Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu, China.
Eur J Radiol. 2013 Jan;82(1):182-6. doi: 10.1016/j.ejrad.2012.09.011. Epub 2012 Oct 15.
CT-guided transthoracic biopsy is a well-established method in the cytologic or histologic diagnosis of pulmonary lesions. The knowledge of its diagnostic performance and complications for cavitary pulmonary lesions is limited. The purpose of this study was to determine the diagnostic accuracy and safety of CT-guided fine needle aspiration biopsy (FNAB) in cavitary pulmonary lesions.
102 consecutive patients with pulmonary cavitary lesions received CT-guided FNAB with use of an 18-gauge (n=35) or 20-gauge (n=67) Chiba for histology diagnosis. The sensitivity, specificity, and diagnostic accuracy of FNAB were calculated as compared with the final diagnosis. Complications associated with FNAB were observed. The diagnostic accuracy and complications were compared between patients with different lesion sizes and different cavity wall thickness.
The overall sensitivity, specificity, and accuracy of FNAB were 96.3%, 98.0%, and 96.1%, respectively. The sensitivity, specificity, and diagnosis accuracy in different lesion size (< 2 cm vs ≥ 2 cm), or different cavity wall thickness (< 5mm vs ≥ 5 mm) were not different (P>0.05; 0.235). More nondiagnostic sample was found in wall thickness <5mm lesions (P=0.017). Associated complications included pneumothorax in 9 (8.8%) patients and alveolar hemorrhage in 14 patients (13.7%) and hemoptysis in 1 patient (1%). No different rate of complications was found with regard to lesion size, wall thickness, length of the needle path and needle size (P>0.05).
CT-guided FNAB can be effectively ad safely used for patients with pulmonary cavitary lesions.
CT 引导下经胸活检是一种成熟的方法，可用于肺病变的细胞学或组织学诊断。对于空洞性肺病变，其诊断性能和并发症的知识有限。本研究的目的是确定 CT 引导下细针抽吸活检（FNAB）在空洞性肺病变中的诊断准确性和安全性。
102 例连续接受 CT 引导下 FNAB 的肺空洞病变患者，使用 18 号（n=35）或 20 号（n=67）Chiba 针进行组织学诊断。FNAB 的灵敏度、特异性和诊断准确性与最终诊断进行比较。观察 FNAB 相关并发症。比较不同病变大小和不同空洞壁厚度患者的诊断准确性和并发症。
FNAB 的总体灵敏度、特异性和准确性分别为 96.3%、98.0%和 96.1%。不同病变大小（<2cm 与≥2cm）或不同空洞壁厚度（<5mm 与≥5mm）之间的灵敏度、特异性和诊断准确性无差异（P>0.05；0.235）。壁厚度<5mm 的病变中，非诊断性样本更多（P=0.017）。相关并发症包括 9 例（8.8%）气胸、14 例（13.7%）肺泡出血和 1 例（1%）咯血。病变大小、壁厚度、针道长度和针的大小与并发症发生率无差异（P>0.05）。
CT 引导下 FNAB 可有效、安全地用于肺空洞病变患者。
