CT导引下活检与介入性治疗(附646例)

CT-Guided Transcutaneous Fine-Needle Aspiration Biopsy and Interventional Therapy

本文报告646例经皮细针穿刺活检和介入性治疗。穿刺活检459例,介入性治疗187例。穿刺活检部位:腹部175例,其中肝脏81例,胰腺56例,腹腔包块7例,肾脏22例,肾上腺5例,脾脏3例,前列腺1例;胸212例;骨骼肌肉系统52例;颅脑20例。介入性治疗:硬化剂治疗156例,其中肾囊肿硬化剂治疗142例,肝囊肿硬化剂治疗14例;抽吸和/或引流25例,其中脑出血血肿抽吸占19例;CT 导引下电针治疗5例;交感神经阴断术1例。各部位穿刺活检正确率是有差异的,肝脏为94%,肾脏95%,胰腺和腹腔包块89%,胸部91%,骨骼肌肉系统90%,颅脑90%。介入性治疗闻效肾囊肿硬化剂治疗为96%,肝囊肿硬化剂治疗为82%,抽吸或引流为87%,并发症发生率胸部为7.5%,腹部为0.06%,颅脑为7.5%。本文详细讨论了穿刺针选择,技术要点。影响正确率的因素等。

This report presented 646 cases of CT transculaneous fine-needle aspirationbiopsy(ENAB)and interventional treatment.Of the 646 patients,ENAB in 459 patientsand interventional treatment in 187 patients were performed.The biopsy site were:ab-domen 175 cases,including liver 81 cases,pancrease 56 cases,abdominal masses 7 cases,kidney 22 cases,adrenal gland 5 cases,spleen 3 cases,and 1 prostate 1 case;thorax 212cases;musculoskeletal system 52 cases;and brain 20 cases.Interventional treatment con-sisted of 156 cases with sclerosing treatment(142 renal cysts,14 hepatic cysts),25 caseswith aspiration and/or drain(including 19 cases brain hemorrhage),5CT-guided electricneedle treatment,and 1 CT-guided sympathectomy with alcohol.The accuracy varied withdifferent locations.The accuracy of the liver biopsy was 94%,kidney 95%,pancreaticand abdominal masses 89%,thorax 91%,musculoskeletal system 90%,and brain 90%.Curative effect of interventional treatment with sclerosing treatment of renal cysts was96%,hepatic cys 82%,aspiration and/or drain 87%.The complication of this groupwere:pneumothorax 7.5%,abdomen 0.06%,and brain 7.5%.The proper selection ofneedles,the method and technique,the influential elements of the accuracy and complica-tions were detailed in this paper.