore the value of second CT-guided percutaneous trans-thoracic biopsy of lung lesions.Methods Repeated CT-guided needle biopsy was performed on 47 in-patients with non-diagnostic lung lesions at first biopsy.The results of second biopsies were analyzed.Results Of 33 malignancy confirmed by surgery or follow-up,30 were diagnosed at second needle biopsy resulting in sensitivity of 90.9%（30/33）,positive predictive value of 100.0%（0/30）and false negative rate of 9.1%（3/33）.Of 14 benign lesions,1 was suspected malignant at second biopsy resulting in false positive rate of 7.1%（1/14）and accuracy of 80.9%（38/47）. Conclusion Repeated CT-guided lung biopsy has high diagnostic accuracy for patients with suspected malignant lesions.