Department of Diagnostic Imaging, Hospital A C Camargo - São Paulo/SP, Brazil.
Clinics (Sao Paulo). 2009;64(12):1139-44. doi: 10.1590/S1807-59322009001200002.
Computed tomography-guided percutaneous fine needle aspiration biopsy of lung lesions is a simple, safe and reproducible procedure. Currently, it is widely used to diagnose lung lesions. However, different factors can influence the success rates of this procedure. The purpose of this study was to determine the influence of radiological and procedural characteristics in predicting the success rates of computed tomography-guided fine needle aspiration biopsy of lung lesions.
A retrospective study was developed and involved 340 patients who were submitted to a consecutive series of 362 computed tomography-guided fine needle aspiration biopsies of lung lesions, between July 1996 and June 2004, using 22-gauge needles (Chiba). Variables such as the radiological characteristics of the lesions, secondary pulmonary radiological findings, and procedural techniques were studied.
For this study, 304 (84%) fine needle aspiration biopsies of lung lesions provided sufficient material for cytological evaluation. The variables that predicted sufficient material for cytological evaluation were lesions larger than 40 mm (p=0.02), lesions on the superior lung lobes (p=0.02), and suspicion of primary lung malignancy (p=0.03). From the multivariate analysis, the only predictive variable for success of the biopsies was localization on the superior lobes (p=0.01).
Computed tomography-guided percutaneous fine needle aspiration biopsy of lung lesions showed greater rates of success in biopsies performed in patients with suspicion of primary lung malignancy, with lesions located in the superior lobes, and that have diameters equal to and larger than 40 mm.
计算机断层扫描引导下经皮肺病变细针穿刺活检是一种简单、安全且可重复的操作。目前，它被广泛用于诊断肺病变。然而，不同的因素会影响该操作的成功率。本研究旨在确定影像学和操作特征对预测计算机断层扫描引导下肺病变细针穿刺活检成功率的影响。
进行了一项回顾性研究，共纳入 340 例患者，这些患者在 1996 年 7 月至 2004 年 6 月期间连续接受了 362 例经计算机断层扫描引导下的肺病变细针穿刺活检，使用 22 号针（Chiba）。研究了病变的影像学特征、肺部的继发性影像学表现和操作技术等变量。
本研究中，304 例（84%）肺病变细针穿刺活检提供了足够的细胞学评估材料。预测有足够细胞学评估材料的变量包括病变大于 40 毫米（p=0.02）、病变位于上肺叶（p=0.02）和怀疑原发性肺癌（p=0.03）。多变量分析显示，唯一能预测活检成功的变量是上叶定位（p=0.01）。
计算机断层扫描引导下经皮肺病变细针穿刺活检在怀疑原发性肺癌、病变位于上叶、直径等于或大于 40 毫米的患者中显示出更高的成功率。
