CT引导下肺门部病变细针穿刺活检的价值

The value of CT-guided needle biopsy for lesions in hilus pulmonis

目的探讨CT引导下肺门部病变穿刺活检的价值。方法 24例因肺门部病变诊疗的患者行CT引导下肺门部病变细针穿刺活检术,分析其穿刺活检的阳性率及临床价值。结果 24例经穿刺活检及临床治疗后随访均证实为恶性病例。其中穿刺明确恶性者21例,有3例穿刺结果未见恶性证据。阳性预测值100.0%(21/21),敏感性87.5%(21/24),假阴性率12.5%(3/24)。穿刺活检的主要并发症有气胸和肺出血,并发症发生率20.8%(5/24)。结论 CT引导下肺门部病变穿刺活检成功率及阳性率高,在熟练掌握穿刺技术的基础上并发症低,对指导临床诊疗有很大帮助。

Objective To explore the value of CT-guided needle biopsy of lesions in hilus pulmonis. Meth-ods CT-guided needle biopsy was carried out among 24 patients with lesions in hilus pulmonis. The sensitivity and clinical value were analyzed in all cases. Results 24 cases were proved to be malignant either by biopsy or follow-up, among which, 21 cases were confirmed by needle biopsy. It was verified that the rate of correct diag-nosis for the malign pathological sensitivity was 87. 5%（21/24）. The positive predictive value was 100. 0%（21/21）. 3 cases（12. 5%） were false-negative, while false-positive was not found. Complications occurred a-mong 5 patients（20. 8%, 5/24）, which mainly were diagnosed as pneumothorax and pulmonary hemorrhage. Conclusions With high successful rate and diagnostic accuracy, CT-guided transthoracic percutaneous biopsy for lesions in hilus pulmonis is a safe and effective technique as long as the operator can master the manipula-tion, which is very helpful in guiding the clinical treatment.