CT导向下经皮针刺活检前纵隔肿瘤

目的　探讨经皮针刺活检前纵隔肿瘤的影响穿刺准确性的因素。资料与方法　回顾性分析 80例前纵隔肿瘤CT导向下经皮针刺活检术。结果　 (1)病理学明确诊断 6 7例 ,不能确定诊断 13例 ;(2 )细针抽吸、切割针活检穿刺敏感性分别为 75 %、90 .5 % ;(3) 16例小病灶穿刺敏感性为 6 8.8% ,6 4例大病灶穿刺敏感性为 87.5 % ;(4)胸腺类肿瘤、淋巴结转移性癌活检准确性均为 92 % ,淋巴瘤活检准确性仅为 6 5 % ,与前两组比较有统计学意义(P <0 .0 5 ) ;(5 )穿刺并发症发生率为 7.5 %。结论　切割针活检阳性率高于细针活检 ,活检阳性率大病灶高于小病灶 ,胸腺类肿瘤、淋巴结转移性癌活检阳性率显著高于淋巴瘤 ;CT导向下经皮针刺活检术是前纵隔肿瘤安全、有价值的诊断方法。

CT-guided Percutaneous Needle Biopsy of Anterior Mediastinal Masses

Objective To evaluate the influence factors on accuracy of percutaneous needle biopsy of anterior mediastinal masses.Materials and Methods 80 patients with CT guided percutaneous needle biopsy of anterior mediastinal lesions were retrospectively analyzed.Results (1)Pathological diagnosis were definite in 67 patients, and were indefinite in 13 patients. (2)The sensitivity was 75% by fine needle aspiration biopsies, and 90.5% by TruCut biopsies. (3)The sensitivity of biopsy was 68.8% in small lesions (16 patients), and 87.5% in large lesions (64 lesions). (4) Diagnostic accuracy of biopsy was 92% for carcinoma or thymoma respectively, but 65% for lymphoma. The differences were significant (P<0.05). (5)The complication rates encountered was 7.5%.Conclusion The sensitivity of biopsies are higher by TruCut biopsies than by fine needle aspiration. The sensivity of lesions in larger are higher than that in small. The sensitivity of pathological diagnosis for carcinoma or thymoma are higher than that for lymphoma. CT guided percutaneous needle biopsy is a safe procedure for diagnosis of anterior mediastinal masses.