超声引导经皮肺穿刺在周围型肺部肿块诊断中的应用价值

Clinical application value of ultrasound-guided percutaneous lung biopsy in peripheral pulmonary masses

目的探讨超声引导经皮肺穿刺在肺部肿块诊断中的临床应用价值及其影响因素。方法经超声、X射线、CT或MRI发现的80例88个肺部肿块,其中男性62例(77.5%),女性18例(22.5%);年龄23～81岁,平均年龄58.3岁。在超声引导下行穿刺细胞学和/或组织病理学活检,分析假阴性结果及影像表现。结果所有病例穿刺全部成功。其中12例单一细胞学检查,病理阳性率58.3%(7/12);28例单一组织病理学检查,病理阳性率92.9%(26/28)。另40例同时做细胞学和组织病理学检查阳性率为97.5%(39/40)。结论超声检查及对肺部肿块穿刺活检在肺部肿块的定位及定性诊断中有着重要的临床价值。若同时对肺部肿块作细胞学和组织病理学检查可提高检查阳性率。

Objective To study the clinical value and influential factors of ultrasound-guided lung biopsy in diagnosis of pulmonary masses.Methods A total of 88 pulmonary masses out in 80 cases were enrolled,male 62（77.5 %）,female 18（22.5 %）,aged 23-81 years,mean age 58.3 years,which were found in ultrasound,X-ray,CT or MRI.All of them were performed the needle aspiration under ultrasound for biopsy with cytological and histological examination.The findings were retrospectively analyzed for false-negative results and imaging patterns.Results Successful procedures were performed in all cases.Twelve tumors were found in the group by cytological examination alone with positive rate 58.3 %（7/12）;28 tumors were found by histological examination alone with positive rate 92.9 %（26/28）;and other 40 tumors were found by both cytological and histological examination with positive rate 97.5 %.Conclusion Ultrasound diagnosis has a significant value for localization and qualitative diagnosis of pulmonary lesions.If needle aspiration biopsy is combined with cytological and histological examination,the positive rate in diagnosis of peripheral pulmonary tumors would be obviously improved.