CT数字化导航活检技术在肺部小病灶诊断中的价值

The value of CT digital navigated puncture technique in the diagnosis of small lung lesions

目的:评估CT三维数字化导航活检技术在肺部小病灶(≤30 mm)诊断的准确率及并发症的发生率。方法:2015年1月—2019年11月纳入255例肺部小病灶(≤30 mm)患者进行穿刺活检。并选用168例CT横断面定位活检作为对照组。评估数字化导航活检技术的准确性,以及气胸、出血等并发症的发生率。结果:与对照组比,数字化导航活检技术显著提高了肺部小病灶诊断的准确率(96.5%(246/255)vs.80.4%(135/168),P=0.003)和一次性穿刺成功率(71.8%(183/255)vs.60.7%(102/168),P=0.020),并缩短了穿刺活检的时间((12.24±2.83)min vs.(24.22±7.21)min,P<0.001)。数字化导航活检技术比CT横断面活检术显著降低了气胸发生率(15.3%vs.23.8%,P=0.028)和出血发生率(14.1%vs.25.0%,P=0.005)。数字化导航活检组,气胸和出血的发生率增加与病灶大小(cm)、胸膜至靶病变距离和穿刺时间有相关性。结论:CT三维导航穿刺技术显著改善了肺部小病灶的活检的准确率和安全性,是一种准确、安全的活检新方法。

Objective:To investigate the accuracy and incidence of complication of CT three-dimensional digital navigated puncture technique in the diagnosis of small lung lesions(≤30 mm).Methods:A total of 255 patients with small pulmonary lesions(≤30 mm),who were admitted to author’s hospital during the period from January 2015 to November 2019 to receive percutaneous puncture biopsy were investigated.One hundred and sixty-eight patients guided by CT cross-sectional image was chose as control group.To assess the accuracy of digital navigated puncture technique,and the incidence of pneumothorax,hemorrhage and so no complication.Results:When compared to control group,digital navigated puncture technique significantly improved the accuracy of diagnosis(96.5%(246/255)vs.80.4%(135/168),P=0.003)and the success rate of one puncture(71.8%(183/255)vs.60.7%(102/168),P=0.020),and shorten the time of biopsy((12.24±2.83)min vs.(24.22±7.21)min,P<0.001).Meanwhile,digital navigated puncture technique significantly decreased the incidences of pneumothorax(15.3%vs.23.8%,P=0.028)and hemorrhage(14.1%vs.25.0%,P=0.005).For the digital navigation biopsy group,the incidence of pneumothorax and hemorrhage had a statistically significant correlation with the size of focus(cm),the distance from pleura to target lesion and the time of puncture.Conclusion:CT three-dimensional digital navigated puncture technique can improve the the diagnostic accuracy and safety,it is an accurate,safe new method of biopsy.