Loubeyre Pierre, Copercini Michele, Dietrich Pierre-Yves
Department of Radiology and Medical Informatics, Geneva University Hospitals, Rue Micheli-du-Crest, CH 1211 Genève 14, Switzerland.
AJR Am J Roentgenol. 2005 Nov;185(5):1294-8. doi: 10.2214/AJR.04.1344.
The purpose of our study was to evaluate the diagnostic yield and the complication rate of percutaneous CT-guided coaxial 18-gauge (1.25-mm diameter) multisampling (five samples) core needle biopsy (CNB) of suspected thoracic lesions.
The records of 75 consecutive patients (29 women, 46 men; age range, 33-92 years) who underwent percutaneous CT-guided adjustable coaxial 18-gauge multisampling (five samples) CNB of a suspected thoracic lesion (eight mediastinal lesions, two chest wall lesions, two pleural lesions, and 63 intrapulmonary lesions) were reviewed.
Ninety-seven percent (73/75) of CNB specimens were considered adequate for a specific diagnosis by the histopathology staff. Diagnostic yield was 97% (95% confidence interval, 91-99%) (72/74) (number of correct diagnoses obtained at CNB / number of definitive diagnoses). There were 61 malignant lesions and 11 benign lesions. There was no false-negative result when CNB was considered adequate for a specific diagnosis by the histopathology staff. Pneumothorax occurred in 19% (12/63 intrapulmonary lesions). One patient required placement of a chest tube. Minor postbiopsy hemoptysis occurred and resolved spontaneously in 11% (7/63) of patients.
Percutaneous CT-guided coaxial multisampling large CNB of suspected thoracic lesions, in a mainly cancer-based population, is an accurate procedure for a specific histologic diagnosis and has a low rate of complications.
我们研究的目的是评估经皮CT引导下同轴18号(直径1.25毫米)多采样(五个样本)粗针穿刺活检(CNB)对疑似胸部病变的诊断率和并发症发生率。
回顾了75例连续患者(29名女性,46名男性;年龄范围33 - 92岁)的记录,这些患者接受了经皮CT引导下对疑似胸部病变(8例纵隔病变、2例胸壁病变、2例胸膜病变和63例肺内病变)进行的可调同轴18号多采样(五个样本)CNB。
组织病理学人员认为97%(73/75)的CNB标本足以做出明确诊断。诊断率为97%(95%置信区间,91 - 99%)(72/74)(CNB获得的正确诊断数/最终诊断数)。有61例恶性病变和11例良性病变。当组织病理学人员认为CNB足以做出明确诊断时,没有假阴性结果。气胸发生在19%(12/63例肺内病变)。1例患者需要放置胸管。11%(7/63)的患者出现轻微活检后咯血且自行缓解。
在以癌症为主的人群中,经皮CT引导下对疑似胸部病变进行同轴多采样大CNB是一种准确的特定组织学诊断方法,并发症发生率低。