胸部肿块的CT导向穿刺活检

CT-guided Core Biopsy of the Thoracic Masses

目的:探讨CT引导下经皮胸部肿块穿刺活检技术及临床应用价值。方法:总结2006年1月到8月CT引导下穿刺切割活检的38例病例,其中32例肺内肿块、6例纵膈内肿块,均作组织病理和细胞涂片检查。结果:本组38例中靶区命中率和切割取材成功率均为100%,病理确诊率97.36%(37/38),细胞涂片阳性率78.94%(30/38),组织病理学阳性率92.11%(35/38),并发症为气胸7.89%(3/38),肺出血13.16%(5/38),少量咯血7.89%(3/38)。结论:经皮胸部肿块穿刺切割活检安全有效,有重要临床意义;综合细胞学及组织病理学,可提高准确性。

Objective The purpose of the study was to evaluate the technique and clinical application of CT guided percutaneous transthoracic tissue core biopsy of the thorax. Methods 38 cases of core needle thoracic biopsy under CT guiding dated from Janunary to August 2006 were .studied, including 32 pulmonary masses, 6 mediastinal masses. All cases examined by smear and histologic diagnosis. Results The successful rate of puncture and the successful rate of incising tissue were 100% （38/38） , the defined pathological diagnostic rate was 97.36% （37/38）, positive predictive values for smear and histologic pathology were 78.94% （ 30/38 ） and 92.11% （ 35/38 ）. Complications included pneumothorax 7.89% （ 3/38 ）, minor hemoptysis 7.89% （3/38）,pulmonary hemorrhage 13.16% （5/38）. Conclusion Our results suggest that CT guided percutaneous core biopsy has high diagnostic accuracy and an acceptable rate of complications, it was of great clinical application; combined use of smear and histologic diagnosis could increase the accuracy.