CT引导下经胸壁针刺活检与吸引对肺部孤立性肿块诊断的比较

为了比较经胸壁针刺肺活检(TTNB)与经胸壁针刺肺吸引(TTNA)在肺部孤立性肿块诊断中的价值,对同一病例,在CT引导下,先采用弹簧式半自动切割针对肺部肿块行TTNB获取活检组织作病理学检查,再用腰穿针行TTNA针吸组织作细胞学检查.结果显示,37例病人均获得满意的标本。经TTNB确诊者34例,确诊率为91.9％,经TTNA确诊25例,确诊率为67.6％,两者有显著性差异(P<0.01).37例病人中,共有并发症6例,发生率为16.2％,其中术后出现气胸2例,发生出血(咯血或肺内出血)4例.提示TTNB与TTNA均是肺部孤立性肿块诊断安全、可靠的方法,但TTNB的诊断率明显高于TTNA,尤其有利于肺部良性病变的诊断,值得广泛应用.

A Comparison between CT-guided Transthoracic Needle Biopsy and Transthoracic Needle Aspiration for Diagnosis of Solitary Pulmonary Nodules

To compare the role between CT-guided transthoracic needle biopsy (TTNB) and transthoracic needle aspiration (TTNA) for diagnosis of solitary pulmonary nodules, CT-guided TTNB with semi-automated cutting needle for pathological examination and TTNA with fine-needle for cytological examination were performed in 37 patients with solitary pulmonary nodules. Sufficient results were obtained from all of 37 patients. 34 patients were diagnosed by TTNB, with 91. 9% diagnostic yield, 94.4% sensitivity, 100% specificity and 94.6% accuracy. 25 patients were diagnosed by TTNA, with 67. 6% diagnostic yield, 69. 4% sensitivity, 100% specificity and 70.3% accuracy. Diagnostic yield and accuracy were statistically higher in TTNB than in TTNA ( P < 0.01). Complications occurred in 6 patients (16.2%) and included pneumothorax in 2 patients and hemoptysis and hemorrhage in 4 patients. It suggested that TTNB was safe and had a higher diagnostic yield as compared with TTNA for diagnosis of solitary pulmonary nodules particularly for benign lesions and it should be recommended to be used further.