Jiao De Chao, Li Teng Fei, Han Xin Wei, Wu Gang, Ma Ji, Fu Ming Ti, Sun Qi, Beilner Janina
Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China; Interventional Therapy Institute of Zhengzhou University Zhengzhou, Henan, People's Republic of China.
Diagn Interv Radiol. 2014 Nov;20(6):470-4. doi: 10.5152/dir.2014.13463.
This study explored the value of flat detector C-arm CT-guidance system in performing percutaneous transthoracic needle biopsy (PTNB) for lung lesions in clinical practice.
A total of 110 patients with solid lung lesions were enrolled to undergo PTNB procedures. The mean diameter of lesions was 4.63 cm (range, 0.6-15cm). The needle path was carefully planned and calculated on the C-arm CT system, which acquired three-dimensional CT-like cross-sectional images. The PTNB procedures were performed under needle guidance with fluoroscopic feedbacks.
Histopathologic tissue was successfully obtained from 108 patients with a puncture success rate of 98.2% (108/110). The diagnostic accuracy rate was found to be 96.3% (104/108). There was only one case of pneumothorax (0.9%) requiring therapy. The rates of mild pneumothorax and hemoptysis were low (12.0% and 6.5%, respectively). In addition, procedural time could be limited with this technique, which helped to reduce X-ray exposure.
Our study shows that C-arm CT-based needle guidance enables reliable and efficient needle positioning and progression by providing real-time intraoperative guidance.
本研究探讨平板探测器C形臂CT引导系统在临床实践中对肺部病变进行经皮经胸针吸活检（PTNB）的价值。
共纳入110例肺部实性病变患者接受PTNB操作。病变的平均直径为4.63 cm（范围0.6 - 15 cm）。在C形臂CT系统上仔细规划并计算针道，该系统可获取类似CT的三维断层图像。PTNB操作在针引导下并结合透视反馈进行。
108例患者成功获取组织病理学组织，穿刺成功率为98.2%（108/110）。诊断准确率为96.3%（104/108）。仅1例气胸（0.9%）需要治疗。轻度气胸和咯血的发生率较低（分别为12.0%和6.5%）。此外，该技术可限制操作时间，有助于减少X线暴露。
我们的研究表明，基于C形臂CT的针引导通过提供实时术中引导，能够实现可靠且高效的针定位和进针。
