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CT引导下经皮切割肺活检对弥漫性肺疾病的诊断价值
引用本文:王辉,季洪健,姚秋菊,陈丽萍,张福琛.CT引导下经皮切割肺活检对弥漫性肺疾病的诊断价值[J].介入放射学杂志,2009,18(9):685-687.
作者姓名:王辉  季洪健  姚秋菊  陈丽萍  张福琛
作者单位:1. 上海解放军第八五医院呼吸科,200052
2. 上海解放军第八五医院放射科,200052
摘    要:目的评价经皮切割肺活检术对弥漫性肺疾病的诊断价值及安全性。方法采用自动弹簧式活检枪(14及16G)对29例弥漫性肺疾病患者在CT引导下行经皮切割肺活检,所获组织送病理组织学及免疫组化检查。并对取材成功率、诊断阳性率以及并发症等进行分析。结果29例患者均获得足够行病理检查的肺组织标本,取材成功率达到100%。有25例获得确诊,诊断阳性率达82.8%。并发症主要为气胸以及肺出血,大多数不严重,且经相应治疗后均在1周内消失。结论对于弥漫性肺疾病,CT引导下经皮切割肺活检术无论在手术操作、取材成功率以及诊断阳性率均优于经支气管肺活检(TBLB)。与开胸肺活检(OLB)和电视引导下胸腔镜肺活检(VATS)相比,并发症少且轻微,患者接受度高。该技术值得推广。

关 键 词:弥漫性肺疾病  经皮肺活检  CT引导  诊断

CT-guided transthoracic cutting needle lung biopsy: its clinical application in diagnosing diffuse lung diseases
WANG Hui,JI Hong-jian,YAO Qiu-ju,CHEN Li-ping,ZHANG Fu-chen.CT-guided transthoracic cutting needle lung biopsy: its clinical application in diagnosing diffuse lung diseases[J].Journal of Interventional Radiology,2009,18(9):685-687.
Authors:WANG Hui  JI Hong-jian  YAO Qiu-ju  CHEN Li-ping  ZHANG Fu-chen
Abstract:Objective To evaluate the clinical application and safety of CT-guided transthoracic cutting needle lung biopsy in diagnosing diffuse lung diseases. Methods By using automatic biopsy gun (14 & 16 gauge), CT-guided transthoracic cutting needle lung biopsy was performed in 29 cases with diffuse lung diseases. The samples obtained were sent for pathological and immunohistochemical examination. The sampling successful rate, the diagnostic accuracy and the occurrence of complications were analyzed. Results Technical success rate was 100%, and large size of sample enough for pathological and immunohistochemical examination was obtained in all 29 cases. Definite pathological diagnosis could be made in 25 cases, with the positive diagnostic rate of 82.8%. The main complications included pneumothorax and pulmonary hemorrhage. The symptoms in most cases were not severe and disappeared within one week after the treatment. Conclusion For the diagnosis of diffuse lung diseases, CT-guided transthoracic cutting needle lung biopsy is a safe, easy, effective and reliable method with high successful rate, high diagnostic value and fewer complications, in these respects this technique is superior to transbronchial lung biopsy, open lung biopsy and video-assisted thoracoscopic lung biopsy. Therefore, this technique should be popularized in clinical practice.
Keywords:diffuse lung diseases  transthoracic lung biopsy  CT-guidance  diagnosis
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