多层螺旋CT图像后处理技术对肺内肿块穿刺术前定位的价值

目的评价多层螺旋CT图像后处理技术(MPR、VR、结构叠加、透明重建)对肺内肿块穿刺术前定位的临床价值。方法收集2012年1月至12月行CT引导下肺穿刺活检术178例患者的完整资料进行回顾性分析。结果 103例行传统的CT引导下肺内肿块穿刺术前定位,89例得到了明确诊断,确诊率为86.4%(89/103),其中,肿块直径<3 cm确诊率为74.2%(23/31),肿块直径3～5 cm确诊率为87.5%(21/24),肿块直径5～10 cm确诊率为93.7%(45/48)。术后19例出现气胸,3例轻微咯血,并发症发生率为21.4%(22/103)。75例行多层螺旋CT图像后处理技术对肺内肿块穿刺术前定位,68例得到了明确诊断,确诊率为90.6%(68/75),其中,肿块直径<3 cm确诊率为87.9%(29/33),肿块直径3～5 cm确诊率为92.0%(23/25),肿块直径5～10 cm确诊率为94.1%(16/17)。术后5例出现少量气胸,1例轻微咯血,并发症发生率为8.0%(6/75)。结论多层螺旋CT图像后处理技术能够更精确的定位肺内肿块,在肺内小肿块和近肺门肿块的显示方面较传统的CT定位技术更具有优越性,提高了肺穿的确诊率并降低了并发症的发生率,值得在临床进一步研究与推广。

The clinical value of positioning before puncture pulmonary mass by image post-processing technique of 64-ranked 128-slice computer tomography

Objective To assess the clinical value of post-treatment rebuilding image technology(MPR,VR) from multi-slice spiral CT in improving positioning accuracy of pulmonary mass puncture.Methods A total of 178 pulmonary mass puncture cases by CT-guided,collected from January to December 2012,were recruited in this study and analyzed retrospectively.Results Among 103 pulmonary mass puncture cases which were directed by traditional CT,86.4%(89/103) cases got confirmed diagnosis,among which 74.2%(23/31),87.5%(21/24)and 93.7%(45/48)were diagnosed in mass diameters less 3cm,3 to 5cm and 5 to 10cm respectively.Only 19 cases had pneumothorax,3 cases had been coughing with slight hemoptysis,and the complication rate was 21.4%(22/103).Whereas,among 75 pulmonary mass puncture cases which were directed by post-processing technique,90.6%(68/75)cases got confirmed diagnosis,among which 87.9%(29/33),92%(23/25) and 94.1%(16/17)were diagnosed in mass diameters less 3cm,3 to 5cm and 5 to 10cm respectively,accompanied by 5 pneumothorax cases and one coughing with slight hemoptysis case,the complication rate being 8%(6/75).Conclusion Multi-slice spiral CT post-processing technique may improve the positioning accuracy of pulmonary mass puncture,and has more advantages than traditional CT,especially in the diagnosis of small pulmonary masses and proximal pulmonary hilar mass,due to its improving the rate of diagnosis and reducing the incidence of complications,which is worth further research and promotion.