自制定位器引导模板辅助PET分子成像定向肺活检术

Self-made locator guiding template-assisted PET molecular imaging–directed lung biopsy

目的探讨自制定位器引导模板辅助技术在正电子发射断层扫描(PET)分子成像定向肺部结节穿刺活检中的应用价值,评估其准确性和安全性。方法收集2018年1月至2018年12月因疑诊为肺癌而需要接受PET分子成像定向肺部结节穿刺活检术的病例60例,采用随机数字表法将研究对象分为观察组(n=30,使用定位器引导模板辅助技术)和对照组(n=30,使用常规徒手操作),比较两组间穿刺针到达预定位置的一次性成功率、穿刺操作时间以及咯血和气胸等并发症的发生率等。结果观察组穿刺针一次性成功率明显高于对照组(86.7%比36.7%,χ^2=15.864,P<0.001);穿刺操作时间明显短于对照组[(21.44±5.75)min比(38.20±8.74)min,t=-8.289,P<0.001];患者并发症发生率明显低于对照组(6.7%比26.7%,χ^2=4.320,P=0.038)。结论自制定位器引导模板辅助技术可使CT实时引导下的PET分子成像定向肺活检术更加精确,缩短操作时间,有效降低并发症发生率,可在临床推广。

Objective To evaluate the clinical application of self-made locator guiding templateassisted technique in PET molecular imaging-directed percutaneous cutting needle biopsy(PCNB)for lung nodular lesions,and to discuss its accuracy and safety.Methods A total of 60 patients with suspected lung cancer,who received PET molecular imaging-directed PCNB during the period from January 2018 to December 2018,were enrolled in this study.Using random number table method,the patients were randomly divided into observation group(n=30,using locator guiding template-assisted technique)and control group(n=30,using conventional manual operation).The success rate of puncturing predetermined location with single manipulation,the time spent for puncturing and the occurrence of complications such as hemoptysis and pneumothorax,etc.were compared between the two groups.Results In the observation group,the success rate of single puncturing was 86.7%,which was significantly higher than 36.7%in the control group(χ^2=15.864,P<0.001);the time spent for puncturing was(21.44±5.75)min,which was obviously shorter than(38.20±8.74)min in the control group(t=-8.289,P<0.001);and the occurrence of complications was 6.7%,which was strikingly lower than 26.7%in the control group(χ^2=4.320,P=0.038).Conclusion The self-made locator guiding template-assisted technique can make CT real-time monitored PET molecular imaging-directed PCNB of lung nodular lesions more accurate,shorten the operation time,and effectively reduce the incidence of complications.Therefore,this technique should be popularized in clinical practice.