CT-guided percutaneous fine-needle aspiration biopsy of pulmonary nodules measuring 10 mm or less
CT-guided percutaneous fine-needle aspiration biopsy of pulmonary nodules measuring 10 mm or less
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DOI：
10.1016/j.crad.2007.09.003
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发表时间：
2008-03-01
影响因子：
2.6
通讯作者：
Weisbrod, G.
中科院分区：
文献类型：
--
作者：
Ng, Y. L.;Patsios, D.;Weisbrod, G.
目的：为了确定价值的计算机断层扫描（CT）引导细针穿刺活检（FNAB）的小肺结节测量10 mm或less.MATERIAL和METHODS：CT引导FNAB的55个结节，测量10 mm或更小，在2003年1月和2006年2月之间进行。使用同轴技术，使用外部19 G Bard Truguide活检针和内部22 G一次性格林活检针。由细胞学技术人员现场评估标本的准确性。记录结节的大小、距胸膜的距离、胸膜穿刺和抽吸的次数、遇到的并发症、细胞学诊断和结果。结果：结节平均直径为9 mm（范围5-10 mm）。距肋胸膜的平均距离为31 mm（范围0-88 mm）。在55例FNAB中，有50例穿过胸膜1次。每例平均进行四次抽吸。25例FNAB（45.5%）足以诊断（24例恶性和1例结核）。在11例FNAB后未明确诊断的病例中，结果不受影响。在10个病例中，样本不足以诊断，结节随后被诊断为恶性。8例病例因随访详情不可用而在最终分析中被排除。恶性肿瘤的敏感性和总体准确性分别为67.7%和78.8%。29例（52.7%）患者发生气胸，其中5例（9.1%）需要胸腔穿刺置管。结论：CT引导下FNAB是一种有用的工具。在肺小结节的诊断和治疗中，尽管诊断准确率和并发症发生率均低于肺大病灶。(C)2007年皇家放射科医师学院。由爱思唯尔有限公司出版。保留所有权利。
AIM: To determine the value of computed tomography (CT)-guided fine-needle aspiration biopsy (FNAB) of small pulmonary nodules measuring 10 mm or less.MATERIAL AND METHODS: CT-guided FNABs of 55 nodules, measuring 10 mm or less, were performed between January 2003 and February 2006. A coaxial technique was used, with an outer 19 G Bard Truguide needle and inner 22 G disposable Greene biopsy needle. Adequacy of specimens was assessed on-site by a cytotechnologist. The sizes of the nodules, distance from pleura, number of pleural punctures and aspirates, complications encountered, cytological diagnosis, and outcome were recorded.RESULTS: The mean nodule diameter was 9 mm (range 5-10 mm). The average distance from the costal pleura was 31 mm (range 0-88 mm). In 50 of the 55 FNABs, the pleura was crossed once. An average of four aspirates was performed per case. Twenty-five FNABs (45.5%) were adequate for diagnosis (24 malignant and one tuberculosis). In 11 cases, where no definite diagnosis was made following FNAB, the outcome was not affected. In 10 cases, samples were insufficient for diagnosis and the nodules were subsequently diagnosed as malignant. Eight cases were excluded in the final analysis as follow-up details were unavailable. The sensitivity for malignancy and overall accuracy were 67.7 and 78.8%, respectively. Pneumothorax occurred in 29 (52.7%) patients, with five (9.1%) requiring thoracostomy tubes.CONCLUSION: CT-guided FNAB is a useful tool. in the diagnosis and management of small pulmonary nodules, despite the tower diagnostic accuracy and higher complication rate than those of larger pulmonary lesions. (C) 2007 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.