CT引导下经皮肺穿刺活检对肺周围性病变的诊断价值

Clinical value of CT guided transthoracic core needle biopsy in diagnosis of pulmonary peripheral lesions

目的 评价CT引导下经皮肺穿刺活检对肺周围性病变的临床诊断价值。方法 搜集 2 2 3例肺周围性病变患者接受CT引导下经皮肺穿刺活检 ,回顾性分析了这些患者的病理结果 ,随访结果 ,肿块大小以及穿刺并发症 ,其它检查情况。结果 穿刺结果恶性病变的阳性预测值为 10 0 %,3例假阴性 ,没有 1例假阳性 ,敏感度为 93 .6%,特异度为 10 0 %;良性病变的阴性预测值为 94.8%;大小结节多次穿刺取材满意率无差异 ;大结节一次穿刺取材满意率优于小结节 (P <0 0 0 5 ) ;常规检查中 ,CT引导下经皮肺穿刺活检对肺部周围性病变病理检查阳性率最高。结论 CT引导下经皮肺穿刺活检对周围型肺部病变的诊断的准确性较高。

Objective To assess the clinical diagnostic value of CT guided transthoracic core needle biopsy (TNB) in patients with pulmonary peripheral lesions. Methods The pathological findings, follow up results, mass size, complications due to paracentesis, and other examination results in 223 patients with pulmonary peripheral lesions undergoing TNB were analyzed retrospectively. Results The positive predictive value of malignant lesions was 100%. False negative was found in 3 cases. There was no false positive of malignant lesions in all the cases. The sensitivity and specificity were 93.6% and 100%, respectively. The negative predictive value of benign lesions was 94.8%. There was no significant difference in the satisfaction rate of multiple biopsy between the large and small nodules. The satisfaction rate of a single biopsy of the large nodule was significantly better than that of the small nodule ( P <0.005). In routine examinations, the positive rate of pulmonary peripheral lesions resulted from CT guided TNB was the highest. Conclusion CT guided TNB, with high accuracy and fewer complications, is very helpful in the diagnosis of pulmonary peripheral lesions.