模拟机定位经胸细针肺穿刺诊断肺癌(附100例报告)

自1986年元月至1988年6月,我们应用模拟机定位经胸细针肺穿刺诊断肺癌100例,90例获阳性结果,阳性率90％。其中周围型肺癌54例,52例阳性,阳性率96.3％;中心型肺癌43例,阳性37例,     

模拟机下经皮胸内肿瘤超细针针吸活检——附100例报告

本文报告了1984年10月～1986年3月我们进行的100例模拟机下经皮胸内肿瘤超细针针吸活检的结果。针吸活检的成功率为94.0％(94/100)其中肺癌65例,诊断正确率87.7％,可疑率为6.2％,误诊率为6.2％。没有明显的并发症。作者认为,模拟机定位具有准确、穿刺少受肿瘤部位及大小的限制且成功率高的优点;超细针针吸活检所获取的细胞学标本结果可与小针及粗针针吸活检标本相媲美,但合并症却更少。该技术是一能早期取得细胞学诊断并值得推广应用的方法。对于外周型(钱币样肿块)作此项检查特别合适。     

CT模拟机引导经皮粗针肺活检对肺周围型肿块的临床价值

目的 探讨CT模拟机定位下经皮粗针肺活检对肺周围型肿块的临床价值.方法 50例肺周围型肿块患者,利用CT模拟机、CT-sim工作站及模拟激光定位系统确定最佳穿刺点,局麻下MAGNUM活检枪经皮刺入病灶,切割组织行病理检查.结果 50例均穿刺成功,获得组织学资料,确诊率100.0%,其中肺癌46例,24例手术,术后病理符合率100.0%.并发症包括气胸2例(4.0%)、咯血4例(8.0%).结论 CT模拟机引导下经皮粗针肺活检术对肺周围型肿块,尤其是病理学阴性肺癌的确诊提供了一种安全、有效、简便的检查手段.     

在模拟机定位下肺肿块活检(附52例临床分析)

模拟机定位下肺肿块穿刺活检,弥补了临床对周边型及近中央型肺肿块性质诊断的缺陷,临床价值极高。我科从1996年9月至1999年2月间,采用模拟机定位细针经皮肺穿刺细胞学检查,获得了满意的效果。1　临床资料11　一般资料　本组52例病人均为我院住院和门诊病人。男性33例,女性...     

模拟机定位细针经皮肺穿刺细胞学诊断61例报告

模拟机定位细针经皮肺穿刺细胞学诊断６１例报告江西省肿瘤医院放疗科（南昌市３３００２９）邬蒙吴新生敖帆刘智华周围型肺癌、肺上沟瘤及其它肺周占位性病变的病理或细胞学诊断，除了开胸手术探查外，经皮肺穿刺常常是唯一的选择，国内外对此研究颇多，但采用的导引方式...     

模拟放疗引导穿刺染色定位切除外周肺部微小结节

背景与目的随着肺癌早期筛查的广泛开展及高分辨率计算机断层扫描（comouted tomography, CT）的普及,临床上微小结节型肺癌在可手术的肺癌中所占的比例大幅增加。如何在术中快速而准确地找到病灶是近年来胸外科医生经常面临的问题。为此我们开展此项研究,旨在探索利用放射治疗计划系统模拟引导穿刺染色定位外周肺部微小结节,并评估这一新方法的定位效率和临床应用价值。方法2012年2月-2015年1月我们对97例患者共100枚直径1 cm内的肺部周围型微小病灶,术前利用放射治疗计划系统,对病灶进行CT模拟定位,患者麻醉后依据术前放疗计划标记的穿刺位点、角度和深度,向病灶注射亚甲蓝,继而手术,在胸腔镜下根据染色标记楔形切除病灶区域肺组织。剖视标本并快速病理检查。统计穿刺注射亚甲蓝的时间、染料注射完毕至剖胸寻视到染色斑的时间、色斑中心点与病灶边缘的距离、定位成功率和并发症率等数据。结果100枚病灶共完成定位96枚,成功率为96%。麻醉后皮肤定位点穿刺注射亚甲蓝的时间为（4.85±1.25）min;染料注射结束至入胸寻找到染色斑的时间为（16.36±2.36）min;色斑中心点与病灶边缘的距离为（4.78±2.34）mm;所有患者无并发症。结论放疗计划系统模拟定位引导穿刺亚甲蓝注射法对肺部周围型微小结节的定位成功率较高,无相关并发症。此方法可避免患者清醒状态下穿刺定位的恐惧和疼痛,并可明显减少患者的辐射危害。     

模拟机下定位经胸细针肺穿刺诊断肺癌(附62例报告)

自1986年1月～1987年底,我们在模拟机下定位用细针经胸肺穿刺共诊断肺癌62例。临床资料男42例、女20例,年龄15～70岁。依胸片测定,肿物最长径<2cm4例,2～3cm11例,3～4cm19例,4～5cm16例,>5cm12例。62例中周围型肺癌30例;中心型肺癌29例;弥散型肺癌3例。62例病人共查痰153次,查到癌细胞9例。30例行纤维     

模拟机结合CT图像三维立体数字化精确定位穿刺(附156例)

目的:探索在模拟机下实施精确、简捷、并发症少的穿刺定位方法.方法:阅读CT图片选择最佳穿刺点后,在模拟机下采用等中心技术结合CT图像参照骨性标志在冠、矢、横状位三维上确定穿刺点.结果:156例经皮穿刺成功率100%,确诊率94.87%,其中肺及纵隔恶性肿瘤132例,结核5例,炎性假瘤3例,肺间质纤维化3例,慢性炎症5例,坏死组织6例,大量淋巴细胞2例,无医源性气胸发生.结论:模拟机结合CT图像三维立体数字化精确定点穿刺是一种简捷、准确、并发症少的技术,为癌症治疗提供精确的技术保障.     

模拟机结合CT图像三维立体数字化精确定位穿刺（附156例）

目的：探索在模拟机下实施精确、简捷、并发症少的穿刺定位方法。方法：阅读CT图片选择最佳穿刺点后，在模拟机下采用等中心技术结合CT图像参照骨性标志在冠、矢、横状位三维上确定穿刺点。结果：156例经皮穿刺成功率100％，确诊率94．87％，其中肺及纵隔恶性肿瘤132例，结核5例，炎性假瘤3例，肺间质纤维化3例，慢性炎症5例，坏死组织6例，大量淋巴细胞2例，无医源性气胸发生。结论：模拟机结合CT图像三维立体数字化精确定点穿刺是一种简捷、准确、并发症少的技术，为癌症治疗提供精确的技术保障。     

模拟定位机导引自动弹力切割枪经皮肺活检在周围型肺癌中的诊断价值

经皮肺穿刺活检是诊断肺占位病变的重要手段之一，特别是对周围性病变，已成为明确病理诊断的首要检查方法。本文回顾性分析我科2003年6月～2006年7月，对经CT扫描疑诊为周围型肺癌的72例患者，以X线放射治疗模拟机导引自动弹力切割枪行经皮肺穿刺活检，总结如下。     

Percutaneous superfine-needle aspiration biopsy of intrathoracic lesions guided by simulator

The result of percutaneous superfine-needle aspiration biopsy in 100 patients with intrathoracic lesions guided by simulator is reported. The success rate of aspiration biopsy was 94%, and no major complication was observed. The method of localization by simulator had advantages such as accuracy in localization, no limitation of mass size and site, and a high rate of puncture success. Cell smears obtained by superfine needle were similar to those obtained by fine- or large-bore needles, but fewer complications were encountered. This is a useful technique that can provide early cytological diagnosis, especially for the peripheral type of pulmonary mass.     

Effectiveness of transbronchial needle aspiration in the diagnosis of exophytic endobronchial lesions and submucosal/peribronchial diseases of the lung

The role of transbronchial needle aspiration (TBNA) in diagnosing endobronchial lung cancers has not been elucidated. The definitive combination of procedures that offers the best diagnostic yield following fiberoptic bronchoscopy remains controversial. This study was designed to investigate the diagnostic yield of transbronchial needle aspiration and other cytologic and histologic diagnostic procedures (i.e., forceps biopsy, brushing, and washing) and to assess the optimal combination for diagnosing endobronchial lung cancers. This prospective study included 95 patients presenting with visible tumors detected during bronchoscopic procedure as either an exophytic endobronchial lesion (EEL) or submucosal-peribronchial disease (SPD). Transbronchial needle aspiration, forceps biopsy, brushing, and washing were performed in all patients, and 91 patients were diagnosed. Rates of positive results were 75.8% for needle aspiration, 71.6% for forceps biopsy, 61.1% for brushing, and 32.6% for washing. Needle aspiration was used as the sole diagnostic method in 11, forceps biopsy was the sole diagnostic method in 5, and brushing was the sole diagnostic method in 4 patients. Washing was not used as the sole diagnostic method in any case. Forceps biopsy yielded the highest diagnostic rate for an EEL (86.4%); however, when compared with needle aspiration (77.9%), no significant difference was observed between these two procedures (P = 0.302). In patients with a diagnosis of SPD, needle aspiration was determined to be the sole diagnostic method in eight patients. In this group of patients, the highest rate of diagnosis was achieved with needle aspiration (72.2%), and when compared with forceps biopsy (47.2%), a significant difference between the two procedures (forceps biopsy versus needle aspiration) was observed (P = 0.049). By adding transbronchial needle aspiration to the conventional diagnostic methods (forceps biopsy, brushing, and washing), the rate of diagnosis increased from 82.1% to 95.8% (P = 0.001), and in patients with a diagnosis of SPD, this rate increased from 69.4% to 94.4% (P = 0.008). In patients with a diagnosis of an EEL, addition of needle aspiration led to an increase in diagnostic yield but this difference was not statistically significant (89.8% versus 96.6%, P = 0.250). In endobronchial lung cancers, transbronchial needle aspiration is a safe method that can be used together with conventional diagnostic procedures to increase the diagnostic yield and should be considered a valuable diagnostic tool, particularly in cases of SPD. The highest rate of diagnostic yield in this study was obtained using a combination of forceps biopsy, transbronchial needle aspiration, and brushing; washing did not contribute to this high rate.     

实时B超引导下胸内肿块细片针吸取活检：附50例分析

From May 1987 to February 1988, fine needle aspiration biopsy of intrathoracic mass guided by real-time sonography was performed in 50 consecutive patients and succeeded in 45 (90%). In this series, there were 34 malignant neoplasms with success rate of 94.12% and 16 benign lesions with success rate of 81.25%. Statistical analysis showed no difference. The success rates were different in various sites: supraclavicular 100% (3/3), parasternal 92.86% (13/14), paravertebral 75.00% (3/4), intercostal 89.66% (26/29). But, the statistical analysis was still not significant. No other complications occurred except mild hemoptysis in 1 case. Fine needle aspiration biopsy of intrathoracic mass guided by real-time sonography, being of simplicity, less complications and no exposure of either patient or operator to radiation, should be used widely.     

超声引导下甲状腺结节细针穿刺细胞学与粗针穿刺组织学检查的对比研究CSCD

目的比较超声引导下甲状腺结节细针穿刺细胞学与粗针穿刺组织学检查的诊断准确率、敏感度、特异性及并发症。方法收集95例超声检查疑似为恶性甲状腺结节患者的98个结节,行超声引导下细针穿刺细胞学与粗针穿刺组织学检查,并经术后常规病理检查证实。比较两种方法诊断甲状腺结节的准确率、敏感度、特异性及术后并发症。分析结节直径大小与取材满意率、诊断准确率的关系。结果 (1)细针穿刺取材满意率89.8%,粗针为96.9%。细针穿刺细胞学诊断甲状腺结节的准确率、敏感度、特异性分别为86.4%、90.5%、82.6%;粗针穿刺组织学诊断为90.5%、91.7%、88.6%;(2)粗针穿刺并发症发生率高于细针穿刺(14.3% vs.2.0%,P<0.05);(3)结节直径≥1.0 cm时,粗针穿刺诊断准确率高于细针穿刺(P<0.05)。结论细针穿刺细胞学与粗针穿刺组织学检查在甲状腺结节良恶性诊断中可互相补充。     

针吸细胞病理学在临床应用中的价值探讨

目的：探讨针吸细胞学在临床应用中的价值。方法：采用细针吸取细胞分析３６１９０人次诊断结果。结果：３６１９０人次针吸细胞学阳性检出率为８９．５％,７９１例细胞学诊断为肿瘤或瘤样增生者与病理对照,诊断符合率为８７．６％;２０６４例细胞学府晨瘤性疾病或病变者,被临床和病理证实为恶性肿瘤者２５例,生肿瘤１５６例,假队性率为８．８％。结论：针吸细胞学诊断的敏感性和特异性尚满意,具实用价值,但其准确性低于病理     

胰腺癌术中组织活检及细胞学诊断的临床意义

目的 探讨胰腺癌术中组织活检和细胞学诊断的临床应用价值.方法 回顾性分析术中行组织活检和穿刺细胞学检查的142例胰腺癌患者的临床资料.142例患者均获得组织病理学诊断,其中80例患者术中行快速冰冻切片病理检查,87例患者术中行穿刺细胞学检查.结果 术中组织活检诊断准确率为83.8%,穿刺细胞学检查诊断准确率为93.1%,差异有统计学意义(P=0.027).术中组织活检和穿刺细胞学检查均无相关并发症发生.结论 胰腺癌组织学诊断困难,术中行组织活检或穿刺细胞学检查安全性和诊断准确率均较高,是提高胰腺癌诊断的有效方法.     

Fine needle aspiration biopsy in clinical management of head and neck tumors

Ninety-five percent (195) of 203 fine needle aspiration biopsies (FNAB) of head and neck specimens contained adequate tissues for histologic evaluation. No complications or needle tract recurrences were identified. Out of 135 patients whose surgical excision followed FNAB, 5% (7/135) of the biopsies were nondiagnostic. Correlation of cytologic and histologic findings of the remaining 128 FNAB revealed a sensitivity rate of 82% (46/56), a specificity rate of 99% (71/72), and a positive predictive of value of 98% (46/47). The diagnostic accuracy of FNAB was better with salivary gland and cervical node specimens than with thyroid, skin, and subcutaneous specimens. Fine needle aspiration biopsy may be considered as the first diagnostic step in the evaluation of the mass of the head and neck region, if the nondiagnostic aspiration rate is low and the diagnostic accuracy is high.     

CT引导下经皮肺细针抽吸活检术的临床应用价值

目的评价CT引导经皮肺细针抽吸活检术的临床应用价值。方法对110例CT引导下经皮肺细针抽吸活检术，病理检查证实93例。结果93例患者中，与病理检查相吻合的肺癌85例，穿刺确诊77例，8例为肺部良性病变。诊断灵敏度90．6％，特异度100．0％，诊断准确率91．4％。并发气胸9．1％，肺内出血10．9％，均自行吸收。结论CT引导经皮肺细针抽吸活检术临床应用准确性较高，并发症较少，有助于肺部病变的诊断。     

模拟定位器引导经皮穿刺肺活检(附19例报告)

1978年4月至1984年2月我们使用模拟定位器引导,对19例周围型肺癌进行经皮肺针吸活检(PALB),获阳性病理诊断12例,阳性率63.2％。其中腺癌5例、鳞癌4例、小细胞癌1例,癌(未分类)2例。PALB阳性组12例中,经药物治疗7例均在3～11月内死亡;采取手术治疗5例,术后病理学诊断与PALB诊断相同。PALB阴性组7例均行手术治疗,术后病理诊断为腺癌3例、鳞癌3例、支气管肺泡癌1例。本方法对肺癌早期诊断为一有用途径。     

CT引导下肺穿刺活检诊断肺部肿瘤

目的:探讨CT引导下经皮肺穿刺活检对肺周围性病灶活组织标本检测诊断的效果。方法:307例患者,其中以咳嗽、胸痛及咯血为主要症状者253例,无明显症状者54例,选用意大利产18G切割活检针,按CT引导的方向,经皮肺穿刺活检对肺周围性病灶取活组织标本。结果:将307例患者肺活检的病理组织标本送检,活检取材成功率为100%。手术并发症:307例肺活检中发生气胸32例(10.42%),其中3例肺压缩>40%,29例肺压缩<10%。15例(4.89%)发生肺活检术后咳血。气胸与咳血的总发生率为15.31%。结论:CT引导下肺穿刺活检术准确率高,为临床诊断提供了新的手段与途径,有较高的实用价值。