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计算机断层扫描引导下经皮穿刺针吸活检术用于直径小于20毫米的孤立性肺结节

Computed tomography-guided percutaneous transthoracic needle biopsy for solitary pulmonary nodules in diameter less than 20 mm.

作者信息

Xu Chunhua, Yuan Qi, Chi Chuanzhen, Zhang Qian, Wang Yuchao, Wang Wei, Yu Like, Zhan Ping, Lin Yong

机构信息

Endoscopic Center of Nanjing Chest Hospital Clinical Center of Nanjing Respiratory Diseases and Imaging Department of Respiratory Medicine, Nanjing Jiangning Hospital, Nanjing, Jiangsu, China.

出版信息

Medicine (Baltimore). 2018 Apr;97(14):e0154. doi: 10.1097/MD.0000000000010154.

Abstract

To evaluate the diagnostic value of computed tomography (CT)-guided percutaneous lung biopsy for solitary pulmonary nodules (SPN) < 20 mm.A total of 248 patients who were diagnosed a SPN of < 20 mm underwent CT-guided percutaneous transthoracic needle biopsy were reviewed.Specimens of 248 patients were obtained successfully. Around 174 cases were proved to be malignancies and 74 cases of benign lesions by biopsy. About 178 malignancies (71.8%) and 70 benign lesions were proved by surgery and clinical course. The diagnostic accuracy was 96.8%. The diagnostic accuracy of large nodules group (>10 and < 20 mm) was 99.3%, higher than 93.5% of small nodules group (≤10 mm) with statistical significance. The incidence of phenmothorax and hemorrhage was 16.1% and 6.8%, respectively. No death-related complications happened. The incidence of phenmothorax was related to puncture times (P = .013) and the length of puncture needle in lung tissues (P = .019).CT-guided percutaneous lung biopsy for SPN of < 20 mm is an efficient and safe diagnostic method.

摘要

评估计算机断层扫描(CT)引导下经皮肺穿刺活检对直径<20mm的孤立性肺结节(SPN)的诊断价值。回顾性分析248例诊断为直径<20mm的SPN患者接受CT引导下经皮经胸针吸活检的情况。成功获取了248例患者的标本。活检证实174例为恶性病变,74例为良性病变。手术及临床病程证实178例恶性病变(71.8%)和70例良性病变。诊断准确率为96.8%。大结节组(>10且<20mm)的诊断准确率为99.3%,高于小结节组(≤10mm)的93.5%,差异有统计学意义。气胸和出血的发生率分别为16.1%和6.8%。未发生与死亡相关的并发症。气胸的发生率与穿刺次数(P = 0.013)及穿刺针在肺组织中的长度(P = 0.019)有关。CT引导下经皮肺穿刺活检对直径<20mm的SPN是一种高效、安全的诊断方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4111/5902292/673478aafb63/medi-97-e0154-g001.jpg

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