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目的 评价CT导向纵隔和肺门肿块穿刺活检的价值。方法 总结 1998-0 4～ 2 0 0 1-12经CT导向穿刺活检的 34例纵隔和肺门肿块病例。纵隔和纵隔旁肿块 19例 ,纵隔内上腔静脉旁和隆突下淋巴结 7例 ,肺门肿块 8例 ,纵隔内淋巴结肿大和肺门肿块病例纤支镜检查均为阴性。CT定位后以 18～ 2 0G切割针及抽吸针从前 ( 19例 )或后 ( 15例 )胸壁避开重要脏器进针 ,穿刺次数 1～ 3次作组织学或加抽吸细胞学检查。结果 32例明确诊断 ,阳性率 94%。 4/34例 ( 12 % )有少量气胸 ,均自行吸收 ,2 /34例 ( 6% )肺内少量出血。本组纤支镜阴性的肺门和近纵隔肺癌以小细胞肺癌为主 ( 11/15 )。结论 CT导向穿刺活检对于纵隔和纤支镜检查阴性的肺门肿块有重要价值 ,安全可靠 ,胸腺部位抽吸活检有利于提高阳性率
Objective To evaluate the value of CT-guided mediastinum and hilar mass biopsy. Methods A total of 34 cases of mediastinum and hilar mass with CT guided biopsy from 1998 to 2004 were retrospectively reviewed. 19 cases of mediastinal and mediastinum masses, mediastinal superior vena cava inferior and subcumbent lymph nodes in 7 cases, hilar tumor in 8 cases, mediastinal lymph nodes and hilar mass cases of bronchoscopy were negative. After CT positioning, 18-20 cm incision needles and aspiration needles were removed from the anterior (19 cases) or posterior (15 cases) chest by the vital organs. The number of punctures was 1 ~ 3 times for histology or aspiration cytology . Results 32 cases of a clear diagnosis, the positive rate of 94%. A small amount of pneumothorax was found in 4 of 34 patients (12%), both self-absorbed and 2/34 patients (6%) having a small amount of bleeding in the lungs. This group of bronchoscopy negative hilar and near mediastinal lung cancer with small cell lung cancer (11/15). Conclusion CT guided biopsy has important value for the hilar mass in the mediastinum and bronchoscopy, which is safe and reliable. Aspiration biopsy in the thymus area is helpful to improve the positive rate