同轴针在锥形束CT引导肺穿刺活检术中的应用价值

Value of coaxial needle in CBCT guided lung puncture biopsy

目的探讨同轴针在锥形束CT(cone-beam computed tomography,CBCT)引导肺穿刺活检术中的价值。方法回顾性分析2015年4月-2016年8月中山大学附属中山医院256例在锥形束CT引导下行肺穿刺活检术的病例。其中2015年4月14日-2015年12月10日使用半自动活检针肺活检病例128例,定义为A组;2015年12月16日-2016年8月2日使用同轴针肺活检病例128例,定义为B组。比较两组恶性病变的诊断灵敏度、特异性、准确率、并发症发生率。结果 A组诊断灵敏度87.3%(96/110),低于B组(96.3%,105/109)(P=0.024);两组诊断特异性均为100%;A组诊断准确率89.1%(114/128),B组96.9%(124/128),差异有统计学意义(P=0.025);A组并发症发生率14.1%(18/128),B组21.9%(28/128),差异无统计学意义(P=0.142)。结论 CBCT引导肺穿刺活检时使用同轴针对提高疾病诊断灵敏度、准确率有帮助。

Objective To investigate the value of coaxial needle in Cone-Beam Computed Tomography （CBCT） guided lung puncture biopsy. Methods A total of 256 patients with pulmonary lesions who had undergone CBCT guided lung puncture biopsy in Zhongshan Hospital Affiliated to Sun Yat-sen University from April 2015 to August 2016 were enrolled in our study. Among them, 128 cases received lung biopsy used semi-automatic biopsy needle from April 14, 2015 to December 10, 2015 （defined as group A）, and 128 cases received coaxial needle lung biopsy from December 16, 2015 to August 2, 2016 （defined as group B）. The sensitivity, specificity, accuracy and complication rate of the two groups for malignant lesions were compared. Results The diagnostic sensitivity of group A was 87.3% （96/110） and 96.3% （105/109） in group B, with statistically significant difference （P=0.024）. The specificity of both group A and group B were 100%, respectively. The diagnostic accuracy of group B was 96.9% （124/128）,significantly higher than that of group A （89.1%, 114/128） （P=0.025）. The incidence of complications was 14.1% （18/128） in group A, and 21.9% （28/128） in group B, without statistically significant difference （P=0.142）. Conclusion CBCT-guided lung coaxial needle biopsy can improve the sensitivity and accuracy of disease diagnosis.