CT引导下经皮肺活检的临床应用

目的:评价CT引导下经皮肺活检诊断肺周围性病变的价值。方法:回顾性分析北京安贞医院87例患者的临床资料。所有患者均采取CT引导下经皮肺活检检查,其中13例实施手术,进一步做病理组织检查。结果:CT引导下经皮肺穿刺活检诊断肺周围性病变的确诊率高达97.7%。在确诊的85例中肺癌41例,结核18例,非特异性炎症9例,坏死性炎症7例,淋巴瘤2例,非精原细胞性生殖细胞肿瘤1例,前列腺癌肺转移1例,血管内皮瘤1例,间皮瘤1例,结节病1例,肺吸虫病1例,皮肌炎1例,特发性肺纤维化1例。实施手术的13例患者术后病理确诊均为阳性,其中包括经皮肺活检未确诊的1例,其术后病理检查为腺癌。CT引导下经皮肺穿刺活检的患者中有16例出现并发症。结论:CT引导下经皮肺活检操作简便、准确率高、安全性好及并发症少,能为肺周围性病变的诊断和鉴别诊断提供可靠依据。

The application of CT-guided percutaneous lung biopsy in diagnosis of peripheral lung diseases

Objective：To evaluate the value of CT-guided percutaneous lung biopsy in the diagnosis of lung peripheral diseases.Methods：The clinical data of 87 patients with lung peripheral diseases in Beijing Anzhen Hospital were retrospectively reviewed,CT-guided percutaneous lung biopsy was applied in all patients.Besides,thoracic operation was carried out in 13 cases,and further histological assay were carried out.Results：The overall diagnostic accuracy was 97.7％.The diagnosis was clarified in 85 patients,including 41 cases of lung cancer,18 cases of tuberculosis,9 cases of nonspecific inflammation,7 cases of necroinflammatory,2 cases of lymphoma,1 case of non-seminoma germ cell tumors,1 case of lung metastasis of prostate cancer,1 case of hemangioendothelioma,1 case of mesothelioma,1 case of sarcoidosis,1 case of paragonimiasis,1 case of dermatomyositis,and 1 case of idiopathic pulmonary fibrosis,respectively.1 case with negative needle biopsy was considered false-negative,which was diagnosed as an adenocarcinoma with surgical resection.For the other 12 patients,the same histologic characteristics were found with surgical confirmation and needle biopsy.Condusion：occurred in 16 cases of all patients after the application of lung biopsy.Conclusion：CT-guided percutaneous lung biopsy has the advantage of easy operation,high accuracy and security with fewer complications in diagnosis and differential diagnosis of peripheral lung disease.