CT引导经皮针吸活检对肺部病变的诊断价值

目的 探讨CT引导下经皮穿刺针吸活检对肺部病变的诊断价值及影响其准确性的因素。方法 回顾性分析自2002年5月至2003年10月连续性行CT引导下肺部病变经皮穿刺针吸活检的412例病例。所用穿刺针为Chiba 18G抽吸针。所取组织行病理组织学检查，并分析其准确性。结果 412例经手术、随访或临床检查证实为恶性肿瘤334例，其中穿刺病理证实为恶性肿瘤313例，确诊率为93．7％(313／334)。假阴性21例，假阴性率为6．3％(21／334)。无假阳性。诊断良性病变56例，良性病变确诊率为71．8％(56／78)。术后发生气胸19例，占总穿刺次数的4．4％。结论 CT引导下经皮穿刺针吸活检术对肺部病变诊断敏感性与病灶大小有关，它是一种安全有效、准确性高．并发症少的诊断方法。

The diagnostic value of CT-guided percutaneous transthoracic needle biopsy in patients with pneumonic diseases

Objective To explore the diagnostic value of CT-guided percutaneous transthoracic needle biopsy in patients with pneumonic diseases and the factors influencing its accuracy. Methods CT-guided percutaneous transthoracic needle biopsy using an 18-gauge Chiba needle was carried out in 412 consecutive patients with pneumonic diseases dated from May 2002 to October 2003,followed by pathological examinations, the accuracy was analyzed in all cases. Results 334 out of 412 cases were proved to be malign either by surgery or follow up or clinical examinations, among which 313 cases were confirmed by needle biopsy. It was verified that the rate of correct diagnosis for the malign pathological was 93.7% (313/334). 21 cases (6.3%) were false negative, while false positive was not found.56 cases were proved to be benign.It was verified that the rate of correct diagnosis for the benign was 71.8%(56/78).Peumothorax occurred in 19 patients. Conclusion CT-guided percutaneous needle biopsy in pneumonic diseases is a safe and effective diagnostic means,which has a high diagnostic rate and few complications. Its accuracy relates to the size of the target lesion.