IG4电磁导航系统辅助CT引导下肺结节穿刺活检术的临床应用

Clinical application of IG4 electromagnetic navigation system-assisted CT-guided percutaneous needle biopsy of pulmonary nodules

目的 评价IG4电磁导航系统在CT引导下经皮穿刺肺活检术中的应用价值。 方法 选择40例患者20例行IG4电磁导航系统辅助CT引导下肺穿刺活检,20例行常规CT引导下肺穿刺活检,记录2组定位时间、调针次数、扫描次数、辐射剂量、瞄准精度以及并发症情况。 结果 IG4电磁导航系统辅助组中20例患者在穿刺过程中成功应用该系统,其肺活检平均定位时间为（10.05±1.75） min （7.5~14.0 min）；穿刺针平均调整次数（1.10±0.31）次（1～5次）；平均扫描次数为（3.30±0.73）次（3～6次）；剂量长度乘积（DLP）均值为（724.25±186.23） mGy·cm （415.50~1 080.50 mGy·cm）； 20次穿刺定位中,15次瞄准精度＜5 mm,4次为5~10 mm,1次为13 mm,穿刺针瞄准精度均值为（4.72±3.33） mm（1～13 mm）。常规穿刺组肺活检平均定位时间（15.10±2.40） min （11～19 min）；穿刺针平均调整次数（4.05±1.32）次（3～7次）；平均扫描次数为（6.05±1.32）次（5～9次）,剂量长度乘积（DLP）均值为（1419.10±387.59） mGy·cm （900.50～1 958.90 mGy·cm）。40例患者均无严重并发症发生。两组患者平均定位时间、平均穿刺针调整次数、平均扫描次数、剂量长度乘积均值对比差异均有统计学意义。 结论 电磁导航系统辅助下CT引导肺穿刺活检术可缩短定位时间,减少调针次数、扫描次数,同时可减少患者接受的辐射剂量,是一种值得推广的影像引导新方法。

Objective To discuss the clinical application of IG4 electromagnetic navigation system in assisting CT-guided percutaneous needie biopsy of puimonary nodules. Methods A total of 40 patients were included in this study. IG4 electromagnetic navigation system-assisted CT-guided percutaneous needle biopsy was performed in 20 patients （study group）, and conventional CT-guided percutaneous needle biopsy was carried out in other 20 patients （ control group）. The time used for localization, the numbers of adjusting the puncture needle, the scanning times, the radiation dose （dose-length product, DLP） , the aiming accuracy and the occurrence of complications in both groups were recorded. Results The IG4 electromagnetic navigation system successfully played its guiding role in performing percutaneous needle biopsy for all 20 patients of the study group; the mean time used for localization was （10.05± 1.75） rain （range 7.5-14 min）; the mean numbers of adjusting the puncture needle were （1.10±0.31） times （range 1-5 times） ; the mean times of scanning were （3.30±0.73） times （range 3-6 times） ; the mean DLP value was （724.25±186.23） mGy.cm （range 415.50-1 080.50 mGy.cm） ; among the 20 times of puncturing localization, aiming accuracy of 〈5 mm was achieved in 15, aiming accuracy of 5- 10 mm in 4 and aiming accuracy of 13 mm in one, with the mean aiming accuracy value being （4.72±3.33） mm （range 1-13 mm）. In the control group, the mean time used for localization was （15.10±2.40） rain （range 11-19 rain） ; the mean numbers of adjusling the puncture needle were （4.05±1.32） limes （ range 3-7 times） ; the mean times of scanning were （6.05±1.32） times （ range 5-9 limes） ; the mean DLP value was （1419.10±387.59） mGy.cm （ range 900.50-1 958.90 mGy·cm）. No severe complications occurred in all 40 patients. Statistically significant differences in the mean time used for localization, in file mean numbers of adjusting the puncture needle, in the mean times of scanning and in the tnean DLP value existed between the two groups. Conclusion For the performance of CT-guided percutaneous needle biopsy of pulmonary nodules, IG4 eleelromagnetic navigation system can shorten the localization lime. reduce the times of adjusting the puncture needle as well as the times of scanning, meanwhile, the radiation dose received by pallents can be decreased. Therefore, it is worth popularizing this technique in clinical practice.