直径3cm以下肺孤立性病灶的CT引导下经皮肺穿刺活检

CT-guided percutaneous transthoracic needle biopsy for solitary pulmonary lesions smaller than 3cm in diameter

目的:评价直径3cm以下肺孤立性病灶的CT引导下经皮肺穿刺活检的价值。方法:68例直径3cm以下肺孤立性病灶在CT引导下,采用抽吸式活检针,选择最佳穿刺层面及穿刺点获取标本。结果:本组病例共行84次穿刺活检,获得细胞学涂片检查者68例,获得组织学检查59例。总的诊断准确度为89.7%,其中细胞学和组织学标本诊断准确度分别为662%(45/68)和81.4%(48/59)。阳性预告值和阴性预告值分别为100%(51/51)和58.8%(10/17)。并发症:气胸16例(23.5%),出血5例(7.4%),咯血4例(5.9%)。结论:CT引导下经皮肺穿刺活检是一种创伤小而实用的定性诊断方法,对直径3cm以下肺孤立性病灶的诊断具有较高的临床应用价值。

Objective:To evaluate the value of CT-guided percutaneous transthoracic needle biopsy of solitary lesions (D<3cm) in lung.Methods:68 patients( between march 1993 and January 2002) with solitary pulmonary lesions which were performed by CT-guided percutaneous transthoracic needle biopsy were reviewed.All of the pulmonary lesions were confirmed by surgery and clinical course.Aspirating needles had been used to make polytopical aspirations from the best-chosen level and site.Results:In the 68 cases,a total of 84 biopsies were done.Cytologic studies were made in all of the cases,and histologic studies in 59 cases.The diagnostic accuracy was 66.2% for cytologic specimens (45/68), 81.4% for histologic specimens (48/59), with a total accuracy of 89.7%.The positive and negative prediction value were 100% (51/51) and 58.8% (10/17),respectively.The incidence of pneumothorax,bleeding and hemoptysis were 19.8%, 8.2% and 6.6%, respectively.Conclusion:CT-guided percutaneous transthoracic needle biopsy of solitary pulmonary lesions is a successful efficient and safty diagnostic method with few complications.It is very helpful in diagnosing solitary pulmonary lesions.