CT引导下经皮同轴针吸式经胸活检（PCTTB）的诊断价值及病理检查评估

The Diagnostic Value of CT-guided Percutaneous Co-axial Trans-thoracic Biopsy (PCTTB) and Evaluation of the Pathologic Examination.

作者信息

Şahan Mehmet Hamdi, Inal Mikail, Muluk Nuray Bayar, Doğan Adil, Atasoy Pınar

机构信息

Department of Radiology, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey.

ENT Department, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey.

出版信息

Curr Med Imaging Rev. 2019;15(5):479-488. doi: 10.2174/1573405614666180704150335.

DOI:10.2174/1573405614666180704150335

PMID:32008555

Abstract

BACKGROUND

We investigated thoracic masses with Computed Tomography (CT)- guided Percutaneous Co-Axial Trans-Thoracic Biopsy (PCTTB).

METHODS

The retrospective data of 86 patients to whom CT-guided PCTTB had been applied were obtained. Eighty-four cases and their pathologic results were included in the study. Localization and appearance of the lesions, pathologic results, and complications were evaluated.

RESULTS

Diagnostic sensitivity of CT-guided PCTTB was 97.6%. In 60.7% of the cases, malign lesions and, in 39.3% of the cases, benign lesions were diagnosed. The mass size was on average greater than 2 cm, and one mass was detected as being more than ≥2 masses. Mainly, irregular contours were observed. Most of the malign tumors were primary malign tumors on both sides (91.7% on the right side and 88.9% on the left side). Squamous Cell Carcinoma (SCC) was the most often detected malign tumor on the right side, and adenocarcinoma was the most often detected malign tumor on the left side. In masses localized on the left inferior lobe, metastasis was often detected. When the number of the mass was ≥2 and the mass had the appearance of consolidation, metastasis was usually detected. Small and large masses were mainly localized on right and left upper lobes. In the small mass group, 75.0% of the cases were benign, and, in the large mass group, 64.5% of the cases were malign (p=0.031, χ2=4.666). Pneumothorax was the most commonly occurring complication (23.8%). In masses localized on the right lower lobe, the pneumothorax ratio increased in benign masses compared to malign masses. The hemorrhage detection rate was 13.0%, and hemoptysis occurred in 14.2% of the cases. Hemorrhage was detected during 11.8% of the large mass biopsies. In females, hemorrhage occurred more often than in males (p=0.026, r= 0.244).

CONCLUSION

CT-guided PCTTB is a safe method to utilize for lung biopsies. Co-axial method increased the diagnostic accuracy of CT-guided percutaneous trans-thoracic biopsies. A single cut also decreased the complication rates.

摘要

背景

我们采用计算机断层扫描（CT）引导下经皮同轴针吸式经胸壁活检术（PCTTB）对胸部肿块进行了研究。

方法

获取了86例行CT引导下PCTTB患者的回顾性数据。本研究纳入了84例患者及其病理结果。对病变的定位与表现、病理结果及并发症进行了评估。

结果

CT引导下PCTTB的诊断敏感性为97.6%。60.7%的病例诊断为恶性病变，39.3%的病例诊断为良性病变。肿块大小平均大于2cm，且发现1个肿块为多发肿块。主要观察到轮廓不规则。大多数恶性肿瘤为双侧原发性恶性肿瘤（右侧91.7%，左侧88.9%）。鳞状细胞癌（SCC）是右侧最常检测到的恶性肿瘤，腺癌是左侧最常检测到的恶性肿瘤。在位于左下叶的肿块中，常检测到转移。当肿块数量≥2且表现为实变时，通常检测到转移。大小肿块主要位于右上叶和左上叶。在小肿块组中，75.0%的病例为良性，在大肿块组中，64.5%的病例为恶性（p = 0.031，χ2 = 4.666）。气胸是最常见的并发症（23.8%）。在位于右下叶的肿块中，良性肿块的气胸发生率高于恶性肿块。出血检出率为13.0%，14.2%的病例发生咯血。在11.8%的大肿块活检中检测到出血。女性出血发生率高于男性（p = 0.026，r = 0.244）。