Xu Q T, Guo J X, Jiangping Ren, Wang R S, Ma J L, Zhou Jianliang
Department of Oncology and Chemoradiotherapy, Ningbo First Hospital, Ningbo 315000, China.
Department of Thoracic Surgery, Ningbo First Hospital, Ningbo 315000, China.
Zhonghua Yi Xue Za Zhi. 2022 May 10;102(17):1278-1282. doi: 10.3760/cma.j.cn112137-20211116-02558.
To explore the clinical value of four dimensional computed tomography (4 D CT) guided combined with deep inhalation and breath hold (DIBH) technique in the preoperative localization of solitary pulmonary nodules. The data of a total of 106 patients with solitary pulmonary nodules from March 2018 to May 2021 in the Ningbo First Hospital were collected retrospectively. Among them, there were 26 males and 80 females aged from 21 to 83 (47.4±14.2) years. According to different localization methods, 53 cases were divided into the control group, as the pulmonary nodules were located by CT guided injection of indocyanine green under calm breathing and 53 cases were divided into in the experimental group, as those patients were treated with indocyanine green injection under the guidance of 4 D CT combined with DIBH technology to locate pulmonary nodules. The three-dimensional distance deviation between pulmonary nodules and indocyanine green injection points was compared between the two groups to obtain the accuracy of pulmonary nodule localization. The preoperative positioning time of the two groups was compared by timing. Among the 106 patients, there were 46 pure ground glass nodules, 32 sub solid nodules and 28 solid nodules, all of which were successfully localized before operation, with a success rate of 100%. The size of pulmonary nodules in the control group was (9.1±2.3) mm and the three-dimensional deviation[(, )]between indocyanine green injection site and pulmonary nodules was axis [7.0 (3.7, 12.6)] mm, axis [6.6 (2.9, 11.2)] mm, axis [3.0 (2.0, 6.0)]mm, respectively, and the preoperative positioning time was (11.4±3.8) min. The size of pulmonary nodules in the experimental group was (8.9±2.1) mm, and the deviations in 3 D direction were axis [4.8 (3.0, 7.9)]mm, axis [3.8 (1.3, 7.5)]mm, axis [4.0 (2.0, 6.0)] mm, respectively. The preoperative positioning time was (9.3±3.0) min. There were statistically significant differences in preoperative positioning time and deviation of and axis between the experimental group and the control group (<0.05), but no statistically significant differences was found in deviation of Z axis (>0.05). 4 D CT guided DIBH technology could improve the accuracy of preoperative localization of pulmonary nodules and save operation time, which is worthy of popularization.
探讨四维计算机断层扫描(4D CT)引导联合深吸气屏气(DIBH)技术在孤立性肺结节术前定位中的临床价值。回顾性收集2018年3月至2021年5月宁波市第一医院106例孤立性肺结节患者的数据。其中男性26例,女性80例,年龄21~83岁(47.4±14.2)岁。根据定位方法不同,将53例患者分为对照组,即平静呼吸下CT引导注射吲哚菁绿定位肺结节;53例患者分为实验组,即4D CT联合DIBH技术引导下注射吲哚菁绿定位肺结节。比较两组肺结节与吲哚菁绿注射点的三维距离偏差,以获得肺结节定位的准确性。通过计时比较两组的术前定位时间。106例患者中,纯磨玻璃结节46例,亚实性结节32例,实性结节28例,均在术前成功定位,成功率100%。对照组肺结节大小为(9.1±2.3)mm,吲哚菁绿注射部位与肺结节的三维偏差[(,)]在X轴为[7.0(3.7,12.6)]mm,Y轴为[6.6(2.9,11.2)]mm,Z轴为[3.0(2.0,6.0)]mm,术前定位时间为(11.4±3.8)min。实验组肺结节大小为(8.9±2.1)mm,三维方向偏差在X轴为[4.8(3.0,7.9)]mm,Y轴为[3.8(1.3,7.5)]mm,Z轴为[4.0(2.0,6.0)]mm。术前定位时间为(9.3±3.0)min。实验组与对照组术前定位时间及X、Y轴偏差差异有统计学意义(<0.05),但Z轴偏差差异无统计学意义(>0.05)。4D CT引导DIBH技术可提高肺结节术前定位的准确性,节省手术时间,值得推广。