Computed Tomography-Guided Percutaneous Needle Biopsy of Indeterminate Pulmonary Pathology: Efficacy of Obtaining a Diagnostic Sample in Immunocompetent and Immunocompromised Patients
Computed Tomography-Guided Percutaneous Needle Biopsy of Indeterminate Pulmonary Pathology: Efficacy of Obtaining a Diagnostic Sample in Immunocompetent and Immunocompromised Patients
复制标题
DOI：
10.3816/clc.2010.n.032
复制
发表时间：
2010-07-01
影响因子：
3.6
通讯作者：
Hofmann, Lawrence V.
中科院分区：
文献类型：
--
作者：
Kothary, Nishita;Bartos, Jason A.;Hofmann, Lawrence V.
目的：我们的目的是评估计算机断层扫描的有效性（CD引导下经皮肺穿刺活检对具有感染或炎症等恶性和非恶性病变风险的患者中具有不确定放射学特征的肺结节的诊断价值。年龄范围18-92岁）的患者进行CT引导下经皮肺活检，包括临床病史和影像学表现不一致的患者或免疫功能低下的患者。结果：在整个队列中，166例（63.4%）有非恶性过程，96例（36.6%）有恶性过程。CT引导下经皮肺活检确诊166例（63.4%）。在166例非恶性病因患者和96例恶性病因患者中，分别有91例（54.8%）和75例（78.1%）明确诊断，差异有统计学意义（P = .0001）。免疫功能正常和免疫功能低下患者之间的总体诊断效率相当（P = .2）;然而，与恶性肿瘤检测相比，单个组中感染或炎症的检测较低（分别为P = 0.02和P = .06）。结论：CT引导下经皮肺活检在临床上同时存在非恶性和恶性病变风险的患者中仍然是一个挑战。尽管CT引导下经皮肺活检可以对大多数恶性肿瘤患者进行准确诊断，但对感染或炎症病变的敏感性明显降低
Purpose: We aimed to evaluate the efficacy of computed tomography (CD-guided percutaneous lung biopsy of pulmonary nodules with indeterminate radiologic characteristics in patients at risk for malignant and nonmalignant processes such as infection or inflammation Patients and Methods: From January 2003 to September 2008, 262 patients (mean age, 59 years; range, 18-92 years) with pulmonary nodules or a mass of uncertain etiology and with indeterminate radiologic characteristics underwent CT-guided percutaneous lung biopsy Patients with discordant clinical history and imaging findings or immunocompromised patients at risk for both etiologies were included. Specimens were submitted for both cytology and microbiology Results: Of the entire cohort, 166 patients (63.4%) had a nonmalignant process, and 96 patients (36 6%) had a malignancy. CT-guided percutaneous lung biopsy established a diagnosis in 166 patients (63.4%) Of the 166 patients with a nonmalignant etiology and 96 patients with malignancy, it provided a definitive diagnosis in 91 patients (54 8%) and 75 patients (78 1%), respectively, a difference that was statistically significant (P = .0001). Overall diagnostic efficacy between immunocompetent and immunocompromised patients was comparable (P = .2); however, detection of infection or inflammation in individual groups was lower compared with detection of malignancy (P = 002 and P = .06, respectively). Conclusion: CT-guided percutaneous lung biopsy in patients who are clinically at risk for both nonmalignant and malignant processes continues to be a challenge Although CT-guided percutaneous biopsy can establish an accurate diagnosis in a large majority of patients with malignancy, it is significantly less sensitive for infectious or inflammatory processes