肺部周围型肿块CT引导下经皮穿刺活检病理对照研究

A comparative surgicopathologic study of peripheral pulmonary masses through percutanous puncture biopsy under CT guidance

目的 了解CT引导下经皮穿刺活检对肺部周围型肿块的诊断价值。方法 对 5 5例肺部肿块行CT导向下经皮穿刺活检并与手术病理结果对比。结果 5 5例中 4 4例手术证实为肺癌 ,CT诊断与病理一致 4 0例 ,准确率为 90 .9% (4 0 4 4 ) ;5例结核肉芽肿 ,准确率为 4 5 ;6例炎性假瘤 (包括 2例隐球菌性肉芽肿 ) ,准确率为 2 6 ;5 5例肺周围型肿块CT总正确诊断率为 83.6 % (4 6 5 5 )。结论 根据影像特征表现CT对肺癌的正确诊断较高 ,但对非肿瘤性肿块正确诊断率较低。CT导向经皮肺穿对肺部肿块诊断是十分有价值的方法 ,且安全可靠 ,对正确制定治病方案具有重要的指导作用。

Objective To improve the diagnostic accurary of peripheral pulmonary masses before operation. Methods 55 cases of peripheral lung mass with percutaneous puncture biopsy under CT guidance were compared with the postoperative pathology. Results 44 out of 55 cases confirmed by operation were lung cancer. 40 cases showed consistent CT findings with pathology reaching accurate rate to 90.9% (40/44). 5 cases were tuberculous granuloma with accurate rate of 80% (4/5). 6 cases were inflammatory pseudotumor (with 2 cases of cryptococcal granuloma) showing accurate rate of 33.3% (2/6). Altogether 55 cases of peripheral lung masses were diagnosed correctly by CT with accurate rate of 83.6% (46/55). Conclusions Percutaneous puncture biopsy under CT guidance for peripheral lung lesions is safe and reliable especially for planning the management.