影响CT引导下胸膜病变同轴活检诊断准确率及相关并发症的因素分析

发布时间：2018-11-08 18:52

【摘要】：目的探讨影响CT引导下同轴活检诊断胸膜恶性病变的准确率和相关并发症的因素。方法分析88例接受CT引导下胸膜病变穿刺活检的病例资料,最终诊断结果依据病理诊断或临床随访。采用单因素及多因素分析CT引导下影响穿刺活检诊断胸膜恶性病变的准确率及相关并发症发生的主要因素。结果 88例患者中CT引导下同轴活检诊断胸膜恶性病变56例,良性病变28,性质待定4例;其诊断胸膜恶性病变的准确率、敏感度、特异度分别为89.29%(75/84)、86.15%(56/65)、100%(19/19)。穿刺活检过程中发生气胸14例,单因素分析提示无影响CT引导下胸膜病变同轴活检诊断准确率的相关因素;多因素分析提示穿刺部位病变大小/胸膜厚度是气胸发生的危险因素(OR:8.744),而胸腔积液是气胸发生的保护因素(OR:0.171)。结论 CT引导下胸膜病变同轴活检是相对安全的技术并且诊断准确率较高,值得临床推广应用。
[Abstract]:Objective to investigate the factors influencing the accuracy and complications of CT guided coaxial biopsy in the diagnosis of pleural malignant lesions. Methods 88 cases of pleural lesions underwent biopsy guided by CT were analyzed. The final diagnosis was based on pathological diagnosis or clinical follow-up. Univariate and multivariate analysis was used to analyze the accuracy of CT guided biopsy in the diagnosis of pleural malignant lesions and the main factors related to the occurrence of complications. Results CT guided coaxial biopsy was performed in 56 cases of malignant pleural lesions, 28 cases of benign lesions and 4 cases of undetermined nature. The accuracy, sensitivity and specificity in diagnosing malignant pleural lesions were 89.29% (75 / 84), 86.15% (56 / 65) and 100% (19 / 19), respectively. There were 14 cases of pneumothorax in the process of puncture biopsy. Univariate analysis showed that there were no related factors affecting the diagnostic accuracy of coaxial biopsy of pleural lesions guided by CT. Multivariate analysis showed that the size of puncture site / pleural thickness was the risk factor of pneumothorax (OR:8.744) and pleural effusion was the protective factor (OR:0.171) of pneumothorax. Conclusion CT guided coaxial biopsy of pleural lesions is a relatively safe technique with high diagnostic accuracy and is worthy of clinical application.
【作者单位】：遂宁市中心医院放射影像科;
【分类号】：R734.3;R730.44

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