超声引导下经皮肺穿刺活检在鉴别诊断肺部周围型肿块中的应用价值研究

Study on application value of ultrasound-guided percutaneous lung biopsy in the differential diagnosis of peripheral pulmonary masses

目的比较超声与CT引导下经皮肺穿刺活检在鉴别诊断肺部周围型肿块中的应用价值。方法回顾分析2020年1月~2022年1月收治的155例肺部周围型肿块患者的临床病历资料,按照经皮肺穿刺活检方法的不同分为超声引导组(83例)与CT引导组(72例)。比较两组患者一次性定位成功率、一次性活检成功率、检查操作时间及并发症发生情况;以穿刺活检取样获得的病理组织学诊断结果为标准,比较两组患者的诊断准确率及恶性肿瘤诊断准确率。结果超声引导组一次性定位成功率、一次性活检成功率分别为93.98%、87.95%,均明显高于CT引导组70.83%、66.67%,超声引导组患者检查操作时间为17~33(21.84±3.05)min,明显短于CT引导组患者检查操作时间18~34(25.66±3.14)min,超声引导组诊断准确率为91.57%,明显高于CT引导组75.00%,超声引导组恶性肿瘤明断准确率为80.72%,明显高于CT引导组的59.72%,超声引导组并发症发生率为7.23%,明显低于CT引导组的18.06%,差异有统计学意义(P<0.05)。结论超声引导下经皮肺穿刺活检对肺部周围型肿块的诊断效能优于CT引导,具有更高检出率,且具有穿刺并发症少的优点,是一种操作简单、穿刺成功率高、创伤小、安全性高的微创介入检查手段,可作为肺部周围型肿块首选的临床诊断方法。

Objective To compare the application value of ultrasound and CT guided percutaneous lung biopsy in the differential diagnosis of peripheral pulmonary masses.Methods The clinical data of 155 patients with peripheral pulmonary mass admitted from January 2020 to January 2022 were retrospectively analyzed,and divided them into ultrasound-guided group(83 cases)and CT-guided group(72 cases)according to different methods of percutaneous lung biopsy.The one-time positioning success rate,the one-time biopsy success rate and the inspection operation time and the occurrence of complications were compared between the two groups.Based on the histopathological diagnosis results obtained by puncture biopsy,the definite diagnosis rate and the definite diagnosis rate of malignant tumor were compared between the two groups.The histopathological diagnosis results obtained by the needle biopsy sampling were used as the standard,and the diagnostic accuracy and diagnostic accuracy of malignant tumor of the two detection methods are compared.Results The success rate of one-time positioning and one-time biopsy in the ultrasound-guided group were 93.98%and 87.95%,respectively,significantly higher than 70.83%and 66.67%in the CT-guided group.The examination operation time of patients in the ultrasound-guided group was 17-33(21.84±3.05)min.The operation time was significantly shorter than that in CT-guided group(18-34)(25.66±3.14)min,The diagnostic accuracy of ultrasound guided group was 91.57%,significantly higher than that of CT guided group 75.00%;the accuracy of malignant tumor diagnosis in ultrasound guided group was 80.72%,significantly higher than that of CT guided group 59.72%;the incidence of complications in ultrasound guided group was 7.23%.It was significantly lower than 18.06%in CT-guided group,and the difference was statistically significant(P<0.05).Conclusion Ultrasound-guided percutaneous lung biopsy is superior to CT in diagnosing peripheral pulmonary masses.It has a higher detection rate,and has the advantages of less puncture complications.It is a minimally invasive interventional method with simple operation,high puncture success rate,low trauma,and high safety,and can be used as the preferred clinical diagnosis of peripheral pulmonary masses.