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目的:探讨 CT引导下胸部肿瘤定位穿刺技术临床应用价值。方法 :2 0 0 1年 3月～ 2 0 0 3年 8月经 CT引导穿刺活检的 32例胸部占位性病变。肺周围性肿块 8例 ,纵隔及肺中央性肿块 2 0例 ,胸水疑胸膜转移 4例。 16例患者曾在纤维支气管镜下做活检 1～ 2次 ,但均未确诊。CT定位后用 16～ 18G切割式穿刺枪从前或后胸壁避开重要脏器进针 ,穿刺 1～ 3次 ,送组织学或加细胞学病理检查。结果 :2 8例明确诊断 ,阳性率 81.82 % (2 8/ 32 ) ,1例气胸 ,2例少量出血 ,其余病例未发生严重并发症。 结论 :CT引导胸部肿瘤定位穿刺技术对纤维支气管镜检查阴性的胸部占位性病变有较重要的临床价值 ,值得进一步推广应用。
Objective: To investigate the clinical value of CT-guided thoracic tumor positioning puncture technique. Methods: From March 2001 to August 2003, 32 cases of chest space-occupying lesions underwent CT-guided biopsy. Peripheral tumors in 8 cases, 20 cases of mediastinal and pulmonary central mass, pleural effusion suspected pleural metastasis in 4 cases. 16 patients had biopsy in the bronchoscope 1 to 2 times, but were not diagnosed. CT positioning with 16 ~ 18G cutting-type puncture gun before or after the chest wall to avoid the key organs into the needle, puncture 1 to 3 times, send histology or cytology plus pathology. Results: Twenty-eight cases were diagnosed correctly. The positive rate was 81.82% (2/8), one case had pneumothorax and two cases had a small amount of bleeding. The rest cases did not have serious complications. Conclusion: CT-guided thoracic tumor positioning puncture technique has important clinical value in the diagnosis of thoracic space-occupying lesions with bronchoscopy. It is worth further promotion and application.