CT引导下经胸膜外腔径路纵隔肿瘤穿刺活检的临床应用

目的评价CT引导下经胸膜外径路纵隔肿瘤穿刺活检的临床价值。材料和方法回顾性分析2009—2011年间本院21例纵隔病变，在cT引导下经胸膜外径路的经皮穿刺活检。所有病例行组织学或细胞学检查，并分析其准确性和并发症。结果21例娲例中，前纵隔穿刺14倒，后纵隔穿刺7例，15例注射了生理盐水在壁层胸膜外脂肪间隙内（胸内筋膜和壁层胸膜之间）；18例得到了病理诊断，包括淋巴瘤5例，转移性肿瘤4例，气管鳞癌1例，胸腺瘤2例，结核3例，结节病1例，神经纤维瘤和神经鞘瘤各1例。3例病检为炎性组织。1例出现前纵隔血肿，所有病例均未发生气胸，并发症发生率4．76％（1／21）。结论CT引导下，经胸膜外径路纵隔肿瘤的穿刺活检是一种安全和简便的定性诊断方法。

The Clinical Application of CT-guided Per- cutaneous Trans-extrapeural Needle Biopsy for Mediastinal Lesions

Objective To evaluate the clinical value of CT-guided percutaneous trans- extrapeural needle biopsy for mediastinal lesions. Materials and methods The biopsy procedure was performed in 21 cases with anterior and posterior mediastinal masses. Cytological and histopathological examinations were done in all cases. The diagnostic accu- racy and complications of the biopsy were analyzed. Results In total 21 cases of needle biopsy, 14 cases of lesions located in the anterior mediatinum and 7 cases of lesions located in the posterior mediatinum. 15 cases were injected saline solution between the endothoracic fascia and the parietal pleura before the biopsy procedure. Pathological diagnosis was obtained in 18 cases, including lymphoma（n=5）, metastaes （n=4）, trachea squamons carci- noma （n= I）, thymoma （n=2）, tuberculosis （n=3）, sarcoidosis （n= I）, neurofibroma （n= 1）, and neurinoma （n=l）. The remaining 3 cases were infectious tisue. One patient presented anterior bematoma after puncture and no pneumothorax presented in all 21 cases the tatol complication incidence was 4.76%（1/21）. Cortdusion CT-guided percutaneous trans- extrapeural needle biopsy tbr mediastinal lesions is a safely and simply technique, it is a suitable method for diagnosis of mediastinal lesions.