Connor S, Dyer J, Guest P
Department of Clinical Radiology, Queen Elizabeth Hospital, Edgbaston, Birmingham, West Midlands, UK.
Eur Radiol. 2000;10(3):490-4. doi: 10.1007/s003300050082.
We reviewed the diagnostic accuracy and complication rates of transthoracic needle biopsy (TNB) with an automated 18-gauge core biopsy needle and gun, using either fluoroscopic or CT guidance. One hundred six lesions were biopsied in 103 patients between 1992 and 1998. Hard-copy images, imaging reports, pathology reports and clinical notes were reviewed. In 3 patients it was not possible to establish the lesion as either malignant or benign from the available follow-up, so these were removed from the analysis of diagnostic accuracy. Adequate samples for histological diagnosis were obtained in 104 of 106 (98%) biopsies. There were 75 of 85 (88%) true-positive core biopsies for malignant lesions and a specific cell type was identified in 70 of 85 (82%) cases. A specific histological diagnosis was obtained in 12 of 18 (66%) biopsies. There was a 19% rate of pneumothorax with only 2.4% requiring drainage. Minor haemoptysis occurred in 3.8% of procedures. The TNB technique with an automated core biopsy needle provides a high level of diagnostic accuracy, effectively distinguishes cell type in malignancy and provides a definite diagnosis in benign disease more frequently than fine needle aspiration (FNA). There is no increased complication rate compared with FNA.
我们回顾了使用自动18号活检针和活检枪，在荧光透视或CT引导下经胸针吸活检（TNB）的诊断准确性和并发症发生率。1992年至1998年间，对103例患者的106个病灶进行了活检。回顾了硬拷贝图像、影像学报告、病理报告和临床记录。在3例患者中，根据现有的随访结果无法确定病灶是恶性还是良性，因此在诊断准确性分析中排除了这些病例。106例活检中有104例（98%）获得了足够的组织学诊断样本。85例恶性病灶的核心活检中有75例（88%）为真阳性，85例中有70例（82%）确定了特定的细胞类型。18例活检中有12例（66%）获得了明确的组织学诊断。气胸发生率为19%，仅2.4%需要引流。3.8%的操作出现少量咯血。使用自动活检针的TNB技术具有较高的诊断准确性，能有效区分恶性肿瘤的细胞类型，在良性疾病中比细针穿刺抽吸（FNA）更频繁地提供明确诊断。与FNA相比，并发症发生率没有增加。
