|
|
Application of CT-guided coaxial needle biopsy in early qualitative diagnosis of pulmonary nodules |
YE Xiaocong1,2 CHEN Qizhong1 HAO Mingzhi1 LIN Hailan1 |
1.Department of Interventional Therapy, Fujian Provincial Cancer Hospital Fujian Medical University Cancer Hospital, Fujian Province, Fuzhou 350014, China; 2.Department of Surgery, Fujian Changtai County Hospital, Fujian Province, Zhangzhou 363000, China |
|
|
Abstract Objective To explore the application value and safety of CT-guided coaxial needle biopsy in the early qualitative diagnosis of pulmonary nodules. Methods A total of 122 patients with pulmonary nodules (≤3 cm) admitted to Fujian Provincial Cancer Hospital from January to December 2017 who underwent percutaneous biopsy with CT-guided coaxial needle biopsy were retrospectively analyzed. The efficacy and safety of this technique were evaluated through the analysis of puncture success rate, incidence of complications and related influencing factors. Results The puncture biopsy was successfully performed in 121 cases (99.18%), among them, 92 cases (75.4%) were malignant tumors, and the puncture was terminated in one case due to pneumothorax compression more than 20%. Among 122 cases, pneumothorax was found in 11 cases (9.02%). Three patients with lung compression more than 20% (2.5%) were improved by self-absorption after observation (without drainage). There were 14 cases of concurrent hemorrhage (11.5%), including one case (0.8%) of hemoptysis, which was improved after hemostasis treatment. There was no gas embolism and no needle implantation occurred in the follow-up period of two years. Pneumothorax was related to emphysema and obstructive pneumonia after pulmonary nodule puncture of patients (all P < 0.05). Hemorrhage after puncture was related to the size of emphysema and pulmonary nodules (all P < 0.05). Conclusion CT-guided coaxial needle biopsy has higher application value and safety in the early qualitative diagnosis of pulmonary nodules.
|
|
|
|
|
[1] 陆荣平,陈立顶,朱彪.CT引导下肺穿刺活检术对老年孤立性肺肿块、结节的诊断及安全性分析[J].影像研究与医学应用,2019,3(22):92-93.
[2] 杜鹏,肖越勇,卢伟.同轴半自动活检枪在肺小结节穿刺活检中的应用[J].中国介入影像与治疗学,2017,14(6):335-338.
[3] 中国抗癌协会肿瘤介入学专业委员会,中国抗癌协会肿瘤介入学专业委员会青委会.胸部肿瘤经皮穿刺活检中国专家共识[J].中华医学杂志,2018,98(23):1822-1831.
[4] 寇咏,王瑶.CT引导经皮肺穿刺活检对肺部病变的诊断意义及并发症原因分析[J].中国实验诊断学,2019,23(11):1896-1899.
[5] Sheth S,Jilani D,Bos A,et al. Core lung biopsy for biomarker analysis:is there increased risk compared with conventional biopsy? [J]. J Thorac Imaging,2015,30(5):314-318.
[6] 李超平,吴钢飞,周星辉,等.CT引导下经皮肺穿刺活检诊断肺部占位病变的敏感性及准确率分析[J].基层医学论坛,2019,23(34):4969-4970.
[7] 李大伟,孙雪峰,谢天海.CT引导下经皮肺穿刺活检术在肺部肿瘤诊断中的应用效果观察[J].世界最新医学信息文摘,2019,19(95):217-218.
[8] 蒋立明,毛伟敏,庞伟强,等.同轴技术在CT引导下肺内小结节穿刺活检中的应用108例分析[J].中国肿瘤,2008, 17(6):532-533.
[9] 宋扬,杨文兴,白美玲.同轴半自动活检针在CT引导下经皮肺穿刺活检中的应用[J].江西医药,2019,54(12):1586-1587,1589.
[10] 陈万海,沈晓文,孙新刚,等.经皮肺活检常见并发症风险因素分析[J].介入放射学杂志,2012,21(2):168-171.
[11] Moreland A,Novogrodsky E,Brody L,et al. Pneumothorax with prolonged chest tube requirement after CT-guided percutaneous lung biopsy:incidence and risk factors [J]. Eur Radiol,2016,26(10):3483-3491.
[12] 李宏伟,卓丽华,龙拥军,等.CT引导下不同路径经皮肺穿刺活检诊断胸膜下结节[J].中国介入影像与治疗学,2019,16(10):620-624.
[13] 陈福涛,钟富宽,白巧红,等.凝血酶封堵法在老年人经皮肺穿刺活检术中的应用[J].中华老年病研究电子杂志,2018,5(4):38-41.
[14] 卫毅楠.CT引导下经皮肺穿刺活检在肺部占位性病变诊断中的诊断价值[J].影像研究与医学应用,2019,3(20):214-215.
[15] 李茹恬,任伟,孔炜伟,等.液性撤退法联合同轴法减少CT引导下经皮肺穿刺活检气胸并发症[J].现代肿瘤医学,2016,24(4):558-561.
[16] 杜永库,马鸣岳,高燕军,等.CT引导下经皮肺穿刺活检对肺部病变的诊断价值[J].实用放射学杂志,2017, 33(7):1100-1102.
[17] 惠俊国,肖扬锐,高瑞杰,等.超声与CT引导下经皮肺穿刺活检诊断周围型肺癌的临床应用及对咯血发生率的影响[J].中国现代医生,2018,56(32):119-121, 125.
[18] 陆荣平,陈立顶,朱彪.CT引导下肺穿刺活检术对老年孤立性肺肿块、结节的诊断及安全性分析[J].影像研究与医学应用,2019,3(22):92-93.
[19] 黄锡坤,郭伟洪,夏秀琼,等.C臂CT引导下经皮肺穿刺活检在肺部小结节诊断中的应用分析[J].中国医药科学,2018,8(6):207-209.
[20] Nour-Eldin NE,Alsubhi M,Emam A,et al. Pneumothorax complicating coaxial and non-coaxial CT-guided lung biopsy:comparative analysis of determining risk factors and management of pneumothorax in a retrospective feview of 650 patients [J]. Cardiovasc Intervent Radiol,2016,39(2):261-270.
[21] Lee SM,Park CM,Lee KH,et al. C-arm cone-beam CT-guided percutaneous transthoracic needle biopsy of lung noudules:clinical experience in 1108 patients [J]. Radiology,2014,271(1):291-300.
[22] 张杨.CT引导下肺穿刺活检诊断肺部局灶性磨玻璃密度结节失败因素分析[J].影像研究与医学应用,2019,3(15):157-159.
[23] 刘红梅,刘世专,孙成晖,等.超声与CT引导下经皮肺穿刺活检诊断周围型肺癌一针阳性率临床对比研究[J].中国医药科学,2019,9(3):107-109,169.
[24] Moyer VA,U.S. Preventive Services Task Force. Screening for lung cancer:US Preventive services task force recommendation statement [J]. Ann Intern Med,2014, 160(5):330-338. |
|
|
|