CT导引肺穿刺活检不同取材方法的诊断价值

目的 探讨CT导引穿刺活检3种取材方法对肺部肿块或结节的诊断价值.方法 适合CT导引穿刺活检的肺部肿块或结节患者,随机分为切割活检组、针吸活检组及切割加针吸活检组,共206例.其中切割活检组67例,针吸活检组69例,切割加针吸活检组70例.根据分组选择相应取材方法,比较3组的诊断正确率及对恶性病变病理组织学分型的正确率.结果 ①206例CT导引穿刺活检总的诊断正确率为74.76％( 154/206),切割组、针吸组和切割加针吸组诊断正确率分别为76.12％(51/67)、62.32％( 43/69)和85.71％( 60/70),差异有统计学意义(x2=10.1763,P =0.0062).②在对恶性病变的病理组织学分型中,3组总的诊断正确率为69.57％(96/138),其中切割组、针吸组和切割加针吸组的诊断正确率分别为72.34％( 34/47)、44.44％( 20/45)和91.30％(42/46),差异有统计学意义(X2=23.8515,P＜0.001).结论 就肺部疾病诊断及恶性病变病理组织学分型,CT导引穿刺活检切割加针吸取材优于单纯切割取材或针吸取材.

Diagnostic value of CT-guided percutaneous lung biopsy based on three different methods

【Objective】 To compare three different methods based on the diagnostic value.【Methods】 Select from June 2006 to March 2009 for CT-guided percutaneous lung biopsy of lung masses or nodules in patients with 206 cases.67 cases in which are cutting biopsy group,69 cases are needle aspiration group,cutting and needle aspiration biopsy group plus 70 cases.Choose the best way to puncture according to the results of thin-layer CT scan.【Results】 The overall diagnostic accuracy rate of 206 cases of CT-guided percutaneous lung biopsy was 74.76%(154/206),the diagnostic accuracy rates in three different methods were 76.12%(51/67),62.32%(43/69) and 85.71%(60/70),(χ2 =10.1763,P =0.0062).For malignant lesions on histopathological typing,the accuracy rate of CT-guided percutaneous lung biopsy was 69.57%(96/138),the accurate diagnosis rates in three different methods were 72.34%(34/47),44.44%(20/45) and 91.30%(42/46)(χ2 =23.8515,P <0.001).【Conclusion】 In the diagnostic accuracy rate of the lung lesions and of the histopathological credits type,cutting and needle aspiration biopsy is better than simply the cutting biopsy or the needle aspiration.