Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, Japan.
Eur J Radiol. 2011 Aug;79(2):e85-9. doi: 10.1016/j.ejrad.2011.03.088. Epub 2011 Apr 23.
The diagnostic performance of percutaneous core needle lung biopsy under multi-CT fluoroscopic guidance for ground-glass opacity (GGO) pulmonary lesions was evaluated.
Out of 90 patients who underwent CT fluoroscopy-guided core needle biopsy of GGO lesions at our institution, the biopsy results and the final diagnoses were retrospectively compared in 67 patients with available data (one lesion per patient). Diagnostic performance was also compared according to the lesion size (≤ 10 mm (n=8) versus 11-20mm (n=42) versus >20mm (n=17)), the percentage of GGO component (50-90% (n=31) versus >90% (n=36)), and the length of needle path (≤ 7 cm (n=45) versus > 7 cm (n=22)). Finally, all 90 cases were reviewed for complications.
The overall sensitivity, specificity, and accuracy were 97%, 100%, and 97%, respectively. The diagnostic sensitivity and accuracy tended to be lower in smaller lesions (≤ 10 mm; 86 and 88%, 11-20mm; 97 and 98%, >20mm; 100 and 100%, respectively, p>0.05), and in lesions with lower percentage of GGO component (50-90%; 93 and 94%, >90%; 100 and 100%, respectively, p=0.21), but statistical significances were not reached. The sensitivity and accuracy were not significantly affected by the length of needle path (≤ 7 cm; 98 and 98%, > 7 cm; 95 and 96%, respectively, p=1.00). Fourteen patients (16%) developed pneumothoraces, and 13 patients (14%) experienced mild hemoptysis, all of which resolved conservatively.
The diagnostic performance was satisfactory, and it was considered that the procedure was appropriate for GGO lesions regardless of lesion size, the percentage of GGO component, or the length of needle path. The procedure was also feasible without any major complications.
评估多 CT 透视引导下经皮肺活检对磨玻璃密度（GGO）肺部病变的诊断性能。
在我院接受 CT 透视引导下 GGO 病变经皮肺活检的 90 例患者中，回顾性比较了 67 例有可用数据的患者（每位患者一个病灶）的活检结果和最终诊断。还根据病变大小（≤10mm（n=8）与 11-20mm（n=42）与>20mm（n=17））、GGO 成分百分比（50-90%（n=31）与>90%（n=36））和针道长度（≤7cm（n=45）与>7cm（n=22））比较了诊断性能。最后，对 90 例患者均进行了并发症回顾。
总的灵敏度、特异性和准确性分别为 97%、100%和 97%。在较小的病变（≤10mm；86%和 88%，11-20mm；97%和 98%，>20mm；100%和 100%，p>0.05）和 GGO 成分百分比较低的病变（50-90%；93%和 94%，>90%；100%和 100%，p=0.21）中，诊断灵敏度和准确性较低，但无统计学意义。针道长度（≤7cm；98%和 98%，>7cm；95%和 96%，p=1.00）对灵敏度和准确性没有显著影响。14 例（16%）患者发生气胸，13 例（14%）患者出现轻度咯血，均经保守治疗缓解。
诊断性能令人满意，考虑到病变大小、GGO 成分百分比或针道长度，该程序适用于 GGO 病变。该程序可行，无重大并发症。
