Computed tomography guided needle biopsy: experience from 1,300 procedures
Computed tomography guided needle biopsy: experience from 1,300 procedures
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DOI：
10.1590/s1516-31802006000100003
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发表时间：
2006-02-01
影响因子：
1.4
通讯作者：
Soares, Fernando Augusto
中科院分区：
文献类型：
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作者：
Chojniak, Rubens;Isberner, Rony Klaus;Soares, Fernando Augusto
背景和目的：计算机断层扫描 (CT) 引导活检在许多情况下被广泛认为是有效且安全的诊断方法。准确性取决于目标器官和针类型。切割针比细针具有优势。本研究介绍了在肿瘤中心进行 CT 引导活检的经验。设计和环境：圣保罗癌症 A.C. 卡马戈医院的回顾性研究。方法：对 1994 年 7 月至 2000 年 2 月期间进行的 1,300 例连续 CT 引导活检进行了分析。 845 例 (65%) 病例怀疑结节或肿块为原发性恶性肿瘤，455 例 (35%) 病例怀疑转移性病变。胸部病变 628 个，腹部病变 281 个，腹膜后病变 208 个，肌肉骨骼病变 134 个，头颈部病变 49 个。所有活检均由一名放射科医生或在他的监督下进行：765 例 (59%) 使用 22 号细针/抽吸技术进行，535 例 (41%) 使用自动 16 或 18 号切针活检进行。 结果：70-92% 的细针活检和 93-100% 的切针活检获得了足够的样本。根据活检部位，细针活检的具体诊断率为 54-67%，切针活检的具体诊断率为 82-100%。对于任何部位，切针活检的样本充足性和特异性诊断率总是更好。 530例肺活检中，气胸84例（16%），血胸2例（0.3%），胸腔引流24例（4.9%）。腹部和腹膜后活检中，有2例出现大出血，1例出现腹膜炎。结论：两种穿刺方式均取得满意的结果，但当需要明确诊断且并发症发生率不高时，应采用切针活检。
CONTEXT AND OBJECTIVE: Computed tomography (CT) guided biopsy is widely accepted as effective and safe for diagnosis in many settings. Accuracy depends on target organ and needle type. Cutting needles present advantages over fine needles. This study presents experience from CT guided biopsies performed at an oncology center.DESIGN AND SETTING: Retrospective study at Hospital do Cancer A. C. Camargo, Sao Paulo.METHODS: 1,300 consecutive CT guided biopsies performed between July 1994 and February 2000 were analyzed. Nodules or masses were suspected as primary malignancy in 845 cases (65%) or metastatic lesion in 455 (35%). 628 lesions were thoracic, 281 abdominal, 208 retroperitoneal, 134 musculoskeletal and 49 head/neck. All biopsies were performed by one radiologist or under his supervision: 765 (59%) with 22-gauge fine-needle/aspiration technique and 535 (41%) with automated 16 or 18-gauge cutting-needle biopsy.RESULTS: Adequate samples were obtained in 70-92% of fine-needle and 93-100% of cutting-needle biopsies. The specific diagnosis rates were 54-67% for fine-needle and 82-100% for cutting-needle biopsies, according to biopsy site. For any site, sample adequacy and specific diagnosis rate were always better for cutting-needle biopsy. Among 530 lung biopsies, there were 84 pneumothorax (16%) and two hemothorax (0.3%) cases, with thoracic drainage in 24 (4.9%). Among abdominal and retroperitoneal biopsies, there were two cases of major bleeding and one of peritonitis.CONCLUSION: Both types of needle showed satisfactory results, but cutting-needle biopsy should be used when specific diagnosis is desired without greater incidence of complications.