超声引导下经皮穿刺活检在肺周围型小病变中的应用

Ultrasound-guided percutaneous cutting biopsy for small peripheral pulmonary lesions

目的评价超声引导下穿刺切割活检在直径<2cm的肺周围型病变中的诊断正确性和安全性。方法35例患者肺周围型病变患者(直径<2cm),选用18G或16G穿刺活检针行超声引导下切割活检,标本送组织病理检查,结果与手术病理及临床随访的最后诊断进行比较。结果35例患者,组织取材满意率为94%(33/35);明确诊断为86%(30/35);其中恶性病变91%(20/22),良性病变77%(10/13);穿刺后并发症共5例,气胸2例,咯血3例。结论超声引导下对肺周围型病变切割活检是一种安全、有效,且诊断正确性高的方法,即使在较小病变(直径<2cm)中,也能取得较好效果。

Objective To evaluate the safety and accuracy of ultrasound-guided percutaneous cutting biopsy in patients with peripheral pulmonary lesions which were smaller than 2cm in diameter. Methods Thirty-five patients with peripheral pulmonary lesions smaller than 2cm in diameter underwent ulltrasound-guided pereutaneous cutting biopsy with 16-gauge or 18-guage needle. All of these cutting specimens were sent for histopathologieal examination, and the results were compared with the final diagnosis which was based on histopathologic analysis of surgical specimens or clinical follow-up. Results The histological adequate specimen was obtained in 94% （33/35） cases, and the eonfirmative diagnosis was obtained in 30 lesions （86%）. Twenty lesions （91%, 20/22） were malignant, and 10 lesions （77%, 10/13） were benign. The complications post biopsy were pneumothorax in two patients and hemoptysis in three patients. Conclusion Ultrasound-guided percutaneous cutting biopsy is a safe and effective method in the diagnosis of peripheral pulmonary lesions, even when the lesion is less than 2em in diameter.