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超声引导下胸部肿瘤的粗针活检

Ultrasound-guided core biopsy of thoracic tumors.

作者信息

Yang P C, Chang D B, Yu C J, Lee Y C, Wu H D, Kuo S H, Luh K T

机构信息

Department of Internal Medicine, National Taiwan University Hospital, Taipei, Republic of China.

出版信息

Am Rev Respir Dis. 1992 Sep;146(3):763-7. doi: 10.1164/ajrccm/146.3.763.

Abstract

Two hundred and eighteen patients, with thoracic tumors larger than 3 cm in size, underwent ultrasound-guided percutaneous transthoracic core biopsy with a large-bore Tru-Cut needle. Fifty-five tumors were in the mediastinum, and 122 tumors were located at subpleural area, and 42 tumors were within the lungs. In 122 subpleural tumors, the sensitivity of ultrasound-guided core biopsy for the diagnosis of malignancy was 96.8%, and accuracy was 97.5%. Sensitivity for the diagnosis of malignant tumors located within the lungs was 94.6%, and accuracy was 95.2%. In 54 patients with mediastinal tumors, definite histologic diagnosis could be obtained in 48 patients (88.9%). The sensitivity of ultrasound-guided biopsy for the diagnosis of malignancy in these 48 mediastinal tumors was 97.1%, with an accuracy of 97.9%. Three patients had complications with minimal pneumothorax and one with mild hemoptysis. We conclude that percutaneous transthoracic core biopsy with Tru-Cut needle under ultrasound guidance is a safe and sensitive way to obtain specimens for accurate histologic diagnosis of thoracic tumors. The diagnostic yield is high, and the technique, relatively simple, can also be used for outpatients.

摘要

218例胸内肿瘤直径大于3 cm的患者接受了超声引导下经胸壁粗针穿刺活检,采用大口径Tru-Cut针。55个肿瘤位于纵隔,122个肿瘤位于胸膜下区域,42个肿瘤位于肺内。在122个胸膜下肿瘤中,超声引导下粗针活检诊断恶性肿瘤的敏感性为96.8%,准确性为97.5%。肺内恶性肿瘤诊断的敏感性为94.6%,准确性为95.2%。在54例纵隔肿瘤患者中,48例(88.9%)可获得明确的组织学诊断。这48例纵隔肿瘤超声引导活检诊断恶性肿瘤的敏感性为97.1%,准确性为97.9%。3例出现轻微气胸并发症,1例出现轻度咯血。我们得出结论,超声引导下使用Tru-Cut针经胸壁粗针穿刺活检是获取标本以准确组织学诊断胸内肿瘤的一种安全且敏感的方法。诊断率高,该技术相对简单,也可用于门诊患者。

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