微弹簧圈用于肺内单纯磨玻璃影术前定位

Clinical study on preoperative computed tomography-guided microcoil localization for pulmonary pure ground-glass opacity

目的 探讨血管内栓塞微弹簧圈用于肺磨玻璃影术前定位的可行性和安全性.方法 2012年12月至2013年9月,北京大学人民医院胸外科30例患者的32处肺内单纯磨玻璃影病灶经术前定位后行胸腔镜手术切除.所有患者均在CT引导、局麻下用21G穿刺针行经皮肺穿刺放置微弹簧圈.定位当日或次日接受胸腔镜手术切除.结果 全组32处磨玻璃影病灶平均直径0.94 cm,距离脏层胸膜平均深度0.71 cm,均成功经皮肺穿刺置入微弹簧圈,定位成功率100％.定位并发症包括无症状气胸7例,疼痛1例,肺内血肿2例,微弹簧圈脱落1例,均无需处理.术前定位后,肺内磨玻璃影的切除成功率为100％.术后病理原位癌17例,腺癌9例,非典型增生4例,炎症2例.结论 血管内栓塞微弹簧圈用于肺磨玻璃影术前定位是一种安全、有效的方法,可提高手术切除的准确率.

Objective The aim of this study is to evaluate the efficacy and safety of preoperative Computed Tomography （CT）-guided microcoil localization for pulmonary ground-glass opacity.Methods We performed CT-guided Microcoil localization in 30 patients with 32 pure ground glass opacities between December 2012 and September 2013.All 30 patients underwent CT-guided micmcoil localization under local anesthesia with a 21G needle percutaneous lung biopsy.All patients accepted video-assisted thoracic surgery after the localization the same day or the next day.Results We located 32 pure ground glass opacitiesin 30 patients.The mean lesion diameter was 0.94 cm,the average depth from the visceral pleura was 0.71 cm,all leisons were successfully located by microcoil,asymptomatic pneumothorax was observed in seven patients,pulmonary hematoma was observed in two patients,pain was observed in one patient,dislodgement was found in one patient during the operation.None of these cases needed surgical treatment.Pathologic diagnoses of the target leisions were as follows：adenocarcinoma in situ （n =17）,adenocarcinoma（n =9）,atypical hyperplasia（n =4）,inflammation （n =2）.After the placement of preoperative CT-guided microcoil localization for pulmonary ground-glass opacity,all the 32 pulmonary pure ground-glass opacities resection success rate was 100％.Conclusion Preoperative CT-guided microcoil localization for pulmonary pure ground-glass opacity is a safe and effective way to improve the accuracy of surgical resection.