CT引导下经皮肺穿刺活检861例回顾性分析

Retrospective analysis of 861 cases of CT-guided percutaneous lung biopsy

目的:探讨CT引导下经皮肺穿刺活检对于肺部疾病诊断的应用价值及操作安全性。方法:回顾性分析2017年1月至2018年7月在淄矿集团有限责任公司中心医院及中国人民解放军总医院行CT引导下经皮穿刺活检的患者861例,分析其穿刺结果及并发症发生情况。结果:861例患者均成功完成穿刺操作,结节性病变296例,团块状病变405例,肺实变病变77例,磨玻璃样病变83例。病理学诊断恶性病变736例,明确诊断率90.7%,提示性诊断率6.3%,非特异性诊断率3%。良性病变125例,明确诊断率49.6%,提示性诊断率21.6%,非特异性诊断率28.8%。并发症出现气胸77例(8.9%),结节样病变发生率最高(15.2%);肺出血103例(11.9%),磨玻璃样病变发生率最高(20.4%);胸膜反应17例(1.9%);穿刺后心腔内出现气体2例(0.2%)。结论:在CT引导下经皮肺穿刺活检术,安全实用,并发症少,有助于尽早明确诊断,对恶性病变的确诊率高于良性病变。

Objective:To investigate the value and safety of CT-guided percutaneous lung biopsy for the diagnosis of pulmonary diseases.Methods:The clinical and imaging data of 861 patients underwent CTguided percutaneous lung biopsy from Central Hospital of Zibo Mining Group and Chinese People's Liberation Army General Hospital from January 2017 to July 2018 were retrospectively analyzed.Results:All the 861 patients were successfully completed the puncture operation.There were 296 cases of nodular lesions,405 cases of mass lesions,77 cases of pulmonary consolidation lesions,83 cases of ground-glass lesions.There were 736 cases of malignant lesions were diagnosed by pathology,with a definite diagnosis rate of 90.7%,a suggestive diagnosis rate of 6.3%,and a non-specific diagnosis rate of 3%.Among 125 cases of benign lesions,the definite diagnosis rate was 49.6%,the suggestive diagnosis rate was 21.6%,and the non-specific diagnosis rate was 28.8%.Complications included pneumothorax in 77 cases(8.9%),with the highest incidence in nodular lesions(15.2%),pulmonary hemorrhage in 103 cases(11.9%),with the highest incidence in ground-glass lesions(20.4%),pleural reactions in 17 cases(1.9%)and two cases of intracardiac gas(0.2%).Conclusions:CT-guided percutaneous lung biopsy is safe and practical with fewer complications.It is helpful to make a definite diagnosis as early as possible.The diagnostic rate of malignant lesions is higher than that of benign lesions.