Chang D B, Yang P C, Luh K T, Kuo S H, Yu C J
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Republic of China.
Chest. 1991 Nov;100(5):1328-33. doi: 10.1378/chest.100.5.1328.
We conducted a study of ultrasound (US)-guided pleural biopsy with a Tru-Cut needle and made a comparison with the results of a traditional pleural biopsy with an Abrams needle. A total of 49 patients with unilateral pleural effusion were included in this study. Twenty-four patients underwent a traditional pleural biopsy with an Abrams needle, and 25 patients underwent a US-guided pleural biopsy with a Tru-Cut needle. The age, sex, and underlying diseases in both groups were compatible. The amount of effusion was much less in the Tru-Cut group. In the patients who underwent the US-guided pleural biopsy with a Tru-Cut needle, the diagnostic sensitivity in pleural tuberculosis was 86 percent (6/7) and in pleural neoplasia it was 70 percent (7/10). In the patients who underwent traditional pleural biopsy with an Abrams needle, the diagnostic sensitivity in pleural tuberculosis was 20 percent (2/10) and in pleural neoplasia it was 44 percent (4/9). The result of US-guided pleural biopsy with a Tru-Cut needle was better than that of pleural biopsy with an Abrams needle, especially in pleural tuberculosis. No complication was found in the Tru-Cut group, but breakage and dislodgment of the tip of an Abrams needle occurred in one patient. The higher diagnostic yield in the Tru-Cut group may be attributed to the US guidance that can delineate the focal pleural abnormalities for biopsy. In conclusion, US-guided pleural biopsy by using a Tru-Cut needle was simple, safe, and well tolerated. It was particularly useful for patients with pleural tumor, thickened pleura, small amounts of pleural effusion, or loculated pleural effusion.
我们进行了一项使用Tru-Cut针进行超声（US）引导下胸膜活检的研究，并与使用Abrams针进行传统胸膜活检的结果进行了比较。本研究共纳入49例单侧胸腔积液患者。24例患者接受了使用Abrams针的传统胸膜活检，25例患者接受了使用Tru-Cut针的US引导下胸膜活检。两组患者的年龄、性别和基础疾病相匹配。Tru-Cut组的胸腔积液量少得多。在接受使用Tru-Cut针的US引导下胸膜活检的患者中，胸膜结核的诊断敏感性为86%（6/7），胸膜肿瘤的诊断敏感性为70%（7/10）。在接受使用Abrams针的传统胸膜活检的患者中，胸膜结核的诊断敏感性为20%（2/10），胸膜肿瘤的诊断敏感性为44%（4/9）。使用Tru-Cut针的US引导下胸膜活检的结果优于使用Abrams针的胸膜活检，尤其是在胸膜结核方面。Tru-Cut组未发现并发症，但1例患者发生了Abrams针尖端折断和移位。Tru-Cut组较高的诊断率可能归因于US引导，它可以勾勒出用于活检的局灶性胸膜异常。总之，使用Tru-Cut针进行US引导下胸膜活检简单、安全且耐受性良好。它对胸膜肿瘤、胸膜增厚、少量胸腔积液或局限性胸腔积液的患者特别有用。
