99mTc-3PRGD2 SPECT/CT显像联合3D打印模板引导下经皮肺穿刺对孤立性肺结节诊断意义

目的分析^99mTc-3PRGD₂ SPECT/CT显像联合3D打印模板引导下经皮肺穿刺对孤立肺结节(SPN)的诊断意义。 方法收集2015年1月至2019年12月在内蒙古医科大学附属医院呼吸科就诊79例SPN患者,男51例,女28例。年龄43~81岁,平均年龄(62.39±8.99)岁。分析^99mTc-3PRGD₂ SPECT/CT显像对SPN的诊断价值及联合3D打印模板经皮肺穿刺术后并发症的相关因素。 结果79例患者均顺利完成SPECT/CT显像及穿刺活检操作。SPN直径为8~30 mm,平均直径为(20.18±5.66)mm。42例SPN(直径≤20 mm)患者采用1根定位针,37例SPN(20 mm<直径≤30 mm)患者未采用定位针;同轴套管活检针穿刺1次52例,穿刺2次21例,穿刺3次6例。所有患者应用同轴套管针进行2次活检。病理学诊断有3例患者因取材不满意而无阳性结果,穿刺活检取材成功率96.2%(76/79),^99mTc-3PRGD₂ SPECT/CT显像良性49例,恶性30例。穿刺病理结果良性56例,恶性23例。穿刺并发症：针道出血、气胸或"针道出血+气胸"发生率与性别、结节直径、结节深度、肺气肿及穿刺次数有关,差异均有统计学意义(P<0.05)。 结论^99mTc-3PRGD2 SPECT/CT显像联合3D打印模板引导下经皮肺穿刺对孤立性肺结节诊断将精准功能影像应用到穿刺中,具有良好的临床应用前景。

Clinical research of 99mTc-3PRGD2 SPECT/CT imaging combined with 3D printing template guided percutaneous lung puncture in the diagnosis of solitary pulmonary nodules

ObjectiveTo explore the value of ^99mTc-3PRGD₂ SPECT/CT imaging combined with 3D printing template in the diagnosis of solitary pulmonary nodules. MethodsAll of 79 patients with SPN were enrolled in the respiratory department of the Affiliated Hospital of Inner Mongolia Medical University in the January 2015 to December 2019, they were 51 males and 28 females, the average age of 62.39±8.99 years old. To analyze the value of ^99mTc-3PRGD₂ SPECT/CT imaging in the diagnosis of SPN and the related factors of complications after percutaneous pulmonary puncture with 3D printing template. ResultsAll 79 patients successfully completed SPECT/CT imaging and biopsy. SPN diameter is 8-30 mm, average diameter is(20.18±5.66)mm. 42 patients with SPN (diameter≤20 mm) were punctured with one positioning needle.37 patients with SPN (20 mm99mTc-3PRGD₂ SPECT/CT imaging. 56 patients were benign and 23 patients were by Puncture pathology. Complications of puncture including needle bleeding, pneumothorax or needle bleeding and pneumothorax, The incidence was related to sex, nodule diameter, nodule depth, emphysema and puncture times. The difference was statistically significant (P<0.05). Conclusion^99mTc-3PRGD₂ SPECT/CT imaging combined with 3D printing template guided percutaneous pulmonary puncture in the diagnosis of solitary pulmonary nodules, It apply accurate functional image to puncture. It has good clinical application feasibility and prospect.