CT导向下纵隔肿瘤穿刺活检术-放射学实践.PDFVIP

2003 11 18 11 Radiol Practice, Nov 2003, Vol 18, No. 11 82 CT ## 庄一平, 张晋, 康铮, 冯勇, 沈文荣 = :评价CT 导向下纵隔肿瘤穿刺活检的临床应用价植: 顾性分析74 例纵隔病变CT 导向下纵 隔穿刺活检术穿刺针采用 18G CHIBA 针18G 切割针, 74 例均做病理组织学检查,8 例作免疫组化: ¹ 病变部位 前纵隔62 例, 中纵隔8例, 后纵隔4 例; º 63 例病理诊断明确: 胸腺瘤 16 例, 恶性淋巴瘤 12 例, 转移性腺癌7 例鳞癌 4 例小细胞癌2 例, 畸胎瘤恶性精原细胞瘤各5 例内胚窦癌2 例, 神经纤维瘤恶性神经鞘膜瘤节细胞神经纤维瘤各1 例,3 例诊断为小圆细胞恶性肿瘤,3 例为异型细胞, 1例诊断为结核; » 11例病理诊断不确定: 临床诊断为恶性淋巴瘤 4 例纵隔淋巴结结核 1例, 经手术病理诊断为胸腺瘤纵隔脂肪瘤血管肉瘤纤维肉瘤各1例, 2 例失访; ¼穿刺活检正确 率为85. 1%,假阴性率为 14.9%, 未见假阳性病例; ½气胸发生率为5. 4%, 为少量气胸,3 例术后痰带血丝, 1例纵隔局限 性血肿:CT 导向下纵隔肿瘤穿刺活检术是纵隔病变安全而有效的诊断方法 = 肿瘤, 纵隔; CT 导向;体层摄影术, X 线计算机 = R734. 5; R814. 42 = A = 1000-0313( 2003) 11-0825-03 Mediastinal lesion:transthoracic needle biopsy with CT guidance ZHUANG i-ping, ZHANG Jin,KANG Zheng, et al.Cancer Institute Hospital of Jiangsu, Nanjing 210009,P. R.China = Abstract Objective: To evaluate the efficacy of CT-guiding percutaneous transthoracic needle biopsy for mediastinal le- sion. Methods:CT-guided percutaneous biopsy of mediastinal lesions was performed in 74 cases with a 18-gauge Chiba or Trucut needle. Pathological examinations were done in all cases, and immunohistochemical cytologic methods were used in 8 cases. Re- sults: ¹ The location of lesions: in anterior mediastinum(n= 62) , in middle mediastinum( n= 8) ,in posterior mediastinum( n= 4) . º Pathological diagnosis was established in 63 cases,including thymoma (n= 16) , lymphoma (n= 12) , metastases ( n= 13) ,ade- nocacinoma( n= 7 ) ,squamous carcinoma (n= 4) ,small cell carcinoma(n= 2) ,teratoma( n= 5) , germ cell tumor(n= 5) ,endoder- mal sinus tumor ( n= 2) , neurofibroma (n= 1) ,malignant neurilemmoma(n= 1) ,ganglioneuroma ( n= 1) ,small round cell tumor (n= 3) ,anaplastic histocyte ( n= 3) , tuberculosis (n= 1) . » Uncertain diagnosis by