直径≤20 毫米的磨玻璃密度肺结节：哪些因素影响 CT 引导下经皮肺穿刺活检的诊断准确性？

Small (≤ 20 mm) ground-glass opacity pulmonary lesions: which factors influence the diagnostic accuracy of CT-guided percutaneous core needle biopsy?

机构信息

Sichuan Key Laboratory of Medical Imaging, Department of Radiology, The Affiliated Hospital of North Sichuan Medical College, 63 Wenhua Road, Nanchong City, 637000, Sichuan Province, China.

Department of Radiology, The People's Hospital of Yuechi County, 22 East Jianshe Road, Yuechi County, 638350, Sichuan Province, China.

出版信息

BMC Pulm Med. 2022 Jul 7;22(1):265. doi: 10.1186/s12890-022-02058-z.

DOI:10.1186/s12890-022-02058-z

PMID:35799223

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9264544/

Abstract

BACKGROUND

The diagnostic accuracy of computed tomography (CT)-guided percutaneous core needle biopsy (CNB) for small (≤ 20 mm) ground-glass opacity (GGO) lesions has not been reported in detail.

OBJECTIVES

To evaluate factors that affect the diagnostic accuracy of CT-guided percutaneous CNB for small (≤ 20 mm) GGO pulmonary lesions.

METHODS

From January 2014 to February 2018, 156 patients with a small (≤ 20 mm) GGO pulmonary lesion who underwent CT-guided CNB were enrolled in this study. Factors affecting diagnostic accuracy were evaluated by analyzing patient and lesion characteristics and technical factors. Significant factors were identified by multivariate logistic regression.

RESULTS

The diagnostic accuracy of CT-guided percutaneous CNB was 90.4% for small (≤ 20 mm) GGO pulmonary lesions. The diagnostic accuracy was higher for larger lesions (72.5% for lesions ≤ 10 mm, 96.6% for lesions between 11 and 20 mm [P < 0.001]). The diagnostic accuracy of CT-guided percutaneous CNB was 74.5% for lesions with > 90% GGO components and 97.2% for lesions with 50-90% GGO components (P < 0.001). In multivariate analysis, the significant factors influencing diagnostic accuracy were lesion size (P = 0.022; odds ratio [OR] for a lesion between 11 and 20 mm in size was approximately 5 times higher than that for a lesion ≤ 10 mm; 95% confidence interval [CI], 1.3 to 18.5), and GGO component (P = 0.015; OR for a lesion with 50-90% GGO components was approximately 6 times higher than that for a lesion with > 90% GGO components; 95% CI: 1.4 to 25.7).

CONCLUSIONS

Lesion size and GGO component are factors affecting diagnostic accuracy. The diagnostic accuracy was higher for larger lesions and lesions with 50-90% GGO components.

摘要

背景

计算机断层扫描（CT）引导下经皮穿刺活检（CNB）对直径≤20mm 的磨玻璃密度（GGO）病变的诊断准确性尚未详细报道。

目的

评估影响 CT 引导下经皮穿刺 CNB 对直径≤20mm 的 GGO 肺部病变诊断准确性的因素。

方法

本研究纳入了 2014 年 1 月至 2018 年 2 月期间 156 名接受 CT 引导下经皮 CNB 的直径≤20mm 的 GGO 肺部病变患者。通过分析患者和病变特征以及技术因素来评估影响诊断准确性的因素。采用多因素逻辑回归识别有意义的因素。

结果

CT 引导下经皮 CNB 对直径≤20mm 的 GGO 肺部病变的诊断准确性为 90.4%。较大的病变（直径≤10mm 的病变为 72.5%，直径为 11-20mm 的病变为 96.6%）的诊断准确性更高（P<0.001）。CNB 对 GGO 成分>90%的病变的诊断准确性为 74.5%，对 GGO 成分 50-90%的病变的诊断准确性为 97.2%（P<0.001）。多因素分析显示，影响诊断准确性的显著因素为病变大小（P=0.022；直径为 11-20mm 的病变的比值比约为直径≤10mm 病变的 5 倍；95%置信区间：1.3 至 18.5）和 GGO 成分（P=0.015；GGO 成分 50-90%的病变的比值比约为 GGO 成分>90%的病变的 6 倍；95%置信区间：1.4 至 25.7）。