不同影像学方法对周围型小肺癌诊断价值比较

目的总结比较不同影像学检查方法对周围型小肺癌的诊断价值。方法收集初诊为周围型小肺癌患者56例,全部病例临床资料齐全,均进行X线胸部正侧位平片、CT、MRI扫描检查,52例行CT引导下经皮肺穿刺活检,33例接受手术治疗,同时接受3~18个月追踪观察。结果初诊为周围型小肺癌的56例中,经进一步检查证实X线平片确诊12例(占21.46%),误诊44例(78.54%);CT扫描确诊21例(占37.50%),误诊35例(占52.79%);56例中有52例接受CT引导经皮肺穿刺活检,计58个病灶,共取材120次,平均2.07次,检查结果52例中恶性肿瘤38例(占73.08%)。52例中33例接受手术治疗,除3例与肺穿刺结果不一致外,其余诊断结果基本一致。经统计学分析,CT引导下经皮肺穿刺活检正确率为94.34%。结论通过四种影像学对周围型小肺癌的诊断价值比较认为:对于难以定性的肺结节病变应及时行CT引导下经皮肺穿刺活检,以免造成误诊和漏诊。

Evaluation of the diagnostic value of the four image techniques to the small peripheral lung cancer

Objective To compare and summarize the diagnostic value of the four image techniques to small peripheral lung cancer.Methods There were 56 patients who had been diagnosed to be the small peripheral lung cancer on their first visit to a doctor of our hospital,and 23 of them were proved to be misdiagnosed by the percutaneous needle lung biopsy guided by CT and surgery.All cases have full clinical datum with the chest X-ray check in posterior to anterior(PA) and left lateral position and the check of CT and MRI.And 52 cases had the percutaneous needle lung biopsy guided by CT;33 cases received surgery therapy,traced for 3-18 months.Results The first visit to a doctor diagnosed 56 small peripheral lung cancer cases;12(21.46%)of them were proved by X-ray check,misdiagnosis 44 cases(78.54%);21 of them proved by CT scan(37.50%),misdiagnosis 35 cases(52.79%).52 cases received the percutaneous needle lung biopsy guided by CT on total 58 focuses,totally took biopsy for 120 times,averagely 2.07 times per focus;the results showed,38 of them were malignant tumors(73.08%).33 cases out of 52 received the surgery therapy,most of them had the same feature as the check of percutaneous needle lung biopsy besides 3 cases.Analysed by the statistics that the correct diagnostic rate of the percutaneous needle lung biopsy guided by CT was 94.34%.Conclusion The comparison of the diagnostic value of 4 image techniques to the Small Peripheral Lung Cancer showed: the suspicious lung nodes should do the percutaneous needle lung biopsy guided by CT immediately,in order to avoid the misdiagnosis and missed diagnosis.