CT导向经皮肺活检196例临床分析

CT guided percutaneous lung biopsy:clinical analysis of 196 cases

目的探讨CT导向经皮肺活检的技术方法、安全性及对肺部疾病的诊断价值。方法回顾性分析了196例CT导向经皮肺活检的病例,探讨CT导向经皮肺活检的技术方法及对肺部病变的诊断价值,分析穿刺准确性和穿刺后并发症的影响因素。结果本组CT导向经皮肺活检均能准确刺入病灶内,病灶刺中率100%。病理诊断为恶性肿瘤103例(103/196,52.5%);11例病理未见恶性肿瘤细胞,后经临床其他方法证实为恶性肿瘤(11/196,5.6%);良性病变73例(73/196,37.2%);9例穿刺病理见异形细胞,经临床随访排除肺内恶性病变(9/196,4.5%)。穿刺后气胸发生率为18.87%(37/196),肺内出血3.6%(7/196),其中2例穿刺后出现咯血1%(2/196)。结论 CT导向经皮肺活检术对肺周围型病灶具有较高的诊断价值,其准确性与病灶大小有关。病灶大小、深度均影响气胸和出血的发生。CT导向经皮肺活检对肺周围型病灶是一种是一种安全有效的定性诊断方法。

Objective To explore the CT guided percutaneous lung biopsy technique, safety and diagnostic value in pulmonary diseases. Methods A retrospective analysis of 196 cases of CT guided percutaneous lung biopsy cases was made The biopsy technique,the value for lung diseases diagnosis, the accuracy of puncture,and the complications were explored. Results This CT guided percutaneous lung biopsy could accurately pierce into the lesion（100%）. Pathological diagnosis of malignant tumor was of 103 cases （103 / 196, 52.5%）; The results ofll cases were false negative（l 1/196, 5.6%）.Benign lesions were in 73 cases （73/196, 37.2%）.The results of cases were false positive （9/196, 4.5%）.After the puncture pneumothorax occurred at a rate of 18.87% （37/196）, pulmonary hemorrhage in 3.6% （7/196）,and hemoptysis in 1% （2/196）. Conclusion CT guided pereutaneous lung biopsy for peripheral pulmonary lesions has a high diagnostic value. CT guided percutaneous lung biopsy is a safe and effective method for qualitative diagnosis.