电视胸腔镜手术前SPECT/CT引导Sens-cure针穿刺定位肺小结节

目的观察电视胸腔镜手术(VATS)前SPECT/CT引导Sens-cure针穿刺定位肺小结节(直径≤10 mm)的价值。方法对19例肺小结节患者行SPECT/CT引导下经皮穿刺定位,共定位21个肺小结节;之后行VATS,根据定位器位置寻找靶病灶,并予以局部楔形切除。观察定位成功率、穿刺定位时间、肺结节大小、胸膜下距离、并发症及病理类型等。结果经皮穿刺定位肺小结节成功率100%,平均定位时间(15.0±3.1)min;病灶最大径(7.1±1.8)mm,胸膜下距离(17.8±5.8)mm;而后均成功完成VATS,完整切除靶病灶,无脱靶。术后病理诊断其中16个(16/21,76.19%)为病变恶性。穿刺后并发症包括少量出血2例、少量气胸3例。结论VATS术前SPECT/CT引导Sens-cure针穿刺定位肺小结节安全有效,可提高VATS成功率。

SPECT/CT guided Sens-cure localization of pulmonary small nodules before video-assisted thoracoscope surgery

Objective To explore the clinical value of SPECT/CT guided Sens-cure needle localization in diagnosis and treatment of pulmonary small nodules(diameter≤10 mm)before video-assisted thoracoscope surgery(VATS).Methods A total of 21 pulmonary small nodules were located by SPECT/CT guided percutaneous localization in 19 patients with pulmonary small nodules before VATS.VATS was then performed,the target lesions were found,and local lung wedge resection was performed according to the location of the locators.The success rate of localization,size of nodules,the subpleural distance,puncture localization time,complications,and pathological types were observed.Results The success rate of percutaneous puncture localization of pulmonary small nodules was 100%,with the average time of(15.0±3.1)min.The maximum diameter of pulmonary small nodules was(7.1±1.8)mm,and subpleural distance was(17.8±5.8)mm.VATS was successfully performed in all 19 patients,and all 21 target lesions were completely resected,no miss occurred.The puncture complications included minor hemorrhage in 2 cases and pneumothorax in 3 cases.Among 21 nodules,16 were pathologically proved malignant after resection(16/21,76.19%).Conclusion Preoperative SPECT/CT guided Sens-cure needle puncture localization of pulmonary small nodules was safe and effective,which could improve the success rate of VATS.