CT导向胸内疑难病灶的经皮活检20例

CT-GUIDED PERCUTANEOUS BIOPSY OF DIFFICULT THORAC1C LESIONS

报告CT导向胸内邻近大血管或直经小于3cm的病灶的经皮针吸活检术20例。这些疑难病灶的径皮活检术操作困难，危险性大，并发症多。本组正确诊断丰85％，其中恶性肿瘤为80％，良性病变为90％。术后小量气胸2例（1％），小量出血1例（5％）。CT扫描能精确确认病灶和穿刺针的位置，并能清楚显示心脏和大血管的轮廓，因此疑难病灶的经皮活检应该在CT导向下操作。

Percutaneous biopsy of thoracic le-sions which are small or even nonvisualized on X-ray, or less accessible is per formed difficultly with more complications. Computed tomography was used to guide transthoracic fine-needle biopsy in 20cases of these difficult lesions. A diagnosis was made in 17 of 20 cases (85%), including 8 of 10proved malignant lesions (80% ) and 9 of 10 proved benign lesions (90% ). Complications were observed in 3 patients (15%), 2 with mild pneumothorax (10% ) and one with mild heloplysis (5 % ). Comput-ed tomography is more superior to conventional flu-oroscopy both in the localization of thoracic lesions and biopsy needles, and in the delineation of vascu-lar and cardiac structures. We suggest to perform percutaneous needle biopsy of these difficult lesions with the guidance of CT scanning. Use of CT guid-ance considerably expands the scope of thoracic le-sions amenable to percutaneous biopsy.