多层螺旋 CT 引导下经胸肺活检术对不同大小肺结节的诊断效能及安全性分析。

Efficacy and Safety Analysis of Multislice Spiral CT-Guided Transthoracic Lung Biopsy in the Diagnosis of Pulmonary Nodules of Different Sizes.

机构信息

Shaanxi Provincial People's Hospital, Xi'an, Shaanxi Province 710068, China.

出版信息

Comput Math Methods Med. 2022 Aug 25;2022:8192832. doi: 10.1155/2022/8192832. eCollection 2022.

DOI:10.1155/2022/8192832

PMID:36060660

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9436531/

Abstract

OBJECTIVE

This study is aimed at investigating the efficacy and safety of multislice spiral CT-guided transthoracic lung biopsy in the diagnosis of pulmonary nodules of different sizes.

METHODS

Data of 78 patients with pulmonary nodules who underwent CT-guided transthoracic lung biopsy in our hospital from January 2020 to December 2021 were retrospectively analyzed, and they were divided into the small nodules group ( = 12), medium nodules group ( = 35), and large nodules group ( = 31) according to the diameter of pulmonary nodules. The results of puncture biopsy and final diagnosis of pulmonary nodules of different sizes were compared. The incidence of complications in patients with pulmonary nodules of different sizes was compared. Univariate analysis was used to compare the incidence of complications in 78 patients. Logistic multiple regression analysis was used to analyze the independent risk factors of pneumothorax in patients with pulmonary nodule puncture. Logistic multiple regression analysis was used to analyze the independent risk factors of pulmonary hemorrhage in patients with pulmonary nodule puncture.

RESULTS

The diagnostic accuracy, sensitivity, and specificity were 83.33%, 100.00%, and 77.78% in small nodules group. The diagnostic accuracy, sensitivity, and specificity of medium nodules group were 85.71%, 100.00%, and 73.68%, respectively. The diagnostic accuracy, sensitivity, and specificity of large nodules group were 93.55%, 100.00%, and 33.33%, respectively. There was no significant difference in the incidence of pneumothorax among the three groups ( > 0.05). The incidence of pulmonary hemorrhage in small nodule group was higher than that in the medium nodule group and large nodule group, and the difference was statistically significant ( < 0.05). There was no significant difference in the incidence of total complications among the three groups ( > 0.05). There were statistically significant differences in clinical data such as the needle tract length, the puncture position, and the distance of the puncture needle passing through the lung tissue in patients with or without pneumothorax ( < 0.05). There were statistically significant differences in needle tract length, distance of puncture needle passing through lung tissue, and size of pulmonary nodules in patients with or without pulmonary hemorrhage ( > 0.05). Logistic multivariate analysis showed that needle tract length ≤ 50 mm, lateral decubitus position, and the distance of puncture needle passing through lung tissue ≥ 14 mm were independent risk factors for pneumothorax after puncture in patients with pulmonary nodules ( < 0.05). The needle tract length > 50 mm, the distance of puncture needle passing through lung tissue ≥ 14 mm, and small nodules (pulmonary nodules diameter ≤ 10 mm) were independent risk factors for pulmonary hemorrhage after puncture in patients with pulmonary nodules ( < 0.05).

CONCLUSION

Multislice spiral CT-guided transthoracic lung biopsy is effective in diagnosing pulmonary nodules of different sizes.

摘要

目的

本研究旨在探讨多层螺旋 CT 引导经胸肺活检术在不同大小肺结节诊断中的疗效和安全性。

方法

回顾性分析 2020 年 1 月至 2021 年 12 月我院收治的 78 例肺结节 CT 引导经胸肺活检患者的临床资料，根据肺结节直径将其分为小结节组（n=12）、中结节组（n=35）和大结节组（n=31）。比较不同大小肺结节穿刺活检结果与最终诊断的符合率，比较不同大小肺结节患者并发症的发生率。采用单因素分析比较 78 例患者并发症的发生率，采用 Logistic 多因素回归分析肺结节穿刺患者气胸的独立危险因素，采用 Logistic 多因素回归分析肺结节穿刺患者肺出血的独立危险因素。

结果

小结节组诊断准确率、敏感度、特异度分别为 83.33%、100.00%、77.78%；中结节组诊断准确率、敏感度、特异度分别为 85.71%、100.00%、73.68%；大结节组诊断准确率、敏感度、特异度分别为 93.55%、100.00%、33.33%。三组患者气胸发生率比较，差异无统计学意义（>0.05）。小结节组肺出血发生率高于中结节组和大结节组，差异有统计学意义（<0.05）。三组患者总并发症发生率比较，差异无统计学意义（>0.05）。气胸患者与非气胸患者的临床资料，如针道长度、穿刺部位、穿刺针穿过肺组织的距离比较，差异有统计学意义（<0.05）。肺出血患者与非肺出血患者的针道长度、穿刺针穿过肺组织的距离、肺结节大小比较，差异有统计学意义（>0.05）。Logistic 多因素分析显示，针道长度≤50 mm、侧卧位、穿刺针穿过肺组织的距离≥14 mm 是肺结节患者穿刺后发生气胸的独立危险因素（<0.05）；针道长度>50 mm、穿刺针穿过肺组织的距离≥14 mm、肺小结节（肺结节直径≤10 mm）是肺结节患者穿刺后发生肺出血的独立危险因素（<0.05）。