平板穿刺模板辅助计算机断层扫描引导下经皮肺穿刺活检在小肺结节中的临床应用

Clinical application of planar puncture template-assisted computed tomography-guided percutaneous biopsy for small pulmonary nodules.

作者信息

Ji Zhe, Wang Guan, Chen Baoming, Zhang Yuwei, Zhang Li, Gao Fuchun, Chai Shude, Huo Bin, Zheng Guangjun, Huo Xiaodong, Wang Baoming, Zhu Xudong, Meng Dan, Liu Lejun, Zhu Rui, Han Mingyong, Zhang Ying, Zhang Kaixian, Wang Junjie

机构信息

Department of Radiation Oncology, Peking University Third Hospital, Beijing; China Northern Radioactive Brachytherapy Group, Tangshan People's Hospital, Tangshan, Hebei, PR China.

China Northern Radioactive Brachytherapy Group; Department of Nuclear Medicine, Tangshan People's Hospital, Tangshan, Hebei, PR China.

出版信息

J Cancer Res Ther. 2018;14(7):1632-1637. doi: 10.4103/jcrt.JCRT_1017_17.

DOI:10.4103/jcrt.JCRT_1017_17

PMID:30589051

Abstract

AIMS

The aims of this study were to evaluate the clinical application of planar puncture template (PPT) in computed tomography (CT)-guided percutaneous needle lung biopsy.

SUBJECTS AND METHODS

A total of 56 patients with small pulmonary nodules who received CT-guided percutaneous lung biopsy assisted by PPT were included in the study. Five steps were included in the study: fixing position, CT scanning and designing needle pathway, installing navigation system and template, puncturing fixation needle, and performing biopsy needle insertion and biopsy. The success rate of puncture, pathological results, and complications were analyzed. In addition, the factors that influenced the success rate and complications were analyzed.

RESULTS

Biopsy was successfully completed in all 56 patients. The nodule diameter was 0.45-3 cm. The fixation needle technique was applied in 47 cases. Biopsy was performed 1 time in 50% of patients and 2 times in 38% of patients. For pathology, only one case showed no positive result, with a puncture success rate of 98%. The diagnostic rate of malignant tumor was 73%. For complications, the incidence of needle tract bleeding was 68%, the incidence of pneumothorax was 30%, and the thoracic drainage was required in two patients. Hemoptysis was observed in two cases. Univariate analysis: The nodule size was related to both the rate of 1-time biopsy and incidence of complications. Smaller nodule was relevant to lower rate of 1-time biopsy (P = 0.01) and higher incidence of complications (P < 0.05). The fixation needle was related to 1-time biopsy rate. The 1-time biopsy rate was significantly higher in patients with fixation needle than those without fixation needle (P = 0.001). Meanwhile, no significant difference was observed in the incidence of complications in different number of fixation needles (P > 0.05).

CONCLUSIONS

PPT-assisted lung biopsy technology can provide high success rate and low complication incidence. It would be helpful to make the puncture procedures more standard for better clinical applications.

摘要

目的

本研究旨在评估平面穿刺模板（PPT）在计算机断层扫描（CT）引导下经皮肺穿刺活检中的临床应用。

对象与方法

本研究纳入了56例接受PPT辅助CT引导下经皮肺穿刺活检的小肺结节患者。研究包括五个步骤：定位、CT扫描与设计穿刺路径、安装导航系统和模板、穿刺固定针以及进行活检针穿刺和活检。分析穿刺成功率、病理结果及并发症情况。此外，分析影响成功率和并发症的因素。

结果

56例患者均成功完成活检。结节直径为0.45 - 3厘米。47例应用了固定针技术。50%的患者进行了1次活检，38%的患者进行了2次活检。病理方面，仅1例未得到阳性结果，穿刺成功率为98%。恶性肿瘤诊断率为73%。并发症方面，针道出血发生率为68%，气胸发生率为30%，2例患者需要胸腔引流。观察到2例咯血。单因素分析：结节大小与1次活检率及并发症发生率均相关。较小结节与较低的1次活检率（P = 0.01）及较高的并发症发生率（P < 0.05）相关。固定针与1次活检率相关。应用固定针的患者1次活检率显著高于未应用固定针的患者（P = 0.001）。同时，不同固定针数量的患者并发症发生率无显著差异（P > 0.05）。