多层螺旋CT 多平面重建功能在CT引导经皮肺内结节穿刺活检定位中的应用

目的 探讨多层螺旋CT多平面重建(MPR)技术在提高肺内结节的穿刺成功率的临床价值。 方法 将50例因肺内结节拟接受穿刺活检患者分为两组:MPR重建图像参照组与轴位图像参照组。在穿刺定位过程中对MPR重建图像参照组患者的容积数据进行轴、矢、冠三方位重建,指导穿刺进针轨迹;轴位图像参照组使用常规轴位图像定位。记录两组在术中调整进针方向的次数及术后并发症,进行统计学分析。 结果 MPR重建图像参照组25例患者成功取到活检组织。轴位图像参照组1例因肺大泡破裂导致穿刺失败,余24例均成功取到活检组织。MPR重建图像参照组在穿刺针过胸膜后调整进针方向平均1次,肺内轻微出血患者3例,少量气胸患者1例;轴位图像参照组在穿刺针过胸膜后调整进针方向平均3次,肺内轻微出血患者4例,少量气胸患者6例。 结论 多层螺旋CT MPR轴位、矢状位及冠状位图像重建功能的使用有助于术者在穿刺活检术中准确把握进针方向,减少术后并发症。

Application of multi-slice spiral CT multiplanar reconstruction technology in CT-guided percutaneous needle biopsy of pulmonary nodules

Objective To explore the value of multi-slice spiral CT multiplanar reconstruction (MPR) technology in CT-guided percutaneous needle biopsy of pulmonary nodulars. Methods Fifty patients with pulmonary nodules underwent CT-guided percutaneous needle biopsy with Toshiba 64-slice spiral CT. All patients were divided into two groups, i.e. test group (MPR group) and control group (axial group). In the puncture course, three-axis vector direction reconstruction were made in MPR group, while the control group using only axial images. The data of the two groups of times of adjust needles during surgery and postoperative complications were recorded and analyzed. Results Biopsy was succefully done in all 25 patients in MPR group. In axial group, biopsy was failed in 1 patient due to lung bullae rupture; the average adjust needle time in MPR group was 1; three patients had minor bleeding; 1 had small amount of pneumothorax. In axial group, the average adjust needle times was 3; 4 patients had minor bleeding; 6 had small amount of pneumothorax. Conclusion Multi-slice spiral CT MPR axial, sagittal and coronal reconstructions can improve the puncture successful rate and reduce the complications during CT-guided percutaneous needle biopsy of pulmonary nodules.