The Value of CT Guided Coaxial Needle Biopsy in the Diagnosis of Solitary Pulmonary Nodules
-
摘要: 目的：探讨CT引导下同轴定位针经皮穿刺活检在孤立性肺结节良恶性的诊断价值，分析影响诊断准确性的因素。方法：选择2017年9月至2019年7月于我院CT室发现孤立性肺结节患者40例，随机分为研究组（接受CT引导同轴定位活检针经皮肺穿刺）和对照组（在CT引导下采用巴氏切割针取材），每组20例，根据CT扫描图像选择最佳穿刺层面及穿刺点获取标本。比较两组患者穿刺活检成功率、诊断准确率及穿刺并发症。结果：研究组患者穿刺活检成功率及诊断准确率高于对照组患者的（P<0.05）；孤立性肺结节（SPN）恶性病变诊断敏感度、特异度分别为92.86%、90.00%，显著高于对照组患者。Kappa检验CT引导下穿刺活检与手术或随访结果一致性较高（Kappa=0.725，P=0.000）。穿刺病灶大小是影响CT引导下穿刺活检诊断SPN的因素。结论：CT引导下同轴定位针经皮穿刺活检可提高穿刺活检成功率及诊断准确率，降低穿刺相关并发症风险，对SPN诊断与手术病理结果一致性较高。Abstract: Objective:To evaluate the diagnostic value of CT-guided percutaneous needle biopsy in benign and malignant Solitary pulmonary nodule, and to analyze the factors affecting the diagnostic accuracy. Method:Forty patients were randomly divided into two groups:Study Group (CT-guided percutaneous lung biopsy with coaxial needle) and Control Group (CT-guided percutaneous lung biopsy with Papanicolaou needle). 40 patients with pulmonary Solitary pulmonary nodule were found in our hospital from September 2017 to July 2019, each group of 20 cases, according to CT scan image to choose the best puncture layer and puncture point to obtain specimens. The success rate, diagnostic accuracy and complications of puncture biopsy were compared between the two groups. Results:The success rate and diagnostic accuracy of puncture biopsy in the study group were higher than those in the control group (P<0.05), and the diagnostic sensitivity and specificity of malignant SPN were 92.86% and 90.00%, respectively, which were significantly higher than those in the control group. The results of CT-guided percutaneous biopsy were consistent with those of operation or follow-up (Kappa=0.725, P=0.000). The size of puncture focus is a factor that affects the diagnosis of SPN by CT-guided needle biopsy. Conclusion:CT-guided percutaneous needle biopsy with coaxial location needle can improve the success rate and diagnostic accuracy, reduce the risk of puncture-related complications, and has a high consistency between diagnosis and pathological results of SPN.
-
Keywords:
- solitary pulmonary nodule /
- spiral CT /
- lung biopsy /
- clinical diagnosis
-
-
期刊类型引用(13)
1. 李腾飞，李俊霞. 良恶性肺结节鉴别诊断中CT引导下经皮肺穿刺活检的应用价值. 黑龙江医药科学. 2025(03): 173-175 . 
百度学术
2. 陈晓雪，李可峰，韩海森，李依明. CT能谱成像参数联合血清细胞角蛋白19片段抗原21-1水平对孤立性肺结节性质的鉴别诊断价值. 实用心脑肺血管病杂志. 2024(09): 95-98 . 百度学术
3. 陈光耀. CT引导下肺结节术前穿刺定位及穿刺活检并发症及风险因素探讨. 影像研究与医学应用. 2023(03): 194-196 . 百度学术
4. 张洁，王金萍，李保启，胡恩庆. 超声造影联合穿刺活检在胸部占位性病变诊断中的价值. 安徽医学. 2023(05): 541-543 . 百度学术
5. 张知远，李知慧，郑若娟. CT引导下同轴针穿刺活检与常规活检术在胸部肿瘤活检中的应用比较. 现代实用医学. 2023(12): 1575-1578 . 百度学术
6. 唐涌通，徐积兰，李小勇，章俊，陈庆乐，阳名华. 应用激光定位仪联合CT三维图像引导下同轴法对疑似肺癌病灶经皮肺穿刺活检术的研究. 赣南医学院学报. 2022(02): 174-176 . 百度学术
7. 杨国富. CT引导下肺结节术前穿刺定位及穿刺活检并发症及风险因素分析. 影像研究与医学应用. 2022(08): 194-196 . 百度学术
8. 苏海波. 低剂量螺旋CT扫描于肺结节诊断中的应用. 影像研究与医学应用. 2022(12): 153-155 . 百度学术
9. 孙维东，葛金梅，穆小飞，陈竹君，蔡晓敏. 双源CT低剂量引导下同轴活检针在经皮肺穿刺活检中的临床应用研究. 影像研究与医学应用. 2021(05): 194-195 . 百度学术
10. 周广新，刘晓真，许宇光，杨坤，汤庆. 经皮超声引导下肺周围型病变同轴穿刺活检联合超声造影的诊断准确性和并发症发生率. 中国医师杂志. 2021(06): 822-825 . 百度学术
11. 王广鑫. CT定位下经皮肺穿刺活检在肺结核鉴别诊断中的运用. 影像研究与医学应用. 2021(11): 84-85 . 百度学术
12. 王建. 小视野扫描方法在肺小结节CT引导下经皮穿刺活检中的应用效果. 临床医学研究与实践. 2021(21): 131-133 . 百度学术
13. 赵庆成，刘海军. CT引导下经皮肺穿刺活检在肺小结节临床诊治中的应用价值. 实用医技杂志. 2021(12): 1447-1449 . 百度学术
其他类型引用(0)
计量
- 文章访问数: 500
- HTML全文浏览量: 12
- PDF下载量: 15
- 被引次数: 13
下载:
