移动CT在肺小结节术前及术中定位中的价值

Value of Mobile CT in Preoperative and Intraoperative Localization of Small Pulmonary Nodules

目的探讨移动CT(mobile CT,MCT)在肺小结节术前及术中定位中的价值。方法 2017年9月～2018年1月我们对50例62个肺小结节术前在MCT引导下用Hook-wire定位针进行肺小结节定位,根据定位行肺小结节切除术,所有肺小结节均送术中冰冻病理检查,若Hook-wire脱落或移位术中再次利用MCT扫描定位。结果 62个肺小结节术前定位成功59个,2个脱钩,1个移位,成功率95. 2%(59/62),脱落、移位率4. 8%(3/62),术中再次利用MCT扫描定位,最终62个肺结节病灶均成功切除。术中冰冻病理结果显示肿物距离切缘2 cm。定位时间(15. 2±5. 1) min。定位后少量气胸11例,肺出血1例,肋间血管出血1例,均未特殊处理。结论 MCT在肺小结节术前及术中定位准确、快速,值得推荐。

Objective To study the value of mobile CT(MCT) in preoperative and intraoperative localization of small pulmonary nodules.Methods An analysis was made on 50 patients with 62 small pulmonary nodules between September 2017 and January 2018.Before the operation,the Hook-wire was used to locate the pulmonary nodules under the guidance of mobile CT.Then the small pulmonary nodules were resected according to the localization.All the pulmonary nodules were tested through intraoperative frozen pathological examination.In the cases of Hook-wire shedding or displacement,MCT scan was used again during the operation.Results Among the 62 small pulmonary nodules,59 nodules were successfully preoperatively localized,2 nodules were unhooked,and 1 nodule was shifted.The success rate was 95.2%(59/62) and the failure rate was 4.8%(3/62).The nodules were relocated intraoperatively again by using MCT until all the nodules were successfully resected.Intraoperative frozen pathology results showed that all tumors were 2 cm from the cutting edge.The localization time was (15.2±5.1) min.Complications during localization included 11 cases of pneumothorax,1 case of pneumorrhagia and 1 case of intercostal vessels hemorrhage.Conclusion MCT has the advantage of accurate,fast preoperative and intraoperative localization of small pulmonary nodules,being recommended in operation.