弹簧活检枪在胸部肿块活检中的应用

CT-Guided Automated Needle Biopsy of Thoracic Lesions

目的 :探讨应用弹簧活检枪行胸部肿块CT引导下穿刺活检的临床价值。材料和方法 :使用 15～ 18G弹簧活检枪在CT引导下对 42例胸部肿块 (肺 3 4例、纵隔 8例 )行穿刺活检术 ,标本行组织学、细胞学检查 ,活检结果与手术及随访结果对照。结果 :活检枪活检总准确性为 90 .5 %。肺部肿块中恶性肿瘤 3 0例、良性病变 4例 ,肺癌假阴性 3例 ,无假阳性 ;纵隔肿块中恶性 8例 ,1例淋巴瘤穿刺物难以定性。并发症发生率 2 1.4% ,其中气胸 6例、针道区少量出血 3例 ,除 1例气胸行闭式引流外均无需处理。结论 :使用弹簧活检枪行CT引导下胸部肿块穿刺活检准确、安全 ,临床价值高。

Purpose: To evaluate the clinical value of CT guided automated needle biopsy of thoracic lesions. Materials and Methods: 34 cases with pulmonary nodules and 8 cases with mediastinal lesions underwent CT guided biopsy with 15 gauge、16 gauge or 18 gauge automated needles. The specimens of all cases received histologic examination and cytologic examination. The results of biopsy were compared with surgery and follow up. Results: The accuracy rate of automated needle biopsy for diagnosis of this group was 90.5%. There were 30 cases with malignant pulmonary tumors and 4 cases with benign pulmonary lesions, the biopsy included false negative in 3 cases but no false positive case. There were 8 cases with malignant mediastinal tumors. One case of lymphoma had insufficient biopsy specimen for diagnosis. Complications included pneumothorax in 6 cases (14.3%) and local bleeding of the lung in 3(7.1%), management was not needed except one who received chest tube placement. Conclusion: CT guided automated needle biopsy of thoracic lesions is accurate and safe procedure for clinical assessment and it is considered valuable for the diagnosis of the chest lesions.