摘要
目的观察CT引导下热消融肺结节联合术中即时活检的可行性。方法回顾性分析331例接受CT引导下经皮肺穿刺活检和/或热消融肺结节患者的资料,共373个病灶。其中102例(102个病灶)仅接受CT引导下经皮肺穿刺活检(单纯活检组),132例(174个病灶)仅接受CT引导下热消融(单纯消融组),97例(97个病灶)接受CT引导下热消融联合术中即时活检(消融联合活检组)。计算技术成功率,记录并发症;评价活检标本病理诊断阳性率(所取组织标本可获得明确病理诊断判定为阳性)及基因检测标本质量。结果对331例均顺利完成操作,技术成功率为100%(331/331)。单纯活检组术后6例(6/102,5.88%)咯血,单纯消融组及消融联合活检组术中及术后均未见咯血。单纯活检组5例、单纯消融组11例、消融联合活检组13例发生气胸,3组间差异无统计学意义(P=0.10);均予CT引导下经皮置管引流。单纯活检组活检组织病理诊断阳性率为73.53%(75/102),消融联合活检组为82.47%(80/97),组间差异无统计学意义(P=0.13)。消融联合活检组共16例接受基因检测分析,活检组织标本均达到质控合格标准。结论CT引导下热消融肺结节联合术中活检可行,可降低出血发生风险,且能满足病理检查及基因检测要求。
Objective To observe the feasibility of CT-guided thermal ablation combined with immediate intraoperative biopsy of pulmonary nodules.Methods Data of 331 pulmonary nodules patients who underwent CT-guided percutaneous lung biopsy and/or thermal ablation with totally 373 lesions were retrospectively analyzed,including 102 patients(102 lesions)underwent only CT-guided percutaneous lung biopsy(biopsy group),132(174 lesions)underwent only CT-guided thermal ablation(ablation group)and 97 patients(97 lesions)underwent CT-guided thermal ablation combined with biopsy(ablation combined with biopsy group).The success rate of operation and complications were counted,and the positive rate of pathological diagnosis of biopsy specimens(the obtained samples were judged as positive when met the requirements of definite pathological diagnosis),and the quality of samples accepted genetic testing were evaluated.Results The operations were performed successfully in all 331 cases,and the technical success rate was 100%(331/331).Postoperative hemoptysis was observed in 6 cases(6/102,5.88%)in biopsy group,but not in the other 2 groups.Pneumothorax requiring CT-guided percutaneous catheter drainage was found in 5 cases in biopsy group,11 in ablation group and 13 cases in ablation combined with biopsy group.No significant difference was found among 3 groups(P=0.10).The positive rate of pathological diagnosis was 73.53%(75/102)in biopsy group and 82.47%(80/97)in ablation combined biopsy group,no significant difference was found between the two groups(P=0.13).Sixteen patients in ablation combined with biopsy group underwent gene testing,and all samples reached the qualified quality control standards.Conclusion CT-guided pulmonary nodular thermal ablation combined with intraoperative biopsy was feasible,which could reduce the risk of bleeding and meet the requirements of pathological examination and gene testing.
作者
郭兰坤
肖越勇
魏颖恬
张肖
张啸波
孟亮亮
杨杰
薛晓东
GUO Lankun;XIAO Yueyong;WEI Yingtian;ZHANG Xiao;ZHANG Xiaobo;MENG Liangliang;YANG Jie;XUE Xiaodong(Department of Radiology, the First Medical Center, PLA General Hospital, Beijing 100853, China;Department of Medical Imaging, Hospital of Beijing Armed Police Force, Beijing 100027, China)
出处
《中国介入影像与治疗学》
北大核心
2022年第3期129-133,共5页
Chinese Journal of Interventional Imaging and Therapy
基金
国家自然科学基金面上项目(81771941)。
