多层螺旋CT导引下经皮肺穿刺活检在肺部占位病变中诊断价值.docVIP

多层螺旋CT导引下经皮肺穿刺活检在肺部占位病变中诊断价值【摘要】 目的 评价多层螺旋CT导引下经皮肺穿刺活检对肺部占位病变的诊断价值及应用的安全性。方法 在多层螺旋CT导引下分别对50例肺部占位病变穿刺活检,对采集的标本行病理学检查,术后行CT扫描明确是否有气胸、出血等并发症,分析取材准确性及并发症出现率。结果 多层CT穿刺活检组50例均穿刺成功,取得满意组织并确诊48例,其中恶性病变38例,良性病变10例。并发症出现率4%。结论 多层螺旋CT引导下穿刺活检成功率和准确率较高,并发症轻,可作为肺部肿块定性诊断的首选方法,值得临床推广。 【关键词】 肺部肿块;经皮肺活检;体层摄影术,X线计算机;诊断 The diagnostic value of multi-slice spiral CT-guided percutaneous needle biopsy of pulmonary occupying lesions CHEN Xiang-meng,WANG Guo-jie,CHEN Xiao-jun,et al.The radiology department of the Fifth Affiliated Hospital,Sun Yat-sen University,Guangdong,Zhuhai510140,China 【Abstract】 Objective To evaluate the diagnostic value and application safety of multi-slice Spiral CT percutaneous needle biopsy of pulmonary occupying lesions.Methods 50 cases patients with benign or m alignant lesion in the lungwere performed 16 slice CT-guided percutaneous needle biopsy respectively.The samples were detected by cytological and pathological measures.CT scan was performed after biopsy to observe aeropleura and hemorrhage and to analyze operating time,accuracy of samples,and complication.Results Among 50 cases,48 cases were final diagnosis.38 were m alignant and 10 were benign lesions.Frequency rate of complication was 4%.Conclusion More information was provided by multi-slice Spiral CT.Multi-slice spiral CT-guided percutaneous needle biopsy had higher successful rate and accurate rate,it should be the leading final diagnosis choice of occupying lesions. 【Key words】 Lung disease;Biopsy;Tomography;X-ray computed;Diagnosis 肺部占位性病变的良、恶性影像判断非常困难,治疗方案的选择主要依据病理结果的不同。不同病理类型、不同分期的肺部疾病治疗方案也不尽相同。因此,肺部占位病变穿刺活检病理取材对指导临床治疗非常有意义。如何准确、及时的确诊肺部占位病变,是临床医生面临的一大难题。通常采用的胸片、CT、MRI 只能提示诊断,不能定性,痰脱落细胞学及纤支镜检查虽然能定性,但受多种因素的影响而确诊率较低。CT 导引下经皮穿刺活检微创、安全、有效。多层螺旋CT 的各向同性能够更好的显示病灶与周围结构的关系,为诊断、穿刺成功提供了更多价值。回顾性分析中山大学附属第五医院16层螺旋CT 导引完成的50例肺部占位病变穿刺活检及其结果,评价CT导引下肺部占位性病变穿刺活检的诊断价值及应用的安全性。 1 资料与方法 1.1 临床资料 本组50例患者均为2007年1月至2009年10月本院发现肺部占位病变患者,其中男36例,女14例,年龄27~78岁,平均年龄56.3岁。临床症状主要有咳嗽、咯血、胸痛等42例,8例无症状,系