CT导向经皮肺部病变穿刺活检的临床效果

Clinical efficacy of CT-guided percutaneous puncture biopsy in diagnosing lung lesions

目的探讨CT导向经皮肺穿刺活检的临床应用和体会。方法 66例经CT导向做肺穿刺活检的患者,肺内肿块为62例,胸膜病变2例,肋骨及胸腺病变各1例,采用切割针和抽吸针。结果经一次穿刺成功诊断59例。穿刺后病理怀疑肺鳞状细胞癌,结果为肺脓肿1例;第一次穿刺假阴性6例,其中有2例再次穿刺成功诊断为肺腺癌和鳞状细胞癌。本组穿刺活检总的成功率为92.4%。结论 CT导向经皮肺穿刺活检是一项安全有效的诊断方法,CT的准确定位和良好的穿刺技术及病理科的配合和熟练的技术操作是提高活检成功率的重要因素。

Objective To evaluate the clinical efficacy of computed tomography（CT）-guided percutaneous puncture biopsy（PCPB） in diagnosing lung lesions.Methods Sixty-six patients with lung lesions which comprised intrapulmonary masses in 62,pleural diseases in 2,costal and thymus lesion in 1 each underwent CT-guided PCPB.All the procedures were performed by using adequate cutting and needle aspiration.Results Among 66 patients,CT-guided PCPB of 59（89.4%） cases was once successful and acquired the definite diagnosis,of other 7（10.6%） cases,one case of squamous cell carcinoma was initially misdiagnosed as lung abscess and six cases were false negative,subsequently,2 of 6 false negative patients underwent second CT guided PCPB and were pathologically diagnosed as lung adenocarcinoma and lung squamous cell carcinoma,respectively.Total diagnostic accuracy of the group CT-guided PCPB for the lung lesions was 92.4%.Conclusion CT-guided PCPB in diagnosing lung lesions is a safe and effective modality,while CT accurate positioning,a good puncture skill,and close cooperation with pathologists are key factors to elevate the successful rate of biopsies.