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CT 引导下经胸穿刺活检术在胸内病变中的应用:同轴与单针技术的比较。

CT-guided transthoracic cutting needle biopsy of intrathoracic lesions: comparison between coaxial and single needle technique.

机构信息

Department of Radiology, Chi-Mei Foundation Medical Center, Tainan, Taiwan.

出版信息

Eur J Radiol. 2012 May;81(5):e712-6. doi: 10.1016/j.ejrad.2011.05.032. Epub 2011 Jun 23.

Abstract

PURPOSE

To evaluate the complication rates and diagnostic accuracy of two different CT-guided transthoracic cutting needle biopsy techniques: coaxial method and single needle method.

METHODS

This study involved 198 consecutive subjects with 198 intrathoracic lesions. The first 98 consecutive subjects received a single needle cutting technique and the next 100 consecutive subjects received a coaxial technique. Both groups were compared in relation the diagnostic accuracy and complication rates.

RESULTS

No significant difference was found between the two groups concerning patient characteristics, lesions and procedure variables. There was a borderline statistical difference in the incidence of pneumothorax at within 24-h post biopsy between patients in the single needle group (5%) and the coaxial group (13%) (P=0.053). Little difference was found in the pneumothorax rate at immediately post biopsy between the two groups, which was 28% in the single needle group and 31% in the coaxial group. There was no significant difference in the hemoptysis rate between the two groups, which was 9.2% in the single needle group and 11% in the coaxial group. Both techniques yielded an overall diagnostic accuracy of 98% for malignant lesions with similar sensitivity (single needle: 96.9% vs. coaxial: 96.4%) and specificity (single needle: 100% vs. coaxial: 100%).

CONCLUSION

There is little difference in the pneumothorax rates and bleeding complications between patients who either received a single needle or a coaxial transthoracic cutting biopsy. Both techniques produce an overall diagnostic accuracy of 98% for malignant lesions.

摘要

目的

评估两种不同 CT 引导经胸穿刺切割针活检技术(同轴法和单针法)的并发症发生率和诊断准确性。

方法

本研究纳入了 198 例连续的胸部病变患者。前 98 例连续患者接受了单针切割技术,接下来的 100 例连续患者接受了同轴技术。比较了两组在诊断准确性和并发症发生率方面的差异。

结果

两组患者的特征、病变和程序变量均无显著差异。单针组(5%)和同轴组(13%)在活检后 24 小时内气胸发生率存在边缘统计学差异(P=0.053)。两组活检后即刻气胸发生率差异不大,单针组为 28%,同轴组为 31%。两组咯血发生率无显著差异,单针组为 9.2%,同轴组为 11%。两种技术对恶性病变的总体诊断准确性均为 98%,敏感性相似(单针:96.9%,同轴:96.4%),特异性也相似(单针:100%,同轴:100%)。

结论

接受单针或同轴经胸切割活检的患者在气胸率和出血并发症方面差异不大。两种技术对恶性病变的总体诊断准确性均为 98%。

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