特殊体位在CT导引经皮肺穿刺活检术的临床应用研究
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| 时间：2009-02-25 16:47:28 来源： 作者： |
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Study on Clinical Application of CTguided Percutaneous Pencturebiopsy of Pulmonary in Special Posture
Wen Xing,Yan Zhengguang,Di Wei,Xiong Tongsheng,Xiao Lihua,Xiao Zubin
（Department of Radiology,PLA 169th Central Hospital,HengYang 421002,China）
Abstract： Objective To evaluate the clinical role and choice rule and relative effected factor on the success rate in CTguided perculaneous puncture biopsy about special posture.Methods Firtyfour patients with solitary or multiple nodules in lung were performed throughout CTguied percutaneous pencture biopsy,eithor taking bone shelter or locating in the side of the heart and great vessel. Results Lateral or tilting posture was underwent ,according to the nodule in lung located in taking bone shelter or in heart and great vessel;Upface、downface、tilting posture or scanning angle of the CTscanner at 5~200was performed,according to the nodule in lung beneath the rib or vertebra;lateral or upface posture was applied,according to the nodule in lung locating in the sternum;Upface posture and tilted the direction of the scanner at 5~150 was adopted,according to the nodule in the garret of the lung. A couple of arms were chaned for the sake of the suitable posture.Conclusion Special posture is a very helpful way. Nodules in the bone shelter or the side of the heart or great vessel in lung were confirmed,with the help of CTguided percutaneous pencture biopsy.
Key words： lung;biopsy;CTguided;Nodule;tomography
自从CT应用于临床以来，CT导引经皮肺穿刺活检术(Percutaneous puncture biopsy PPB)已广泛开展,对于肺部病变的诊断和鉴别诊断起了关键性的作用[1,2]，但是,对于一些位于肺周边部骨骼庇护区或位于心脏和（或）大血管旁的肺部结节性病变(简称特殊部位病变),采用常规体位则难以完成CT定位PPB或风险极大，限制了CT导引PPB的普遍开展。为此，解决好这个难题成了影像科医师重要课题之一。为了提高CT导引PPB水平，探讨其概念、选用原则、临床应用价值和影响因素，我们通过采用特殊体位对54例肺特殊部位病变行CT导引PPB，效果满意，现报告如下。
1 材料和方法
1.1 一般资料
本组54例患者，均为胸部X线或CT检查显示肺部单发或多发结节影，且不能除外恶性病变，而常规痰细胞学和纤维支气管镜检查不能确诊的患者。特殊部位病变位于肩胛骨庇护区18例，心影、大血管旁17例，肋骨或横突下9例，胸骨后或纵隔病变6例，肺尖部4例。
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