肺内周围性孤立性结节的CT引导下经皮肺穿刺活检的临床价值

The Clinical Value of Transthoracle Needle Biopsy of Peripheral Pulmonary Solitary Nodules Under CT-Gulded

目的:探讨CT引导下经皮肺穿刺活检术对肺内周围性孤立性结节的临床价值。方法:收集2004年3月至2005年3月期间50例肺内周围性孤立性结节行CT引导下经皮肺穿刺活检并经手术病理、临床治疗或随访观察证实的资料。采用美国Cook公司的抽吸式活检针和套管式自动活检枪,选择最佳穿刺层面及穿刺点获取标本。结果:50例肺内周围性孤立性结节病灶中经手术病理、临床治疗或随访观察证实为肺癌38例(腺癌23例、鳞癌12例、小细胞癌3例)、结核球8例,炎性假瘤4例。而CT引导下经皮肺穿刺活检诊断为肺癌36例(腺癌21例、鳞癌12例、小细胞癌3例)、结板球8例,炎性假瘤6例。并发症有气胸5例(10.0%)、咯血3例(6.0%)、痰中带血2例(4.0%)。结论:CT引导下经皮肺穿刺活检为肺内周围性孤立性结节的明确诊断提供一种安全有效的检查方法,具有较高的临床应用价值。

Objective To explore the clinical value of transthoracic needle biopsy of peripheral pulmonary solitary nodules under CT-guided. Methods 50 paitents （between March 2004 and march 2005 ）with peripheral pulmonary solitary nodules were collected,which were performed by pereutaneous transthoracic needle biopsy under CT-guided and were confimed by surgery pathology ,clinical therapy or follow-up survey Aspirating needles and detachable biopsy gun had been used to choose the best lamella and point of puncture to get samples. Results The 50 cases were proved to be 38 cases of pulmonary carcinoma （23 cases of adenocareinoma, 12 cases of squamous carcinoma,3 cases of small carcinoma）8 cases of tuberculoma,4 cases of inflammatory pseudotumor. And by pereutaneous transthoracic needle biopsy under CT-guided they were diagnosed to be 36 cases of pulmonary carcinoma（21 cases of adenocarcinoma, 12 cases of squamous carcinoma, 3 cases of small cell carcinoma） , 8 cases of tubereuloma, 6 cases of inflammatory pseudotumor. The complications were 5 cases （ 10. 0% ） of pneumothorax, 3 cases （6. 0% ） of hemoptysis, 2 cases （4. 0% ） of sputum containing blood. Conclusion Pereutaneous transthoracic needle biopsy under CT-guided provided a safe and efficient diagnostic method for peripheral pulmonary solitary nodules with few complications.