经皮经胸肺穿刺针吸活检：612例病变回顾
Percutaneous transthoracic needle biopsy of the lung: review of 612 lesions.
作者信息
Swischuk J L, Castaneda F, Patel J C, Li R, Fraser K W, Brady T M, Bertino R E
机构信息
Department of Radiology, University of Illinois College of Medicine at Peoria, USA.
出版信息
J Vasc Interv Radiol. 1998 Mar-Apr;9(2):347-52. doi: 10.1016/s1051-0443(98)70279-9.
PURPOSE
The results and complications of 651 pulmonary fine-needle aspiration biopsies (FNABs) were reviewed. The number of needle passes and needle size were correlated to pneumothorax and chest tube placement rates.
MATERIALS AND METHODS
FNAB of the lung was performed on 651 occasions in 612 patients with 18- to 22-gauge Franseen needles. Diagnostic rates were calculated. The number of needle passes performed and needle size used were evaluated for their association with pneumothorax and subsequent chest tube placement.
RESULTS
Diagnostic accuracy was 94% with sensitivity for malignancy of 95%. Positive and negative predictive values were 99.5% and 90%, respectively. Pneumothorax occurred in 26.9% of patients with 9.2% requiring chest tube placement. Increasing numbers of needle passes and larger needle sizes did not increase the rates of pneumothorax or chest tube placement.
CONCLUSIONS
FNAB of the lung has excellent diagnostic rates and remains the procedure of choice for diagnosing pulmonary lesions. This large study contradicts perceptions that pneumothorax and chest tube placement rates decrease with thinner needles and fewer passes.
目的
回顾651例肺细针穿刺活检（FNAB）的结果及并发症。穿刺针数和针的尺寸与气胸及胸腔置管率的相关性进行了研究。
材料与方法
对612例患者进行了651次肺FNAB，使用18至22号 Franseen针。计算诊断率。评估穿刺针数和所用针的尺寸与气胸及随后胸腔置管的相关性。
结果
诊断准确率为94%，恶性肿瘤的敏感性为95%。阳性和阴性预测值分别为99.5%和90%。26.9%的患者发生气胸，9.2%的患者需要胸腔置管。穿刺针数增加和针的尺寸增大并未增加气胸或胸腔置管率。
结论
肺FNAB具有出色的诊断率，仍然是诊断肺部病变的首选方法。这项大型研究与细针和较少穿刺次数会降低气胸和胸腔置管率的观点相矛盾。
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