Peng Min, Xu Wen-bing, Shi Ju-hong, Cai Bai-qiang, Tian Xin-lun, Liu Tao, Zhang Hong, Xiao Yi, Liu Wei, Feng Rui-e, Liu Hong-rui, Zhu Yuan-jue
Department of Respiratory Diseases, Chinese Academy of Medical Sciences, Beijing, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2012 Mar;35(3):171-5.
This study was to evaluate the efficacy and limitation of CT-guided percutaneous cutting needle lung biopsy in the diagnosis of diffuse parenchymal lung diseases (DPLD).
A total of 481 patients admitted in Peking Union Medical College Hospital from January 2000 to December 2008 underwent CT-guided percutaneous cutting needle lung biopsy. The patients were evaluated by clinical history, physical examination and lung HRCT. Those with localized opacity or lesions in a single lung in the CT scan were excluded. Finally, 248 patients with DPLD in HRCT were enrolled for this study.
The study patients included 114 males and 134 females, and the mean (± SD) age at diagnosis was 50 ± 16 (range from 13 - 78) years. Confirmed diagnosis by percutaneous needle lung biopsy was obtained in 130 patients (52.4%), including pulmonary infection (35.4%, 46/130), pulmonary malignant diseases (25.4%, 33/130), bronchiolitis obliterans organizing pneumonia/organizing pneumonia (22.3%, 29/130), pulmonary vasculitis (6.2%, 8/130), granulomatous lesions (4.6%, 6/130), pulmonary sarcoidosis (2.3%, 3/130), acute interstitial pneumonia (1.5%, 2/130), pulmonary amyloidosis (1.5%, 2/130), and pulmonary alveolar proteinosis (0.8%, 1/130). Open lung biopsy/video-assisted thoracoscopic surgery was performed in 37 out of 118 cases for which the diagnosis was undetermined by percutaneous lung biopsy. Confirmed diagnosis was obtained in 36 patients, including non-specific interstitial pneumonia (NSIP, 33.3%, 12/36), usual interstitial pneumonia (UIP, 8.3%, 3/36), pulmonary infection (16.7%, 6/36), neoplasm (8.3%, 3/36), lymphoid interstitial pneumonia, pulmonary vasculitis (5.6% 2/36), hypersensitivity pneumonitis (5.6%, 2/36), and pulmonary sarcoidosis, allergic bronchopulmonary aspergillosis, pulmonary hyalinizing granuloma, pneumoconiosis, Castleman's disease, and lymphoproliferative disorder (1 case respectively).
CT-guided percutaneous cutting needle lung biopsy can provide confirmed diagnosis in half of patients with DPLD, and has a high diagnostic yield in patients with infectious or neoplastic diseases, but it is not a good method for diagnosis of interstitial lung diseases such as NSIP and UIP.
本研究旨在评估CT引导下经皮切割针肺活检在弥漫性肺实质疾病（DPLD）诊断中的有效性及局限性。
2000年1月至2008年12月在北京协和医院住院的481例患者接受了CT引导下经皮切割针肺活检。通过临床病史、体格检查及肺部高分辨率CT（HRCT）对患者进行评估。排除CT扫描显示肺部有局限性实变或单发病灶的患者。最终，248例HRCT显示为DPLD的患者纳入本研究。
研究患者包括男性114例，女性134例，确诊时的平均（±标准差）年龄为50±16（13 - 78岁）岁。130例患者（52.4%）经皮肺穿刺活检确诊，包括肺部感染（35.4%，46/130）、肺部恶性疾病（25.4%，33/130）、闭塞性细支气管炎伴机化性肺炎/机化性肺炎（22.3%，29/130）、肺血管炎（6.2%，8/130）、肉芽肿性病变（4.6%，6/130）、肺结节病（2.3%，3/130）、急性间质性肺炎（1.5%，2/130）、肺淀粉样变性（1.5%，2/130）及肺泡蛋白沉积症（0.8%，1/130）。118例经皮肺活检未能明确诊断的患者中，37例行开胸肺活检/电视辅助胸腔镜手术。36例患者确诊，包括非特异性间质性肺炎（NSIP，33.
