超声引导穿刺组织学与细胞学检查在胸部病变的应用

The Evaluation of Ultrasonographically Guided Biopsy in Thoracic Disease

对９２例胸部病变患者者超声引导穿刺活检，病变来自胸膜８例、胸壁７例、纵隔７例、肺周边部５９例及中心部８例。取材成功率达９７％（８９／９２），其中≤３ｃｍ的病灶也达９７％（２８／２９）。在穿刺过程中，手感和取材部位的确认是取材成功的关键因素。对比细胞学和组织学检查，前者成功率和诊断准确率分别达９７％（８６／８９）和９２％（８２／８９），后者为８８％（７８／８９）和８２％（７３／８９）。结合应用两种方法，将有利于提高准确率。本文的并发症发生率为５．４％（５／９２），３例咳嗽伴少量血痰，２例轻度气胸，均未治疗而自愈。

Ultrasonographically guided biopsy was performed in 92 patients with thoracic disease which originated from the pleura(n=8),thoracic wall(n=7),mediastinum(n=7),and periphery(n=95)or central part(n=8)of the lung.Sufficiet diagnostic materials were taken in taken in 97%(89/92)of the cases,including 97%(28/29)of the subjects whose size of the lesion was<3cm.Both successful rate of puncture and diagnostic accuracy for cytologic analysis(97%,86/89 and 92%,82/89)were higher than those for pathologic diagnosis(88%,78/89 and 82%,73/89).No serious complications occurred in our group. Our results show that the key factors to obtain adequately diagnostic samples are operators,hand sense and avoidance from taking specimens in certral necrosis or inflammatory process next to the tumor,and the total diagnostic accuracy would be increased by combining the cytologic and pathologic examinations.