非同轴技术CT引导下肺病变细针穿刺活检的诊断准确性及安全性：442例活检的单中心经验
Diagnostic accuracy and safety of CT-guided fine needle aspiration biopsy of pulmonary lesions with non-coaxial technique: a single center experience with 442 biopsies.
作者信息
Uzun Çağlar, Akkaya Zehra, Düşünceli Atman Ebru, Üstüner Evren, Peker Elif, Gülpınar Başak, Elhan Atilla Halil, Ceyhan Koray, Atasoy Kayhan Çetin
机构信息
Department of Radiology, Ankara University School of Medicine, Ankara, Turkey.
出版信息
Diagn Interv Radiol. 2017 Mar-Apr;23(2):137-143. doi: 10.5152/dir.2016.16173.
Abstract
PURPOSE
We aimed to evaluate the diagnostic accuracy and safety of computed tomography (CT)-guided biopsy of pulmonary lesions with fine needle aspiration (FNA) using non-coaxial technique.
METHODS
We analyzed 442 patients who underwent CT-guided lung biopsy with FNA and non-coaxial technique to determine the diagnostic outcomes, complication rates, and independent risk factors for diagnostic failure and pneumothorax.
RESULTS
Diagnostic accuracy, sensitivity, and specificity were 97.6%, 97.3%, and 100%, respectively. Age and >35 mm lesion size were significant risk factors for diagnostic failure. The rates of pneumothorax and chest tube placement were 19% and 2.9%, respectively. Middle and lower lobe location, lesion to pleura distance >7.5 mm, and >45° needle trajectory angle were significant risk factors for pneumothorax.
CONCLUSION
CT-guided FNA of pulmonary lesions with non-coaxial technique is a safe and reliable method with a relatively low pneumothorax rate and an acceptably high diagnostic accuracy.
摘要
目的
我们旨在评估使用非同轴技术的计算机断层扫描（CT）引导下经细针穿刺抽吸（FNA）对肺部病变进行活检的诊断准确性和安全性。
方法
我们分析了442例行CT引导下经FNA非同轴技术肺活检的患者，以确定诊断结果、并发症发生率以及诊断失败和气胸的独立危险因素。
结果
诊断准确性、敏感性和特异性分别为97.6%、97.3%和100%。年龄和病变大小>35 mm是诊断失败的显著危险因素。气胸率和置胸管率分别为19%和2.9%。中叶和下叶位置、病变与胸膜距离>7.5 mm以及针道角度>45°是气胸显著危险因素。
结论
CT引导下经非同轴技术对肺部病变进行FNA是一种安全可靠的方法，气胸率相对较低，诊断准确性较高，可接受。
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本文引用的文献
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2
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3
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4
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Acad Emerg Med. 2010 Jun;17(6):649-51. doi: 10.1111/j.1553-2712.2010.00773.x.
5
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Acta Radiol. 2010 Jun;51(5):527-33. doi: 10.3109/02841851003691979.
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7
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8
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Chest. 2004 Sep;126(3):748-54. doi: 10.1378/chest.126.3.748.
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