全自动活检枪在CT引导下肺亚厘米结节穿刺活检中的应用

Application of automatic biopsy gun in performing CT- guided puncture biopsy of pulmonary subcentimeter nodules

目的总结对于肺亚厘米结节(≤1 cm)在CT引导下应用全自动活检枪进行穿刺活检的应用体会。方法 78例肺亚厘米结节患者,在CT引导下应用全自动活检枪采用多点多次取材进行经皮穿刺活检并送病检,统计穿刺成功率、并发症及病理结果。结果全自动活检枪组穿刺活检成功率为91.0%(71/78);气胸发生率17.9%(14/78),出血发生率30.8%(24/78);所有病例随访均未发生感染、肿瘤针道种植、转移等并发症。活检成功的71例患者中检出鳞癌7例,腺癌25例,小细胞癌5例,转移癌3例,肺间质慢性炎13例,肉芽肿性炎12例,真菌4例,尘肺结节1例,肺错构瘤1例。结论使用全自动活检枪对肺亚厘米结节行穿刺活检是一种安全、可靠,成功率高的诊断方法。

Objective To investigate the application of automatic biopsy gun in CT- guided percutaneous biopsy for the diagnosis of pulmonary sub- centimeter nodules（≤1 cm）. Methods A total of 78 patients with pulmonary sub- centimeter nodules were enrolled in this study. Under CT guidance, percutaneous multi- point and multi- sampling puncture biopsy with automatic biopsy gun was carried out in all patients. The success rate of puncturing, the complications and pathological results were analyzed. Results The success rate of puncturing was 91.0%（71/78）. The incidence of pneumothorax was 17.9%（14/78） and the incidence of hemorrhage was 30.8%（24/78）. In all patients, no pulmonary infection, tumor tract seeding or metastasis was observed during the follow- up period. Among the 71 patients who had a successful biopsy, squamous cell carcinoma was detected in 7, adenocarcinoma in 25, small cell carcinoma in 5, metastatic lesion in 3,chronic interstitial lung inflammation in 13, granulomatous inflammation in 12, pulmonary fungus in 4,pneumoconiosis nodule in one and pulmonary hamartoma in one. Conclusion For CT- guided percutaneous puncture biopsy of pulmonary sub- centimeter nodules, the use of automatic biopsy gun is safe and reliable with higher success rate.