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目的 比较螺旋CT Pinpoint立体定位激光导引系统与普通CT在引导穿刺、活检中的临床应用价值。方法 选择 2组共 112例经螺旋或常规CT难以确诊的胸、腹部局限性肿块患者 (每组5 6例 ) ,分别在Pinpoint立体定位系统或常规CT导引设备下行穿刺取活检 ,将其 1次进针成功率、重复穿刺率及穿刺精确度分级进行 χ2 检验和Ridit等级对照研究。结果 立体定位组 1次进针成功率为 6 6 0 7% (37/5 6 ) ,普通CT组为 35 71% (2 0 /5 6 ) (χ2 =10 3,P <0 0 0 5 )。重复进针率立体定位组为12 5 0 % (7/5 6 ) ,普通CT组为 30 36 % (17/5 6 ) (χ2 =5 3,P <0 0 2 5 )。穿刺精确度的Ridit对照研究结果为 ,∑f1R =2 2 94 ,∑f2 R =31 35 ,R1=0 4 0 96 (立体定位组 ) ,R2 =0 5 5 98(普通CT组 ) (U =3 2 4 >1 96 ,P <0 0 5 ) ,2组间差异有显著性意义。结论 Pinpoint三维立体激光定位系统是 1种超选择性无辐射性导引技术 ,能有效地增加穿刺的精确度和安全性 ,同时对提高临床诊断、治疗水平等方面比普通CT更具使用价值。
Objective To compare the clinical value of spiral CT pinpoint stereotactic laser guidance system and general CT in guiding puncture and biopsy. Methods A total of 112 patients with localized thoracic and abdominal masses (56 cases in each group) who were difficult to diagnose by spiral CT or conventional CT were selected and biopsied by Pinpoint stereotactic system or conventional CT guidance equipment respectively. Secondary needle success rate, repeat puncture rate and puncture accuracy grade χ2 test and Ridit level control study. Results The success rate of primary needle injection in stereotaxic group was 66.07% (37/5 6), that of common CT group was 35 71% (20/56) (χ2 = 10 3, P 0 05) . The rate of repeat needle approach was 135% (7/5 6) in stereotactic group and 30 36% (17/5 6) in normal CT group (χ2 = 53, P <0 025). The results of the Ridit-control study of puncture accuracy were Σf1R = 2 2 94, Σf2 R = 31 35, R1 = 0 4 0 96 (stereotaxic group), R2 = 0 5 5 98 (normal CT group) 3 2 4> 1 96, P 0 05). There was significant difference between the two groups. Conclusion Pinpoint three-dimensional laser positioning system is a super-selective non-radiation guided technology that can effectively increase the accuracy and safety of puncture, while improving the clinical diagnosis and treatment of more than ordinary CT more value.