CT-guided cutting needle lung biopsy using modified coaxial technique: factors effecting risk of complications

Purpose

We present our 7-year experience with coaxial computed tomography (CT)-guided cutting needle lung biopsy and evaluate the factors affecting risk of complications.

Material and method

Between June 2000 and March 2007, we performed 225 CT-guided coaxial lung biopsies in 213 consecutive patients (161 men, 52 women). Lesion size, lesion depth, lesion location, needle-pleural angle, presence of pleural effusion, patient's position, and complications secondary to biopsy procedure (pneumothorax and bleeding) were noted. Pneumothorax was graded as mild, moderate, and severe. Bleeding complications were graded as mild, moderate, and severe.

Results

Two hundred twenty-five biopsy procedures were performed in 213 patients. The mean diameter of the lung lesion was 41.3 ± 20.1 mm. The mean distance from the peripheral margin of the lesion to the pleura was 17.3 ± 19.2 mm. After 225 procedures, there were 42 mild (18.6%), 13 moderate (5.7%), and 4 severe (1.7%) pneumothoraxes. Small hemoptysis occurred in 27 patients (12%), and mild parenchymal hemorrhage occurred in 2 patients (0.8%). The overall complication rate was 39.1%. Although, a statistically significant correlation was found between female sex, presence of emphysema, lesion depth, and pneumothorax, none of these factors had a predictive value for pneumothorax. Although, statistically significant correlations were found between female sex, lesion size, and bleeding, only lesion size had a predictive value for bleeding.

Conclusion

The most frequent and important complications of this procedure are pneumothorax and bleeding. But any factor is the predictor of pneumothorax and lesion depth is a poor predictor of bleeding complication.     

Breath-hold after forced expiration before removal of the biopsy needle decreased the rate of pneumothorax in CT-guided transthoracic lung biopsy

Purpose

To assess the effect of a breath-hold after forced expiration on the rate of pneumothorax after computed tomography (CT)-guided transthoracic needle biopsy of pulmonary lesions.

Materials and methods

Between January 2008 and December 2011, percutaneous CT-guided lung biopsy was performed in 440 patients. Two hundred and twenty-one biopsies were performed without (control group) and two hundred and nineteen biopsies were performed with (study group) the study maneuver – a breath-hold after forced expiratory approach. Multivariate analysis was performed between groups for risk factors for pneumothorax, including patient demographics, lesion characteristics, and biopsy technique.

Results

A reduced number of pneumothoraces (18 [8.2%] vs 35 [15.8%]; P = 0.014) but no significant difference in rate of drainage catheter insertions (2 [0.9%] vs (4 [1.8%]; P = 0.418) were noted in the study group as compared with the control group. By logistic regression analysis, three factors significantly and independently affected the risk for pneumothorax including lesion size (transverse and longitudinal diameter), distance from pleura and utilizing or avoiding the breath-hold after deep expiration maneuver.

Conclusion

Breath-holding after forced expiration before removal of the biopsy needle during the percutaneous CT-guided transthoracic lung biopsy almost halved the rate of overall pneumothorax. Small lesion size (longitudinal diameter) and the distance from pleura were also predictors of pneumothorax in our study.     

CT引导下经皮肺穿刺活检术后气胸发生率的相关因素分析

目的分析影响CT引导下经皮肺穿刺活检术后气胸发生率的因素。方法观察162例CT引导下经皮肺穿刺活检术后患者气胸发生的情况（病灶直径1～6cm），分析其出现的相关因素并行非条件Logistic回归。结果术后CT发现气胸32例，发生率为19．8％。X^2检验表明患者是否合并慢性肺阻塞性疾病（COPD）、病灶与胸壁的距离、穿刺针停留时间及病灶直径等4个因素与气胸发生率有关。其中COPD患者67例术后发生气胸22例（32．8％）；病灶紧贴胸壁（48例）、病灶与胸壁距离〈2cm（55例）及病灶与胸壁距离〉2cm（59例）患者术后发生气胸分别为0、14（25．5％）、18例（30．5％）；穿刺针在胸腔内停留时间〈10min（83例）、10～20min（51例）、〉20min（28例）的患者术后发生气胸例数分别是8（9．6％）、10（19．6％）、14（50．0％）例；病灶直径〈2cm（65例）、2～4cm（52例）、〉4cm（45例）的患者术后发生气胸分别是19（29．2％）、8（15．4％）、5（11．1％）例。其中前3项经多因素Logistic回归分析，是气胸发生的危险因素（其OR值分别为4．652，4．030，2．855）。结论当病灶离胸壁远，患者合并有COPD，病灶直径小的患者，穿刺前要充分考虑到气胸发生的可能，减少穿刺针在胸腔内停留时间，可使CT引导下经皮肺穿刺活检术后气胸发生率大为降低。     

Systemic arterial air embolism and tension pneumothorax: two complications of transthoracic percutaneous thin-needle biopsy in the same patient

Systemic arterial air embolism and tension pneumothorax are two rare and severe complications of transthoracic fine-needle biopsy. We report on a patient who developed both complications during the same procedure and recovered successfully after resuscitation and hyperbaric oxygen therapy. Favourable outcome of systemic air arterial embolism has been reported infrequently in the literature. In our case tension pneumothorax may have influenced favourably the course of the illness due to collapse of distal airways and the reduction of the venous return to the heart from the affected side. Received: 25 October 1995; Revision received 29 March 1996; Accepted: 9 April 1996     

CT引导下125I粒子植入治疗肺癌术后气胸发生率的相关因素分析

目的 分析影响CT引导下经皮肺穿刺¹²⁵I粒子植入治疗肺癌术后气胸发生率的因素.方法 观察821例CT引导下经皮肺穿刺肺癌¹²⁵I粒子植入术后患者198例发生气胸的情况,分析其出现的相关因素.结果 术后CT发现气胸198例,发生率为24.1%.发现植入针进针平均深度、患者是否合并慢性阻塞性肺疾病(COPD)、是否合并肺不张、植入针道数目、手术时间、进针角度及肿瘤直径7个因素与术后气胸发生率相关(χ² =10.293、11.463、5.310、8.868、13.348、9.326、16.504,P<0.05).其中COPD患者176 例术后发生气胸65例(36.9%);植入针进针的深度<6 cm(205例)、8~12 cm(378例)及>12 cm(238例)患者术后发生气胸分别为29例(14.1%)、98例(25.9%)、71例(29.8%);植入针道数目<5(183例)、5~10 (408例)、>10(230例)的患者术后发生气胸例数分别是31例(16.9%)、92例(22.5%)、75例(32.6%);手术时间<10 min(198例)、10~20 min(412例)、>30 min(211例)的患者术后发生气胸分别为27例(13.6%)、101例(24.5%)、70例(33.2%);合并肺不张患者132例术后发生气胸的19例(14.4%).其中前4项经多因素logistic回归分析是气胸发生的危险因素(OR=1.676、2.147、1.827、2.368,P<0.05),最后1项是气胸的保护因素(OR=0.367,P<0.05).结论 当病灶离胸壁远,患者合并有COPD,术中植入针道较多的患者,粒子植入前要充分考虑到气胸发生的可能,减少穿刺针数目及加快手术时间,可使CT引导下经皮肺癌¹²⁵I粒子植入术后气胸发生率大为降低.     

Variables affecting the risk of pneumothorax and intrapulmonal hemorrhage in CT-guided transthoracic biopsy

The influence of various variables on the rate of pneumothorax and intrapulmonal hemorrhage associated with computed tomography (CT)-guided transthoracic needle biopsy of the lung were evaluated retrospectively. One hundred and thirty-three patients underwent CT guided biopsy of a pulmonary lesion. Two patients were biopsied twice. Variables analyzed were lesion size, lesion location, number of pleural needle passes, lesion margin, length of intrapulmonal biopsy path and puncture time. Eighteen-gauge (18G) cutting needles (Trucut, Somatex, Teltow, Germany) were used for biopsy. Pneumothorax occurred in 23 of 135 biopsies (17%). Chest tube placement was required in three out of 23 cases of pneumothorax (2% of all biopsies). Pneumothorax rate was significantly higher when the lesions were located in the lung parenchyma compared with locations at the pleura or chest wall (P < 0.05), but all pneumothorax cases which required chest tube treatment occurred in lesions located less than 2 cm from the pleura. Longer puncture time led to an increase in pneumothorax rate (P < 0.05). Thirty-seven (27%) out of 135 biopsies showed perifocal hemorrhage. Intrapulmonal biopsy paths longer than 4 cm showed significantly higher numbers of perifocal hemorrhage and pneumothorax (P < 0.05). Significantly more hemorrhage occurred when the pleura was penetrated twice during the puncture (P < 0.05). Lesion size <4 cm is strongly correlated with higher occurrence of perifocal hemorrhage (P < 0.05). Lesion margination showed no significant effect on complication rate. CT-guided biopsy of smaller lesions correlates with a higher bleeding rate. Puncture time should be minimized to reduce pneumothorax rate. Passing the pleura twice significantly increases the risk of hemorrhage. Intrapulmonal biopsy paths longer than 4 cm showed significantly higher numbers of perifocal hemorrhage as well as pneumothorax.     

Fibrin glue for sealing the needle track after percutaneous lung biopsy: Part I—experimental study

Purpose Evaluate the effectiveness of fibrin glue for the embolic occlusion of needle tracks following percutaneous lung biopsy (PLB).Methods Twenty-six rabbits underwent computed tomography (CT)-guided PLB using a coaxial system consisting of 19-and 22-gauge needles. Thirteen rabbits were used as controls (group A). In 13 other rabbits (group B), fibrin glue labelled with I¹³¹ fibrinogen and contrast medium was injected into the track. Both groups were examined by CT for the presence and severity of pneumothorax (mild: less than 20%; severe: more than 20%). Group B was also examined scintigraphically and their lungs were studied histologically. Results: In group A, pneumothorax developed in eight animals (61.6%) and was severe in six (46.1%) whereas in group B, pneumothorax developed in five animals (38.5%) and was severe in one (7.7%). Though the difference between the two groups in overall incidence of pneumothorax was not significant (p > 0.1), it was significantly higher (p < 0.025) for severe pneumothorax in group A. No signs of systemic embolism were observed.Conclusions Based on this animal model, fibrin glue is a safe and useful sealant following PLB and reduces the incidence of severe pneumothorax.     

Transthoracic needle biopsy of lung masses: a survey of techniques

AIM: In order to assess the range and everyday use of the various techniques for percutaneous transthoracic needle biopsy of lung masses in the USA and Canada, we surveyed thoracic radiologists in academic and community practice on their standard approach to the procedure. MATERIALS AND METHODS: The 300 questionnaires that were mailed to members of the Society of Thoracic Radiology throughout the USA and Canada contained specific questions on their approach to a transthoracic needle biopsy of a routine case of a 3cm lung mass located in the right lower lobe 1cm from the pleural surface. RESULTS: A total of 140 (47%) members responded. Of the 139 responders who performed lung biopsies, 103 (74%) were located at a teaching centre affiliated to a university or medical school, and 36 (26%) were community-based radiologists. In total 97 (70%) replied that they would perform the procedure under CT guidance, 31 (22%) under either CT or fluoroscopy guidance, and 11 (8%) only under fluoroscopy. Fine-needle aspiration was the procedure of choice for the given case by 101 (73%) responders, whereas 20 (14%) preferred doing core biopsy, and 18 (13%) chose both techniques. On-site cytology confirmation for obtaining diagnostic material was available to 101 (73%) responders. Before performing the procedure, 107 (77%) verified coagulation tests whereas 32 (23%) did not. Follow-up imaging for pneumothorax assessment was not routinely performed by 15 (11%) responders. CONCLUSION: The majority of radiologists performed percutaneous transthoracic needle biopsy of a lung mass under CT guidance, by fine-needle aspiration, using repeated pleural puncture technique, and with a cytologist on site. A significant minority did not obtain coagulation screening before the procedure, and a small minority did not routinely assess for pneumothorax by late chest radiography.     

CT-guided percutaneous lung biopsy: comparison of conventional CT fluoroscopy to CT fluoroscopy with electromagnetic navigation system in 60 consecutive patients

Purpose

To determine if use of an electromagnetic navigation system (EMN) decreases radiation dose and procedure time of CT fluoroscopy guided lung biopsy in lesions smaller than 2.5 cm.

Materials/methods

86 consecutive patients with small lung masses (<2.5 cm) were approached. 60 consented and were randomized to undergo biopsy with CT fluoroscopy (CTF) (34 patients) or EMN (26 patients). Technical failure required conversion to CTF in 8/26 EMN patients; 18 patients completed biopsy with EMN. Numerous biopsy parameters were compared as described below.

Results

Average fluoroscopy time using CTF was 28.2 s compared to 35.0 s for EMN (p = 0.1). Average radiation dose was 117 mGy using CTF and 123 mGy for EMN (p = 0.7). Average number of needle repositions was 3.7 for CTF and 4.4 for EMN (p = 0.4). Average procedure time was 15 min for CTF and 20 min for EMN (p = 0.01). There were 7 pneumothoracesin the CTF group and 6 pneumothoraces in the EMN group (p = 0.7). One pneumothorax in the CTF group and 3 pneumothoraces in the EMN group required chest tube placement (p = 0.1). One pneumothorax patient in each group required hospital admission. Diagnostic specimens were obtained in 31/34 patients in the CTF group and 22/26 patients in the EMN group (p = 0.4).

Conclusions

EMN was not statistically different than CTF for fluoroscopy time, radiation dose, number of needle repositions, incidence of pneumothorax, need for chest tube, or diagnostic yield. Procedure time was increased with EMN.     

CT导向经皮肺穿刺活检术的临床应用

目的：评价CT导引下经皮肺穿刺活检的临床应用价值。方法：回顾性分析经手术或病理证实的CT导向肺穿刺活检38例。活检的要点包括选择最佳层面、进针点及作点扇状快速抽吸。结果：38例中明确诊断33例，其中腺癌11例，鳞癌4例，转移癌1例，未分化癌1例，查到癌细胞但未能分型2例，异形细胞3例，肺脓肿4例，肺结核4例，炎性假瘤3例。未明确诊断5例。发生气胸2例，少量咯血2例。穿刺活检总确诊率为86．8％。结论；CT导引下肺穿刺活检确诊率高，并发症少，是一种简便、实用、安全的检查方法，应广泛推广应用。     

CT引导下肺实性结节切割活检术后出血与气胸的多因素分析

目的 探讨CT引导下经皮穿刺肺实性结节切割活检术后并发出血、气胸的危险因素.方法 回顾性分析肺实性结节(≤3 cm)320例经16 G半自动切割活检的临床及影像学资料,行单因素和多因素Logistic回归分析.结果 活检术后针道出血发生率33.1％,气胸发生率18.1％,良恶性诊断准确率约99.6％.针道长度是出血的独立危险因素,针道每增加3 cm,风险增加3.881倍,且风险也随穿刺时间(P=0.061)和穿胸膜次数(P=0.062)呈正相关.年龄、位置和针-胸膜夹角是气胸独立风险因素,年龄每增加10岁,风险增加2.102倍;上肺叶病灶显著低于下肺叶;针-胸膜夹角每增加20°,风险增加2.413倍,肺气肿以微弱差距(P=0.086)被排除方程之外.以出血、气胸概率值绘制ROC曲线,AUC值分别为0.753和0.725.结论 CT引导下肺实性结节切割活检术后出血、气胸的发生受多种因素影响,术前仔细评估,术中操作熟练度可以有效预判和降低出血、气胸的发生.     

CT引导下经皮肺穿刺活检861例回顾性分析

目的：探讨CT引导下经皮肺穿刺活检对于肺部疾病诊断的应用价值及操作安全性。 方法：回顾性分析2017年1月至2018年7月在淄矿集团有限责任公司中心医院及中国人民解放军总医院行CT引导下经皮穿刺活检的患者861例,分析其穿刺结果及并发症发生情况。 结果：861例患者均成功完成穿刺操作,结节性病变296例,团块状病变405例,肺实变病变77例,磨玻璃样病变83例。病理学诊断恶性病变736例,明确诊断率90.7%,提示性诊断率6.3%,非特异性诊断率3%。良性病变125例,明确诊断率49.6%,提示性诊断率21.6%,非特异性诊断率28.8%。并发症出现气胸77例（8.9%）,结节样病变发生率最高（15.2%）;肺出血103例（11.9%）,磨玻璃样病变发生率最高（20.4%）;胸膜反应17例（1.9%）;穿刺后心腔内出现气体2例（0.2%）。 结论：在CT引导下经皮肺穿刺活检术,安全实用,并发症少,有助于尽早明确诊断,对恶性病变的确诊率高于良性病变。     

CT fluoroscopy-guided vs. multislice CT biopsy mode-guided lung biopsies: accuracy, complications and radiation dose

Background

The aim of this retrospective study was to compare the diagnostic accuracy, the frequency of complications, the duration of the interventions and the radiation doses of CT fluoroscopy (CTF) guided biopsies of lung lesions with those of multislice CT (MS-CT) biopsy mode-guided biopsies.

Methods

Data and images from 124 consecutive patients undergoing CTF-guided lung biopsy (group A) and 132 MS-CT-biopsy mode-guided lung biopsy (group B) were reviewed. CTF-guided biopsies were performed on a Siemens Emotion 6 CT scanner with intermittent or continuous CT-fluoroscopy, MS-CT biopsy mode-guided biopsies were performed on a Siemens Emotion 16 CT scanner. All biopsies were performed with a coaxial needle technique.

Results

The two groups (A vs. B) did not differ significantly regarding sensitivity (95.5% vs. 95.9%), specificity (96.7% vs. 95.5%), negative predictive value (87.9% vs. 84%) or positive predictive value (98.8% vs. 98.9%). Pneumothorax was observed in 30.0% and 32.5% of the patients, respectively. Chest tube placement was necessary in 4% (group A) and 13% (group B) of the patients. The duration of the intervention was significantly longer in group A (median 37 min vs. 32 min, p = 0.04). The mean CT dose index (CTDI) was 422 in group A and 36.3 in group B (p < 0.001).

Conclusion

Compared to CTF-guided biopsies, chest biopsies using the MS-CT biopsy mode show dramatically lower CTDI levels. Although the diagnostic yield of the procedures do not differ significantly, biopsies using the MS-CT-biopsy mode have a three-fold higher rate of chest tube placement.     

多层CT引导下经皮同轴穿刺活检技术的临床应用

目的探讨多层螺旋CT引导下经皮同轴穿刺肺内病变的诊断价值。方法回顾性分析143例肺部占位病变患者行152次多层螺旋CT引导下同轴穿刺活检,并计算其阳性率及并发症的发生率。结果活检阳性率94.9%,特异度100%;其中恶性肿瘤116例(鳞癌48例、腺癌34、小细胞未分化癌6例、大细胞癌4例、肺泡癌8例、转移癌16例),19例良性病变,包括结核7例,炎性假瘤9例,错构瘤1例,肺脓肿1例和隐球菌肺炎1例。结论多层螺旋CT引导下经皮同轴穿刺活检诊断准确率高,是安全的经皮肺内活检方法。     

CT引导下肺活检后速发性气胸和迟发性气胸的对比研究北大核心CSCD

目的探讨CT引导下肺活检术后速发性气胸和迟发性气胸的危险因素。方法回顾性分析532例接受CT引导下肺活检患者的临床资料。肺活检术后4 h和出院前至少两次复查胸片。根据患者病变和肺活检相关变量评估速发性和迟发性气胸的危险因素。结果共有158例患者发生气胸,其中速发性气胸132例,迟发性气胸26例。病变大小是速发性和迟发性气胸共同的独立危险因素。肺气肿、肺下叶位置、肺内穿刺距离长是速发性气胸的独立危险因素。肺上叶位置和胸膜穿刺次数多是迟发性气胸独立的危险因素。有14例(8.9%)患者需要置胸管或引流管,其中速发性气胸9例,迟发性气胸5例。迟发性气胸组胸管置入率高于速发性气胸组(P<0.01)。结论对于肺气肿、肺下叶病变、肺内穿刺距离长的患者,CT引导下肺活检后往往立即发生气胸。由于迟发性气胸对胸管引流的要求较高,多次穿刺累及肺上叶的小病变需注意监测。     

Percutaneous CT-guided lung biopsy: sequential versus spiral scanning. A randomized prospective study

The aim of this study was to evaluate in a prospective and randomized study spiral versus sequential scanning in the guidance of percutaneous lung biopsy. Fifty thoracic lesions occurring in 48 patients were biopsied by a senior and a junior operator. Six different time segments of the procedure were measured. Scanning mode versus length of procedure, pathological results, irradiation and complications were evaluated. Total duration of the procedure and of the first sampling was significantly longer with spiral CT for the senior operator (p < 0.004). No significant time difference was observed for the junior operator. Diameter of the lesion, depth of location, position of the patient and needle entry site did not influence the results. The sensitivity was 90.9, specificity 100, positive predictive value 100 and negative predictive value 60 % for spiral CT, and 94.7, 100, 100 and 85.7 % for sequential CT, respectively. Eleven pneumothoraces and ten perinodular hemorrhages were seen with spiral CT and six and ten, respectively, with sequential CT. The mean dose of irradiation was 4027 mAs for spiral CT and 2358 mAs for conventional CT. Spiral CT does neither reduce procedure time nor the rate of complications. Pathological results do not differ compared with sequential CT, and total dose of irradiation is higher with spiral scanning. Received: 17 September 1998; Revision received: 14 December 1998; Accepted: 17 December 1998     

Systemic air embolism after percutaneous transthorasic needle biopsy of the lung

Computed tomography (CT)-guided percutaneous transthoracic biopsy of the lung is a well-established diagnostic technique, but it can pose complications to the patients. Air embolism is one of the rarest but potentially fetal complications of this procedure. The authors report a fetal case of systemic and massive air embolism to the coronary and cerebral arteries after the performance of lung biopsy. Careful reviewing of the obtained CT images during the procedure may avoid a missing systemic air embolism and can immediately provide an adequate therapy also in asymptomatic patients. This extremely rare complication is an inevitable event and may happen in spite of appropriate experience and meticulous care.     

Efficacy of manual aspiration immediately after complicated pneumothorax in CT-guided lung biopsy

PURPOSE: The goal of this study was to evaluate the efficacy of simple aspiration of air from the pleural space to prevent increased pneumothorax and avoid chest tube placement in cases of pneumothorax after computed tomography (CT)-guided lung biopsy. MATERIALS AND METHODS: This retrospective study was based on experience with 283 consecutive percutaneous needle lung biopsies with real-time CT fluoroscopic guidance. While patients were on the CT scanner table, percutaneous manual aspiration was performed in all those with moderate or large pneumothorax demonstrated on postbiopsy chest CT images regardless of symptoms. The authors evaluated the frequency of biopsy-induced pneumothorax, management of each such case, and factors that influenced the incidence of worsening pneumothorax that required chest tube placement despite manual aspiration. RESULTS: Of the 104 (36.7%) pneumothoraces occurring after 283 biopsy procedures, 52 were treated with manual aspiration immediately after biopsy. In 95 of the 104 pneumothoraces (91.3%), the pneumothorax had resolved completely on follow-up chest radiographs without chest tube placement. Only nine patients (3.2% of the entire series; 8.7% of those who developed pneumothorax) required chest tube placement. Requirement of chest tube insertion significantly increased parallel to the increased volume of aspirated air. The optimal cutoff level of aspirated air on which to base a decision to abandon manual aspiration alone and resort to chest tube placement was 543 mL. CONCLUSION: Percutaneous manual aspiration of biopsy-induced pneumothorax performed immediately after biopsy may prevent progressive pneumothorax and eliminate the need for chest tube placement. However, in cases in which the amount of aspirated air is large (such as more than 543 mL in this study), the possibility of required chest tube placement increases.     

机器人三维靶向定位系统在CT引导下肺穿刺活检术中的应用

 目的 探讨MAXIO^TM机器人三维靶向定位系统在CT引导下肺穿刺活检术中的应用。方法 选择2017-08至09 40例经评估适合行肺穿刺活检术患者,随机分为试验组和对照组,每组20 例。试验组采用MAXIOTM机器人三维靶向定位系统在CT引导下行肺穿刺活检术,对照组采用传统格栅定位器行CT引导下穿刺活检。比较试验组与对照组平均操作时间、一次性穿刺成功率、扫描次数、并发症发生率、活检病理诊断阳性率。结果 试验组和对照组肺穿刺平均操作时间分别为(24.0±3.9)min和(27.3±4.1)min,两组比较差异无统计学意义(t=-1.91,P>0.05);试验组和对照组一次性穿刺成功率分别为75%(15/20)和25%(5/20),两组比较差异有统计学意义(χ²=8.10,P<0.05);试验组和对照组平均扫描次数分别为(4.1±0.5)次和(6.0±1.3)次,两组比较差异有统计学意义(t=-4.65,P<0.05);试验组和对照组并发症发生率分别为10%(2/20)和40%(8/20),两组比较差异有统计学意义(χ²=4.68,P<0.05);试验组和对照组活检病理诊断阳性率分别为100%(20/20)和90%(18/20),两组比较差异无统计学意义(χ²=2.05,P>0.05)。结论 MAXIO^TM机器人三维靶向定位系统在CT引导下肺穿刺活检术前较为精确地规划了穿刺路径,机械臂实时立体引导操作,一次性穿刺成功率提高,扫描次数减少,辐射剂量降低,并发症发生率低,具有较高的临床应用价值。