CT定位经皮肺穿刺活检术对周围型肺占位病变诊断的临床应用

Clinical application of CT locating percutaneous needle biopsy in the diagnosis of peripheral pulmonary space occuping lesions

目的探讨CT定位经皮肺穿刺活检术用于肺周围型占位病变诊断的意义。方法采用美国Cook公司的PREMED716、18、19、20G软组织活检针或不带针芯的细针,长度分别为8、10、12、16cm,外径分别为0.7、0.8、0.9mm,多数选用0.8mm,在PICKERIQXTRACT机导向下穿刺65例肺周围型占位病变。结果65例经皮肺穿刺活检,经病理检查证实62例,其中原发性恶性肿瘤56例,结核3例,炎性假瘤2例,转移性癌1例,3例未能得到明确诊断,组织学诊断率为95.4%,术后4例并发少量气胸,2例出现血丝痰,均未作特殊处理。结论CT定位经皮肺穿刺活检是比较安全、准确率很高的诊断手段,且在经济上也是可行的技术,可在有条件的单位广泛应用。

Objective To explore the significance of CT locating percutaneous needle biopsy in the diagnosis of peripheral pulmonary space occuping lesions.Methods Sixty- five patients with peripheral pulmonary space occuping lesions underwent CT locating percutaneous needle biopsy.This procedure was performed by using PREMED 16,18,19 and 20 G soft tissue biopsy needle with length of 0.8,1.0,1.2 and 1.6 cm and with outside diameter of 0.7,0.8 and 0.9 mm(mostly using 0.8 mm)made in American Cook company under PICKER IQXTRACT guiding. Results Among all patients, the pathology demonstrated 62 cases, of them, primary malignant tumor in 56, tuberculosis in 3, inflammatory pseudotumor in 2, metastatic carcinom in a case, while other 3 cases were pathogically non- definite diagnosed. The accuracyof histological examinations was 95. 4% . 4 patients complicated with slight pneumothorax,2 patients presented bloody sputum but they did not underwent the specific treatment. Conclusion CT locating percutaneous needle biopsy is a safe and effective means for diagnosing peripheral pulmonary space occuping lesions and economically is feasible so that it is a promising method in many kinds of hospital. [