CT导引下肺内病变经皮穿刺活检--大、小病灶的比较

目的 :探讨CT导引下穿刺活检对肺内小病灶的诊断价值及病灶大小对诊断正确率和并发症发生率的影响。方法 :回顾复习有手术病理、临床或影像学随访的肺内病变CT导引下活检 2 74例 ,其中小病灶 (Φ≤ 2cm) 5 2例 ,大病灶 (Φ >2cm) 2 2 2例。依据手术病理或临床随访结果判断活检病理诊断结果是否正确。比较大、小病灶在诊断正确率和并发症发生率方面的差异。结果 :CT导引下穿刺活检对肺内小病灶诊断正确率73 .1 % (3 8/5 2 )显著低于对大病灶的诊断正确率 89.2 % (1 98/2 2 2 ) (P <0 .0 1 )。小病灶气胸发生率 (1 5 .4% )略高于大病灶 (1 2 .6% ) ,两者间无统计学差异 (P >0 .0 5 )。结论 :CT导引下经皮经胸穿刺活检对肺内小病灶是一种安全、准确的诊断和鉴别诊断方法。

CT-guided percutaneous transthoracic aspiration biopsy:comparison of small and large pulmonary lesions

Objective:To evaluate the role of CT guided transcutaneous needle aspiration biopsy for diagnosis of small pulmonary lesions and compare the diagnostic accuracy and safety of CT guided transcutaneous needle aspiration biopsy of small lesions and large lesions.Methods:CT guided percutaneous transthoracic biopsy was performed in 274 patients that had surgical resection or clinical follow up, of which 52 lesions were less than or equal to 2 cm in diameter(small lesions),222 lesions were greater than 2 cm in diameter(large lesions).Diagnostic accuracy was calculated by comparing pathologic diagnoses based on biopsy with final diagnoses based on histologic findings from surgery or clinical follow up. The diagnostic accuracy, complication rate of small and large lesions were compared.Results:The diagnostic accuracy of CT guided percutaneous needle aspiration biopsy of small lesions(73.1%)was significantly lower than that of big ones(89.2%),( P <0.01). The prevalences of pneumothorax for small and large lesions were 15.4% and 12.6% ,respectively( P >0.05).Conclusion:CT guided percutaneous needle aspiration biopsy is an accurate and safe means of diagnosis and differential diagnosis for small pulmonary lesions.CT guided biopsy has less accurate for small pulmonary lesions than for large lesions.The pneumothorax rates for both are similarly low.