Transthoracic CT-guided biopsy with multiplanar reconstruction image improves diagnostic accuracy of solitary pulmonary nodules
Transthoracic CT-guided biopsy with multiplanar reconstruction image improves diagnostic accuracy of solitary pulmonary nodules
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DOI：
10.1016/s0720-048x(03)00216-x
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发表时间：
2004-08-01
影响因子：
3.3
通讯作者：
Sugimura, K
中科院分区：
文献类型：
--
作者：
Ohno, Y;Hatabu, H;Sugimura, K
目的：探讨多平面重建（MPR）图像在ct引导下活检中的应用价值，探讨影响气胸诊断准确性和气胸发生率的因素。材料与方法：390例肺结节396例，分别行经胸ct引导下穿刺活检（TNAB）和经胸ct引导下切针穿刺活检（TCNB），其中孤立性肺结节250例行常规ct引导活检（常规方法），81例行ct透视活检（ct透视法），65例行常规ct引导下联合MPR成像活检（MPR法）。比较两种方法的成功率、总体诊断准确率、气胸发生率及总手术时间。对影响ct引导下活检诊断准确性和气胸发生率的因素进行统计学评价。结果：MPR的成功率（TNAB: 100.0%, TCNB: 100.0%）和总体诊断准确率（TNAB: 96.9%, TCNB: 97.0%）显著高于常规方法（TNAB: 87.6和82.4%,TCNB: 86.3和81.3%）（P < 0.05）。活检方法、病变大小和针径长度对诊断准确性有影响（P < 0.05）。病理诊断方法、病灶大小、穿刺次数及FEV1.0%对气胸发生率有显著影响（P < 0.05）。结论：在ct引导下使用MPR进行肺活检有助于提高诊断准确性，且无明显增加气胸发生率或总手术时间。2003爱思唯尔爱尔兰有限公司版权所有。
Objective: To evaluate the utility of multiplanar reconstruction (MPR) image for CT-guided biopsy and determine factors of influencing diagnostic accuracy and the pneumothorax rate. Materials and methods: 390 patients with 396 pulmonary nodules underwent transthoracic CT-guided aspiration biopsy (TNAB) and transthoracic CT-guided cutting needle core biopsy (TCNB) as follows: 250 solitary pulmonary nodules (SPNs) underwent conventional CT-guided biopsy (conventional method), 81 underwent CT-fluoroscopic biopsy (CT-fluoroscopic method) and 65 underwent conventional CT-guided biopsy in combination with MPR image (MPR method). Success rate, overall diagnostic accuracy, pneumothorax rate and total procedure time were compared in each method. Factors affecting diagnostic accuracy and pneumothorax rate of CT-guided biopsy were statistically evaluated. Results: Success rates (TNAB: 100.0%, TCNB: 100.0%) and overall diagnostic accuracies (TNAB: 96.9%, TCNB: 97.0%) of MPR were significantly higher than those using the conventional method (TNAB: 87.6 and 82.4%, TCNB: 86.3 and 81.3%) (P < 0.05). Diagnostic accuracy were influenced by biopsy method, lesion size, and needle path length (P < 0.05). Pneumothorax rate was influenced by pathological diagnostic method, lesion size, number of punctures and FEV1.0% (P < 0.05). Conclusion: The use of MPR for CT-guided lung biopsy is useful for improving diagnostic accuracy with no significant increase in pneumothorax rate or total procedure time. (C) 2003 Elsevier Ireland Ltd. All rights reserved.