CT引导下经皮穿刺活检对无胸腔积液胸膜病变的诊断价值

The clinical value of CT-guided percutaneous biopsy in diagnosing pleural lesions without associated pleural effusion

目的探讨CT引导下经皮穿刺活检对不明原因、无胸腔积液的胸膜病变的诊断价值及安全性。方法回顾性分析62例不明原因且无胸腔积液的胸膜病变患者经CT引导下经皮穿刺活检术的诊断结果及并发症。结果本组62例患者,均经CT引导经皮穿刺成功取材1~2条,取材成功率为100%。59例患者获得明确的病理诊断,3例病理无法检出,诊断率95.1%。59例获病理结果的患者中转移癌33例(53.2%),恶性间皮瘤2例(3.2%),胸膜结核瘤18例(29.0%),非特异性炎症6例(9.7%)。发生并发症4例(6.5%),表现为疼痛(2例)皮下血肿和气胸各1例,未出现严重并发症或死亡病例。结论对于不明原因且无胸腔积液的胸膜病变,CT引导下经皮穿刺活检诊断率高、并发症少,是一种微创、简便、安全、有效的检查手段。

Objective To assess the diagnostic value and safety of CT-guided percutaneous biopsy for unexplained pleural lesions without associated pleural effusion.Methods The clinical data of 62 patients with unexplained pleural lesions without associated pleural effusion were retrospectively collected.CT- guided percutaneous biopsy was performed in all patients.The pathological results and the complications were analyzed.Results Successful sampling of 1 -2 tissue strips with CT - guided percutaneous biopsy was achieved in all 62 patients,the success rate of sampling was 100%.Definite pathological diagnosis was obtained in 59 patients,and definite pathological diagnosis couldn't be obtained in 3 patients,the diagnostic rate was 95.1%.Of the 59 patients who got definite pathological diagnosis,metastatic carcinoma was seen in 33(53.2%),malignant mesothelioma in 2(3.2%),pleural tuberculoma in 18(29.0%), and nonspecific inflammation in 6(9.7%).Complications occurred in 4 patients(6.5%),two of them suffered from pain at the puncture site.No serious complications or deaths occurred.Conclusion For the unexplained pleural lesions without associated pleural effusion,CT- guided percutaneous biopsy is a minimally- invasive, simple,safe and effective diagnostic means with high diagnostic rate and less complications.