Knox A M, Fon G T, Orell S
Department of Radiology, Flinders Medical Centre, Bedford Park, South Australia.
Australas Radiol. 1991 May;35(2):152-6. doi: 10.1111/j.1440-1673.1991.tb02854.x.
Over a 42 month period 133 patients underwent 148 CT guided biopsies of 104 pulmonary lesions (78%), 21 mediastinal/hilar masses (16%) and 8 pleural lesions (6%). There were 48 cases (32%) complicated by a pneumothorax, of which 13 (9%) required a chest drain. Two cases each of minor haemopneumothorax (1.4%) and haematoma (1.4%) were found, and haemoptysis occurred in a single patient (0.7%). This low complication rate reflects the use of the 22 gauge Chiba needle, the small number of passes undertaken at each sitting and the wide range of lesion size. In four cases no diagnosis was established either at the time of biopsy or subsequently. There were 100 cases proven to be malignant, of which 81 were diagnosed at the first biopsy. Three further cases were regarded as suspicious of malignancy. Of the 29 patients with benign disease, a specific diagnosis was made in 10 (34%) and nonspecific inflammation was seen in 17 (59%) further patients. Fine needle aspiration under CT control is a useful and accurate diagnostic technique. It has widened the scope of lesions which can be biopsied, enabling small, deep or necrotic parenchymal lesions to be targeted accurately. A precise placement of the needle tip into pleural or mediastinal lesions is a further advantage. However, if an inadequate sample is obtained, the biopsy may need to be repeated.
在42个月的时间里，133例患者接受了148次CT引导下的活检，其中104处肺部病变（78%）、21处纵隔/肺门肿块（16%）和8处胸膜病变（6%）。有48例（32%）并发气胸，其中13例（9%）需要胸腔引流。发现2例少量血气胸（1.4%）和2例血肿（1.4%），1例患者出现咯血（0.7%）。这种低并发症发生率反映了22号千叶针的使用、每次穿刺次数少以及病变大小范围广。4例在活检时或之后均未明确诊断。有100例被证实为恶性，其中81例在首次活检时被诊断。另有3例被视为可疑恶性。在29例良性疾病患者中，10例（34%）做出了明确诊断，17例（59%）患者可见非特异性炎症。CT引导下细针穿刺抽吸是一种有用且准确的诊断技术。它扩大了可进行活检的病变范围，能够精确靶向小的、深部的或坏死的实质病变。将针尖精确置入胸膜或纵隔病变是另一项优势。然而，如果获取的样本不足，可能需要重复活检。
