CT引导下经皮肺部肿块穿刺活检

CT -guided percutaneous aspiration biopsy of pulmonary mass

目的回顾性分析131例CT引导下肺部肿块穿刺活检诊断的准确性及敏感性，探讨其临床应用价值。方法回顾性总结分析131例CT引导下肺部肿块穿刺活检及其病理诊断结果，每个病例均同时采用病理组织学检查和病理细胞学检查。诊断结果由手术病理诊断及临床随访证实。同时随访评估气胸及出血等并发症情况。结果90％的病例获得了足够的免疫组织化学检查样本，100％病例均获得了足够的病理细胞学检查样本。组织学检查的阳性率及诊断符合率分别为87．7％和97．5％，病理细胞学检查的阳性率及诊断符合率分别为91．6％和91．7％，两种方法结合所有病例的总体阳性率及诊断符合率分别为94．6％和96．7％。131例中发生气胸5例，出血10例。结论CT引导下经皮肺部肿块穿刺活检是一种安全、有效的检查方法，两种方法的结合可以获得更为准确的诊断结果。

Objective To retrospectively analyze the sensitivity and accuracy of computed tomography （CT） -guided aspiration biopsy of pulmonary mass. Methods One hundred and thirty -one consecutive CT - guided biopsies performed between July 2009 and December 2010 were analyzed. Both cytomorphology and histopathology were performed in each case. The diagnostic accuracy was assessed by a positive histological result from the operative specimen or based on treatment response and clinical follow - up. Each case was reviewed for complications, including pneumothorax and haemorrhagia. Results Sufficient histopathologic samples were obtained in 90% cases, and sufficient cytomorphologic samples were obtained in 100% cases. The sensitivity and overall accuracy for histopathology were 87.7% and 97.5%, respectively. The sensitivity and overall accuracy for cytomorphology were 91.6% and 91.7%, respectively. The sensitivity and overall accuracy in all cases were 94.6% and 96.7%. There were only 5 pneumothorax and 10 haemorrhages. Conclusions CT - guided percutaneous aspiration biopsy is a safe and effective technique for the diagnosis of pulmonary mass, and the combination of cytomor- phology and histopathology has higher sensitivity and accuracy than that when only one examination was performed.