CT引导下经皮肺穿刺在肺弥漫性病变中诊断价值

Diagnostic value of CT guided percutaneous lung biopsy in diffuse lung diseases

目的评价CT引导下经皮肺穿刺在肺弥漫性病变中的诊断价值。方法应用16 GBARD活检针穿刺32例肺部弥漫性病变患者,主要影像学改变包括弥漫性网格样结节或结节影,网状线形阴影和弥漫性磨玻璃影。结果 32例患者均取材成功,并获得明确诊断,10例恶性肿瘤,(其中5例肺泡癌,5例肺癌肺内转移),22例良性病变(7例粟粒性肺结核,7例间质性肺炎,2例肺泡蛋白沉积征,2例肺真菌病,1例闭塞性支气管炎伴机化性肺炎,1例肺结节病,1例过敏性肺炎,1例弥漫性泛细支气管炎)。主要并发症是气胸(22.5%)和出血(21.9%)。结论 CT引导下经皮肺穿刺是一种实用、安全、并发症低的技术,对弥漫性肺疾病有很高的确诊率。

Objective To assess the diagnostic value of CT-guided percutaneous lung biopsy in diffuse lung diseases.Methods CT-guided percutaneous lung biopsy was performed in 32 patients with diffuse lung diseases by 16G BARD biopsy needle.The main imaging changes of these patients included network of diffuse nodular or nodular,diffuse reticular lines shadow and diffuse ground-glass density in the lungs.Results Punctures were successful in all 32 patients,and the diseases were clearly diagnosed,which included 10 patients with malignant tumor（5 cases of bronchioloalveolar carcinoma and 5 cases of metastatic carcimoma） and 22 patients with benign tumor（7 cases of disseminated pulmonary tuberculosis,7 cases of interstitial pneumonia,2 cases of pulmonary alveolar proteinosis,2 cases of pulmonary mycoses,1 case of bronchiolitis obliterans with organizing pneumonia,1 case of sarcoidosis of lung,1 case of allergic pneumonia and 1 diffuse panbronchiolitis）.The major complications of puncture were pneumothorax（22.5%） and bleeding（21.9%）.Conclusion CT-guided percutaneous lung biopsy is a useful and safe technique with low complication and high accuracy rate in the diagnosis of patients with diffuse lung diseases.