CT引导下肺内大血管旁小病灶穿刺活检技术的临床应用

目的：评价CT引导经皮穿刺肺内大血管旁直径≤2cm病灶的临床价值。方法：CT引导经皮穿刺肺内大血管旁直径≤2cm病灶72例，分析其敏感性、特异性、准确性及并发症。结果：恶性肿瘤的诊断敏感性833％（45／54），阳性预测值100％；良性病变诊断特异性100％，阴性预测值66．7％（18／27），总诊断准确率84．7％（61／72）气胸发生率6．9％（5／72），肺内出血发生率8.3％（6／72），均未作特殊处理自愈。病灶周围有肺气肿是气胸及肺内出血的危险因素（X^2=10．9、8．5，P〈0．05），而病灶部位、大小及深度均与上述并发症无关（P〉0．05）。结论：CT引导经皮穿刺肺内大血管旁直径≤2cm病灶准确性较高而并发症较低。

Clinical Application of CT-guided Percutaneous Fine Needle Aspiration for Small Pulmonary Nodules near Great Vessels

Objective: To evaluate the clinical value of CT-guided percutaneous fine needle aspiration for the pulmonary nodules less than or equivalent to 2.0 cm in diameter around great vessels. Method: Seventy-two patients underwent CT-guided percutaneous fine needle aspiration. Sensitivity, specificity and accuracy were calculated, and complications were analyzed. Results: Diagnostic sensitivity and positive prediction value of malignant diseases was 83.3% and 100%, and diagnostic specificity and negative prediction value of the benign diseases was 100% and 66.7%, respectively. The accuracy was 84.7%. Pneumothorax and bleeding occurred in 6.9% (5/72) and 8.3% (6/72) of the cases, respectively. Emphysema around the lesion was a significant complication after the aspiration. However, the position, size and depth of the pulmonary nodules have no correlation with the occurrence of complications. Conclusion: CT-guided percutaneous fine needle aspiration in small pulmonary nodules near the great vessels has a high diagnostic accuracy and a low complication incidence.