Diagnostic accuracy and safety of CT-Guided percutaneous needle aspiration biopsy of the lung: Comparison of small and large pulmonary nodules
Diagnostic accuracy and safety of CT-Guided percutaneous needle aspiration biopsy of the lung: Comparison of small and large pulmonary nodules
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DOI：
10.2214/ajr.167.1.8659351
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发表时间：
1996-07-01
影响因子：
5
通讯作者：
McLoud, TC
中科院分区：
文献类型：
--
作者：
Li, HQ;Boiselle, PM;McLoud, TC
OBJECTIVE.本研究的目的是比较直径小于或等于1.5 cm的肺结节与直径大于1.5 cm的肺结节的CT引导下经皮针吸活检的诊断准确性和安全性。我们回顾性分析了连续的97例患者，这些患者接受了CT引导下经皮肺结节针吸活检，然后手术切除（n = 95）或尸检（n = 2）。通过检查CT图像，我们将27个结节分类为小结节（小于或等于1.5 cm），70个结节分类为大结节（>1.5 cm）。通过比较基于活检的细胞学诊断与基于手术或尸检的组织学结果的最终诊断来计算诊断准确性。每个病例都要检查可能的并发症，包括气胸和胸管放置。CT引导下经皮穿刺活检对大结节的诊断准确率为96%。对小结节的诊断准确率为74%，差异有统计学意义（p <0.05）。在我们的人群中，小结节和大结节的气胸患病率几乎相同（分别为22%和21%）。在我们的人群中放置胸管的患病率约为2%。小结节置管率为0%，大结节置管率为3%。CT引导下经皮肺穿刺活检对肺小结节的准确性明显低于对肺大结节的准确性，但两者的并发症发生率均较低。
OBJECTIVE. The purpose of this study was to compare the diagnostic accuracy and safety of CT-guided percutaneous needle aspiration biopsy of pulmonary nodules less than or equal to 1.5 cm in diameter with those of nodules greater than 1.5 cm in diameter.MATERIALS AND METHODS. We retrospectively reviewed a consecutive series of 97 patients who underwent CT-guided percutaneous needle aspiration biopsy of a lung nodule and then surgical resection (n = 95) or autopsy (n = 2). By examining CT images, we classified 27 nodules as small (less than or equal to 1.5 cm) and 70 nodules as large (>1.5 cm). Diagnostic accuracy was calculated by comparing cytologic diagnoses based on biopsy with final diagnoses based on histologic findings from surgery or autopsy. Each case was reviewed for possible complications, including pneumothorax and chest tube placement.RESULTS. The diagnostic accuracy of CT-guided percutaneous needle aspiration biopsy of large nodules was 96%. The diagnostic accuracy for small nodules was 74%, a statistically significant difference (p < .05). The prevalences of pneumothorax in our population were nearly identical for small and large nodules (22 and 21%, respectively). The prevalence of chest tube placement in our population was approximately 2%. The prevalences of chest tube placement were 0% for small nodules and 3% for large nodules.CONCLUSION. CT-guided percutaneous needle aspiration biopsy is significantly less accurate for small pulmonary nodules than for large pulmonary nodules, but the complication rates for both are low.