CT引导下经胸骨老年人纵隔内肿块细针穿刺活检

目的探讨老年人纵隔内肿块CT引导下细针穿刺活检术。方法CT引导下细针穿刺活检，所有穿刺中均应用同轴活检技术。先用18G、100mm长千叶针（导向针）用于穿透皮肤及胸骨，再用20—22G、150mm半自动切割针或20—22G、150mm千叶针通过导向针管进到病灶内，进行切割或抽吸，取得标本涂片、固定，并快速行细胞学检查。结果45例纵隔内肿块老年患者，21例病变位于中纵隔，24例位于前纵隔隐于胸骨后，病灶周围均包裹含气肺组织。所有穿刺均经胸骨径路，避开含气肺组织、纵隔内大血管，无一例出现气胸及大出血。活检诊断正确率为86．7％（39／45）。结论CT引导下应用同轴技术经胸骨纵隔内肿块穿刺，对老年人纵隔内肿块病理诊断提供了较安全的方法。

CT-guided fine-needle biopsy of mediastinal tumour in old patients

Objective To discuss the technique of CT-guided fine-needle biopsy of mediastinal tumour in old patients. Methods 45 old patients under going CT-guided fine-needle biopsy of mediastinal mass were analyzed. The coxial biopsy technique and fast cytological examination were used . Firstly, penetrating the skin and the sternum using 18G and 100mm long chibe needle (targeting needle). Secondly, using a 20-22G semi-automatic dissection needle or chiba needle to make a dissection or aspiration of the tumour through the tube of 18G targeting needle, and making a fast cytological examation of the samples. Results 21 masses were in the mediul mediastinum; 24 masses were in the anterior mediastinum.All tumours were enclosed by pneumo-tissue and trans-sternum approach were adopted. During and after the biopsy , there was no pneumothorax and hemorrhea. The accuracy of the biopsy was 86.7%(39/45). Conclusions CT-guided trans-sternum fine-needle biopsy with the coaxial technique is a safe method for old patients with mediastinial masses.