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目的探讨DSA实时引导及LCI三维重建在经皮肺穿刺活检中的临床应用价值。方法应用DSA实时引导及LCI三维重建技术确定穿刺点及穿刺针与肺结节的空间关系,采用18G活检针(美国COOK公司)摄取活组织。所有穿刺组织作细胞学及组织学检查,部分加作免疫组化检查。全部病例的诊断经手术或病理得到证实。结果本组46例病灶,其中鳞癌10例,腺癌22例,小细胞癌4例,干酪样坏死3例,炎性假瘤2例,肝转移瘤2例,肺纤维组织增生2例,间皮瘤1例。穿刺活检阳性率为97.8%(45/46)。术后患者发生气胸3例,占6.5%(3/46);痰中带血3例,少量咯血1例,占8.7%(4/46),未发生血胸、感染等情况。结论 DSA实时引导及LCI三维重建在经皮肺穿刺活检中定位准确、操作简单、安全性高,肺内小结节检出率高,肺占位病变诊断方面应用前景广泛。
Objective To investigate the clinical value of DSA real-time guidance and LCI three-dimensional reconstruction in percutaneous pulmonary biopsy. Methods DSA real-time guidance and LCI three-dimensional reconstruction techniques were used to determine the spatial relationship between the puncture point and the puncture needle and pulmonary nodules. The 18G biopsy needle (American COOK Company) was used to ingest the living tissue. All puncture tissue cytology and histology, some plus for immunohistochemistry. The diagnosis of all cases was confirmed by surgery or pathology. Results 46 cases of this group of lesions, including 10 cases of squamous cell carcinoma, 22 cases of adenocarcinoma, small cell carcinoma in 4 cases, 3 cases of caseous necrosis, 2 inflammatory pseudotumor, liver metastases in 2 cases, 2 cases of pulmonary fibrosis, Mesothelioma in 1 case. The positive rate of biopsy was 97.8% (45/46). Postoperative pneumothorax occurred in 3 cases, accounting for 6.5% (3/46); sputum blood in 3 cases, a small amount of hemoptysis in 1 case, accounting for 8.7% (4/46), no hemothorax, infection and so on. Conclusion DSA real-time guidance and LCI three-dimensional reconstruction in percutaneous lung biopsy accurate positioning, simple operation, high safety, high detection rate of pulmonary nodules, lung space-occupying lesions in the diagnosis of a wide range of applications.