de Farias André Piovesan, Deheinzelin Daniel, Younes Riad N, Chojniak Rubens
Departments of Radiology, Cancer Hospital 'A. C. Camargo', Brazil.
Rev Hosp Clin Fac Med Sao Paulo. 2003 Mar-Apr;58(2):69-74. doi: 10.1590/s0041-87812003000200003. Epub 2003 Jun 25.
To report the experience of a radiology department in the use of computed tomography guided biopsies of mediastinal lesions with fine and cutting needles, describing the differences between them. The results of adequacy of the sample and histologic diagnoses are presented according to the type of needle used.
We present a retrospective study of mediastinal biopsies guided by computed tomography performed from January 1993 to December 1999. Eighty-six patients underwent mediastinal biopsy in this period, 37 with cutting needles, 38 with fine needles, and 11 with both types (total of 97 biopsies).
In most cases, it was possible to obtain an adequate sample (82.5%) and specific diagnosis (67.0%). Cutting-needle biopsy produced a higher percentage of adequate samples (89.6% versus 75.5%, P = 0.068) and of specific diagnosis (81.3% versus 53.1%, P = 0.003) than fine-needle biopsy. There were no complications that required intervention in either group.
Because they are practical, safe, and can provide accurate diagnoses, image-guided biopsies should be considered the procedure of choice in the initial exploration of patients with mediastinal masses. In our experience, cutting needles gave higher quality samples and diagnostic rates. We recommend the use of cutting needles as the preferred procedure.
报告放射科使用细针和切割针在计算机断层扫描引导下对纵隔病变进行活检的经验，描述两者之间的差异。根据所用针的类型，呈现样本充足性和组织学诊断结果。
我们对1993年1月至1999年12月期间计算机断层扫描引导下的纵隔活检进行了一项回顾性研究。在此期间，86例患者接受了纵隔活检，其中37例使用切割针，38例使用细针，11例两种针都使用（共97次活检）。
在大多数情况下，可以获得充足的样本（82.5%）和明确的诊断（67.0%）。与细针活检相比，切割针活检获得充足样本的百分比更高（89.6%对75.5%，P = 0.068），明确诊断的百分比也更高（81.3%对53.1%，P = 0.003）。两组均无需要干预的并发症。
由于图像引导下的活检实用、安全且能提供准确诊断，应被视为纵隔肿块患者初始检查的首选方法。根据我们的经验，切割针能提供质量更高的样本和诊断率。我们建议首选使用切割针。
