同轴活检技术在CT引导下纵隔内肿块穿刺活检中的临床应用

目的评价应用同轴活检技术及快速细胞学检查,进行CT引导下纵隔内肿块穿刺活检的临床价值.方法CT引导下应用同轴活检技术和快速细胞学检查经皮纵隔内肿块穿刺活检48例.先用18G,10cm长chiba针(导向针)穿透皮肤、胸壁软组织,甚至胸骨、椎体到达病灶边缘外5mm处,再用20～22G半自动切割针或chiba针通过导向针管到达病灶内,并对病灶进行切割或抽吸,取得标本进行涂片固定,然后行快速细胞学检查.结果48例活检病变穿刺25例经胸骨旁径路,19例经胸骨径路,4例俯卧经椎旁径路.穿刺时均避开了含气的肺组织和纵隔内大血管.所有病例均无重复穿刺.活检诊断正确率91.7%(44/48).结论应用同轴活检技术和快速细胞学检查为各类纵隔内肿块的穿刺活检提供了一种更安全、更可靠的方法.

The clinical application of CT-guided mediastinum tumor puncture biopsy with the same axle transfixion pin biopsy technique and fast cytological examination

Objective To evaluate the clinical application value of CT-guided mediastinum tumor puncture biopsy with the same axle transfixion pin biopsy technique and fast cytological examination. Methods The clinical data of 48 cases of CT-guided mediastinum tumor puncture biopsy with the same axle transfixion pin biopsy technique and fast cytological examination were retrospectively analysed .Firstly, the skin and chest wall soft tissue, even the breast bone and centrum to the edge of tumour was penetrated using 18G and 10cm long chiba needle (targeting needle). Secondly, using 20-22G semi-automatic dissection needle or chiba needle to puncture the tumour through the 18G targeting needle and making dissection or aspiration and fast cytological examination of the sample. Thirdly, comparing the results with the routine CT-guided mediastinum tumor puncture biopsy to evaluate the quality of our method. Results 25 cases were punctured through the route of parasternal ;19 cases through the route of breast bone ;4 cases through the route of paracentrum under face lying. The accuracy and false negative rate of the puncture biopsy were 91.7%(44/48) and 8.3%(4//44) respectively. The lung and great vessels in the mediastinum were not damaged and there were not repeat puncturation. Conclusion It is a safer and reliable method. for the CT-guided mediastinum tumor puncture biopsy with the same axle transfixion pin biopsy technique and fast cytological examination.