超声引导下经皮穿刺活检对鉴别肺部周围型肿块的应用价值

The value of ultrasound guided percutaneous biopsy in the differential diagnosis of peripheral pulmonary masses

目的:评价超声引导下经皮穿刺活检对鉴别肺周围型肿块的应用价值。方法:152例经胸部CT检查示肺部周围型肿块患者行二维超声及彩色多普勒超声检查,明确病灶的大小、形态、位置、血流情况、回声及与毗邻脏器之间的关系。在超声定位和引导下行经皮肺穿刺活检术,取标本行组织病理学检查,并与肺癌切除术后病理结果对照,评价穿刺成功率、组织学诊断正确率和术后并发症发生率。结果:152例中145例成功穿刺并取得理想标本,其中126例一次取材成功,成功率为95.4%(145/152)。确诊142例,其中恶性病变118例,良性病变24例,肺鳞癌伴感染误诊为肺脓肿3例,组织学诊断正确率为97.9%(142/145)。经皮穿刺活检术后出现气胸5例、胸腔积液3例、痰中带血1例、发热3例,并发症发生率为7.9%(12/152)。结论:超声引导下经皮肺穿刺活检是一种安全可靠、创伤小、操作灵活、成功率高的微创介入检查技术,对肺周围型肿块诊断和手术评估有重要价值。

Objective:To evaluate the to application value of ultrasound guided percutaneous puncture biopsy for peripheral lung tumor identification.Methods:152 cases of Lung Peripheral masses were examined by two-dimensional ultrasound and color Doppler ultrasound,and the size,shape,location,blood flow,echo and the relationship between the adjacent organs and the lesions were examined by chest CT examination.Objective to evaluate the success rate of puncture,the accuracy of histological diagnosis and the incidence of postoperative complications after percutaneous lung biopsy under ultrasound guidance.Results:In 152 cases,145 cases were successfully punctured and obtained ideal specimens,126 of them were successful in one time,and the success rate was 95.4%(145/152).142 cases were diagnosed,including 118 cases of malignant lesions,24 cases of benign lesions,3 cases of lung squamous cell carcinoma with infection misdiagnosed as pulmonary abscess,and the accuracy rate of histological diagnosis was 97.9%(142/145).After percutaneous biopsy,there were 5 cases of pneumothorax,3 cases of pleural effusion,1 cases of blood in sputum,3 cases of fever,and the incidence of complications was 7.9%(12/152).Conclusion:Ultrasound guided percutaneous lung biopsy is a safe,reliable,minimally invasive,flexible operation,high success rate of minimally invasive interventional examination technology,which is of great value for the diagnosis and surgical evaluation of pulmonary peripheral masses.