The Value of CT Guided Coaxial Needle Biopsy in the Diagnosis of Solitary Pulmonary Nodules
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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.
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Keywords:
- solitary pulmonary nodule /
- spiral CT /
- lung biopsy /
- clinical diagnosis
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