增强CT三维立体定位技术引导经皮肺穿刺的临床应用价值

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英文篇名：Application value of enhanced CT three dimensional stereotaxic technique in percutaneous puncture biopsy 作者：陈家飞 ; 黎川 ; 江开航 英文作者：CHEN Jia-fei;LI Chuan;JIANG Kai-hang;Department of Radiology,First Hospital Affiliated to Army Medical University;Department of Radiology,Fifth People's Hospital of Chongqing; 关键词：经皮穿刺 ; 增强CT ; 平扫CT ; 三维立体定位技术 英文关键词：percutaneous puncture;;enahanced CT;;flat scan CT;;three dimensional stereotaxic technique 中文刊名：JJXZ 英文刊名：Journal of Regional Anatomy and Operative Surgery 机构：陆军军医大学第一附属医院放射科;重庆市第五人民医院放射科; 出版日期：2018-12-25 出版单位：局解手术学杂志 年：2018 期：v.27;No.157 基金：重庆市科学技术委员会重庆市社会事业与民生保障科技创新专项(cstc2016shms-ztzx10002);; 军事医学与战创伤救治临床新技术计划(SWH2016YSCXYB-12) 语种：中文; 页：JJXZ201812003 页数：4 CN：12 ISSN：50-1162/R 分类号：17-20

摘要

目的探讨增强CT三维立体定位技术引导经皮肺穿刺的临床价值。方法回顾性分析33例接受平扫CT引导下经皮肺穿刺活检(平扫CT组)和33例接受增强CT三维立体定位技术引导穿刺(增强CT组)患者的临床资料。增强CT组薄层体积扫描数据经MPR技术处理,确定穿刺点、穿刺角度,避开血管等重要器官,以肺内病灶实质部位为穿刺目标。对比分析2组患者一次穿刺活检成功率、穿刺过程中CT扫描次数、病理阳性率、穿刺时间、并发症发生率。结果 2组患者均穿刺成功。平扫CT组患者一次穿刺成功率明显低于增强CT组,差异具有统计学意义(χ2=10. 395,P=0. 001)。平扫CT组穿刺过程中CT扫描次数明显多于增强CT组(t=-4. 713,P <0. 01)。平扫CT组穿刺时间明显多于增强CT组(t=-8. 726,P <0. 01)。平扫CT组病理阳性率低于增强CT组(t=4. 227,P=0. 04)。2组术后并发症发生率差异无统计学意义(P> 0. 05)。结论多层螺旋CT增强三维立体定位技术引导经皮肺穿刺可全方位、多角度定位病灶,优化穿刺路径,提高穿刺效率,减少穿刺、扫描次数,安全性较高。
        Objective To evaluate the clinical value of enhanced CT three dimensional stereotaxic technique for guiding percutaneous puncture biopsy. Methods A retrospective study was performed on 33 cases of flat scan CT guided percutaneous puncture biopsy( the flat scan CT group) and 33 cases of enhanced CT 3 D stereotaxic technique guided percutaneous puncture biopsy( the enhanced CT group). The scanning data of the enhanced CT group were processed by MPR technique to determine the puncture point and angle,and to avoid the important organs such as blood vessel,and set the intrapulmonary lesion parenchyma as the puncture target. The success rate of single puncture biopsy,number of CT scanning during the puncture,pathological positive rate,puncture time and complication rate of the two groups were compared and analyzed. Results Patients of the two groups were successfully punctured. The success rate of single puncture biopsy in the flat scan CT group was lower than that of the enhanced CT gfroup,and the difference was statistically significant( χ2= 10. 395,P = 0. 001). The number of CT scanning in the flat scan CT group was significantly more than that in the enhanced CT group( t =-4. 713,P < 0. 01). The puncture time of the flat scan CT group was significantly more than that of the enhanced CT group( t =-8. 726,P < 0. 01). The positive rate of pathology in the flat scan CT group was lower than that in the enhanced CT group( t = 4. 227,P = 0. 04). There was no significant difference in the incidence of postoperative complications between the two groups( P > 0. 05). Conclusion Multi-slice spiral CT three dimensional stereotaxic technique for guiding percutaneous puncture biopsy can be all-round and multi-angle,which could optimize the puncture path,improve the puncture efficiency,and reduce the puncture and scanning times with high safety.

引文

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