目的 探讨CT引导下空针导航联合平静呼吸法在穿刺活检肺亚厘米结节的应用价值。方法 选取2016-05至2018-10武警四川总队医院放射科诊断的肺亚厘米结节(≤1 cm)患者63例,在 CT引导下应用空针导航联合平静呼吸法进行穿刺取材,统计分析穿刺活检成功率、术后相关并发症及术后病理诊断结果。结果 空针导航联合平静呼吸法穿刺活检成功率为98.4%(62/63);术后气胸发生率20.6%(13/63),术后出血发生率31.7%(20/63);病例随访中均未发现感染或肿瘤播散转移等。成功穿刺活检的62例中:鳞癌4例,腺癌21例(原位腺癌3例),转移癌2例,恶性黑色素瘤1例;慢性炎性反应19例,肉芽肿性炎7例,粉尘沉着伴淋巴细胞增生5例,肺泡上皮增生2例,真菌1例。结论 对肺亚厘米结节患者采用空针导航联合平静呼吸法进行穿刺活检安全可靠且成功率高,是诊断早期肺癌的重要手段。
Abstract
Objective To investigate the clinical value of empty needle navigation combined with quiet breathing in CT-guided puncture biopsy of lung subcentimeter nodules.Methods A retrospective analysis was conducted of sixty-three patients with subcentimeter pulmonary nodules (≤1 cm) treated in our hospital. Puncture materials were collected by using empty needle navigation combined with quiet breathing under the guidance of CT, and the success rate of puncture biopsy, postoperative complications and results of postoperative pathological diagnosis were statistically analyzed.Results The success rate of puncture biopsy was 98.4% (62/63). The incidence of pneumothorax and hemorrhage was 20.6% (13/63) and 31.7% (20/63)respectively. Neither infection nor tumor spread or metastasis were found during the follow-up. Among the 62 patients with successful biopsy, 4 cases of squamous cell carcinoma, 21 cases of adenocarcinoma (3 cases of adenocarcinoma in situ), 2 cases of metastatic carcinoma and 1 case of malignant melanoma were reported. There were 19 cases of chronic inflammation, 7 cases of granulomatous inflammation, 5 cases of dust accumulation accompanied by lymphocytic hyperplasia, 2 cases of alveolar epithelial hyperplasia, and 1 case of fungus.Conclusions Puncture biopsy in patients with subcentimeter pulmonary nodules by using empty needle navigation combined with quiet breathing is a safe and reliable method with a high success rate. It is an important means for early diagnosis of lung cancer.
关键词
空针导航 /
平静呼吸 /
CT引导穿刺 /
肺亚厘米结节
Key words
empty needle navigation /
quiet breathing /
CT-guided puncture /
lung subcentimeter nodules
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