比较超声与增强CT经皮穿刺混杂密度胸部病变

doi:10.6040/j.issn.1671-7554.0.2021.0871

摘要/Abstract

摘要： 目的经皮穿刺混杂密度胸部病变时,比较超声引导与增强CT引导两种手段间在穿刺成功率、病理诊断符合率、并发症发生率的差异并分析原因。方法收集2015年2月至2020年6月CT显示胸部混杂密度病变328例,CT显示病变内部密度不均,且病变与胸壁相贴,其中超声引导组136例(超声引导穿刺)和增强CT引导组192例(对照术前增强CT引导穿刺),对比两组间穿刺成功率、病理诊断符合率及并发症发生率的差异。结果超声引导组穿刺成功率［94.12%(128/136)］、并发症发生率［8.82%(12/136)］与增强CT引导组穿刺成功率［93.75%(180/192)］、并发症发生率［9.38%(18/192)］差异无统计学意义(P>0.05);超声引导组病理诊断符合率［81.25%(104/128)］低于增强CT组病理诊断符合率［97.78%(176/180)］,差异有统计学意义(χ2=24.73,P<0.001)。结论增强CT引导下经皮穿刺混杂密度胸部病变可识别病变活性区,避开大血管及不张肺,较超声引导下取材更加准确有效。

关键词: 超声, 增强CT, 混杂密度, 胸部病变, 经皮穿刺

Abstract: Objective To compare the differences in puncture success rate, pathological diagnosis compliance rate, and complication rate between ultrasound-guided and enhanced CT-guided means during percutaneous puncture of mixed-density chest lesions, and to analyze the causes. Methods From February 2015 to June 2020, a total of 328 cases with CT-displayed mixed-density lesions in the chest were enrolled. CT showed uneven density inside the lesions, which were adjacent to the chest wall. The cases received ultrasound-guided puncture(the ultrasound group, n=136)or control preoperative enhanced CT-guided puncture(the enhanced CT group, n=192). The differences in the rates of successful puncture, compliant pathological diagnosis and complications between the two groups were compared. Results There was no statistical difference between puncture success rates of the ultrasound group and enhanced CT group ［94.12%(128/136)vs 93.75%(180/192), P>0.05］. Also, there was no statistical differences between complication rates of the two groups ［8.82%(12/136)vs 9.38%(18/192), P>0.05］. While, the pathological diagnosis compliance rate of the ultrasound group ［81.25%(104/128)］ was lower than that of the enhanced CT group ［97.78%(176/180)］ with the statistical difference(χ2=24.73,P<0.001). Conclusion Enhanced CT-guided percutaneous puncture of mixed-density thoracic lesions is more accurate and effective than ultrasound-guided sampling by identifying the active zone of the lesion and avoiding large vessels and non-distended lungs.

Key words: Ultrasound, Enhanced CT, Mixed density, Thoracic lesion, Percutaneous puncture

中图分类号:

R445

董亮,崔文超,周青,张龙云,周炜,张欣,赵超. 比较超声与增强CT经皮穿刺混杂密度胸部病变[J]. 山东大学学报 (医学版), 2022, 60(5): 98-103.

DONG Liang, CUI Wenchao, ZHOU Qing, ZHANG Longyun, ZHOU Wei, ZHANG Xin, ZHAO Chao. Comparison of ultrasound and enhanced CT percutaneous puncture of mixed density chest lesions[J]. Journal of Shandong University (Health Sciences), 2022, 60(5): 98-103.

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