超声与CT引导下经皮肺穿刺活检在临床诊断中的应用

目的探讨超声与CT引导下经皮肺穿刺活检肺内病灶在临床中的应用。方法回顾性分析63例经皮肺穿刺活检肺内病灶的患者资料,根据病灶部位的不同,采用超声或CT引导下穿刺活检。经病理明确诊断61例。结果 63例患者超声引导穿刺14例,CT引导穿刺49例。穿刺后结果示:恶性肿瘤共48例,其中原发性肺癌41例(鳞癌17例、腺癌21例、未分化癌3例),由其他部位或器官转移性肿瘤6例,胸膜间皮瘤4例(良性3例,恶性1例),诊断为结核者2例,炎性假瘤8例,不能明确诊断2例。穿刺活检诊断准确率为96.8%,均未出现危及生命的严重并发症。结论超声与CT引导下经皮肺穿刺活检是一种安全性高、确诊率高的方法,对于肺内病灶良恶性的鉴别有重要的意义。根据病灶部位的不同正确选地择超声或CT引导,利用其各自的优势,不仅可以提高安全性和准确性、还可以减少并发症,具有较高的临床应用价值。

Application of Ultrasound and CT-Guided Percutaneous Lung Puncture Biopsy in Clinical Diagnosis

Objective To explore the clinical application of ultrasound and CT-guided percutaneous lung puncture biopsy in lung lesions. Methods The clinical data of 63 patients with percutaneous lung puncture biopsy in lung lesions was retrospectively analyzed. Based on the lesion site, puncture was made with the aid of ultrasound or CT. 61 cases were pathologically diagnosed. Results Among 63 patients, 14 cases underwent ultrasound-guided puncture, and 49 cases underwent CT-guided puncture. Malignant tumor was discovered in 48 cases, including 41 cases of primary lung cancer （17 cases of squamous cell carcinoma, 21 cases of adenocarcinoma, 3 cases of undifferentiated carcinoma）, 6 cases of metastatic tumors from other parts or organs, 4 cases of pleura mesothelioma （3 benign and 1 malignant）, 2 cases of tuberculosis, 8 cases of inflammatory pseudotumor. And 2 cases could not be diagnosed. The accuracy of biopsy diagnostic was 96.8%, and no life-threatening serious complications occurred. Conclusions Ultrasound and CT-guided percutaneous lung puncture biopsy is a safe, effective and significant diagnostic method for the identification of benign and malignant lung lesions. Correctly selecting ultrasound or CT guidance according to the site of the lesion can not only improve the safety and accuracy, but also reduce complications, which has great clinical value.