Diagnostic Value of CT-Guided Percutaneous Lung Biopsy in Pulmonary Diseases_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

XiSuya ^1,2 ,  XuYu ¹ , GaoZhancheng ¹

1. Department of Respiratory and Critical Care Medicine，Peking University People’s Hospital，Beijing，100044，China;
2. ;

Corresponding?author：

XuYu, Email: lizard_xy@163.com

Keywords：

CT-guided percutaneous lung biopsy; Histopathology; Tissue culture

DOI：

10.7507/1671-6205.2016113

Video：

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Objective To evaluate the diagnostic value of computer tomography (CT)-guided percutaneous lung biopsy and tissue culture in pulmonary diseases. Methods After the preoperative evaluation, 48 patients underwent CT-guided percutaneous lung biopsy were analyzed, and 16 patients accepted tissue culture. The clinical significance of combined diagnostic rate of histopathology and tissue culture was investigated. Results All patients were punctured successfully. The pathological diagnosis confirmed 26 (54.2%) cases with malignant lesions and 16 (33.3%) cases with benign lesions. Six cases could not be pathological diagnosed. The pathological diagnostic rate was 87.5%. Sixteen patients accepted tissue culture. Among them 3 cases with benign lesions were cultured. The positive rate of tissue culture was 18.8%, and improved to 30.0% in the patients with benign lesion. The combined diagnostic rate of histopathology and tissue culture was 89.6%. In addition, the accuracy rate of pathological diagnosis in the group of lung nodules was 95.0%, higher than the others. The accuracy rate of pathological diagnosis in lung nodules of 2cm~3cm in diameter was 100.0%, and the positive rate of tissue culture in lung lump of 3cm~5cm in diameter was 25.0%. The incidence of pneumothorax and hemorrhage was 14.6%. Conclusions CT-guided percutaneous lung biopsy is a safe and effective diagnostic method. For pulmonary infectious diseases, combination of CT-guided percutaneous lung biopsy and tissue culture can improve the early diagnostic rate.

Citation： Xi Suya, Xu Yu, Gao Zhancheng. Diagnostic Value of CT-Guided Percutaneous Lung Biopsy in Pulmonary Diseases. Chinese Journal of Respiratory and Critical Care Medicine, 2016, 15(5): 490-494. doi: 10.7507/1671-6205.2016113 Copy

1.	方林, 華緒柏. CT引導下經皮肺穿刺活檢對肺占位疾病應用分析.中國實用內科雜志, 2013, 33(S1):130-132.
2.	姜曉紅, 羅明興, 李曉玲, 等. 40例CT引導下經皮肺穿刺活檢臨床病理分析.中國呼吸與危重監護雜志, 2007, 6:301-302.
3.	張春芳, 印洪林, 陸珍鳳, 等.642例CT引導下經皮肺穿刺活檢病理診斷分析.臨床與試驗病理學雜志, 2011, 27:376-379.
4.	Yang W, Sun W, Li Q, et al. Diagnostic accuracy of CT-guided transthoracic needle biopsy for solitary pulmonary nodules. PLoS One, 2015, 10:e0131373.
5.	Cardoso LV, Souza Júnior AS. Clinical application of CT and CT-guided percutaneous transthoracic needle biopsy in patients with indeterminate pulmonary nodules.J Bras Pneumol, 2014, 40:380-388.
6.	馬玙.肺結核與肺癌.中國實用內科雜志, 2015, 35:675-678.
7.	孟家曉, 李品林, 王建華, 等.經皮肺穿刺活檢+組織培養在菌陰肺結核診斷中的價值.影像診斷與介入放射學, 2013, 22:177-180.
8.	燕軍, 李吉臣, 張西嶺, 等. CT引導下肺組織穿刺活檢病理檢查聯合組織培養診斷特殊類型肺炎的價值.中華實用診斷與治療雜志, 2015, 29:660-661.
9.	趙罡, 史曉寶, 盧再鳴, 等. CT引導下肺內直徑小于等于30mm以下結節穿刺活檢:探討穿刺活檢準確率的影響因素及其安全性.中國臨床醫學影像雜志, 2015, 26:391-394.
10.	Yamagami T, Iida S, Kato T, et al. Combining fine-needle aspiration and core biopsy under CT fluoroscopy guidance:a better way to treat patients with lung nodules? Am J Roentgenol, 2003, 180:811-815.
11.	張磊, 莊平, 張晉, 等. CT引導下經皮肺活檢術診斷正確率及并發癥的影響因素.臨床腫瘤學雜志, 2011, 16:342-345.
12.	Hung WH, Chang CC, Ho SY, et al. Systemic air embolism causing acute stroke and myocardial infarction after percutaneous transthoracic lung biopsy-a case report. J Cardiothorac Surg, 2015, 10:121-123.
13.	倪穎夢, 時國朝, 萬歡英, 等. CT引導下經皮肺穿刺的安全性及其影響因素.中國呼吸與危重監護雜志, 2011, 10:162-167.
14.	Khan MF, Straub R, Moghaddam SR, et al. Variables affecting the risk of pneumothorax and intrapulmonal hemorrhage in CT-guided transthoracic biopsy. Eur Radiol, 2008, 18:1356-1363.

1. 方林, 華緒柏. CT引導下經皮肺穿刺活檢對肺占位疾病應用分析.中國實用內科雜志, 2013, 33(S1):130-132.
2. 姜曉紅, 羅明興, 李曉玲, 等. 40例CT引導下經皮肺穿刺活檢臨床病理分析.中國呼吸與危重監護雜志, 2007, 6:301-302.
3. 張春芳, 印洪林, 陸珍鳳, 等.642例CT引導下經皮肺穿刺活檢病理診斷分析.臨床與試驗病理學雜志, 2011, 27:376-379.
4. Yang W, Sun W, Li Q, et al. Diagnostic accuracy of CT-guided transthoracic needle biopsy for solitary pulmonary nodules. PLoS One, 2015, 10:e0131373.
5. Cardoso LV, Souza Júnior AS. Clinical application of CT and CT-guided percutaneous transthoracic needle biopsy in patients with indeterminate pulmonary nodules.J Bras Pneumol, 2014, 40:380-388.
6. 馬玙.肺結核與肺癌.中國實用內科雜志, 2015, 35:675-678.
7. 孟家曉, 李品林, 王建華, 等.經皮肺穿刺活檢+組織培養在菌陰肺結核診斷中的價值.影像診斷與介入放射學, 2013, 22:177-180.
8. 燕軍, 李吉臣, 張西嶺, 等. CT引導下肺組織穿刺活檢病理檢查聯合組織培養診斷特殊類型肺炎的價值.中華實用診斷與治療雜志, 2015, 29:660-661.
9. 趙罡, 史曉寶, 盧再鳴, 等. CT引導下肺內直徑小于等于30mm以下結節穿刺活檢:探討穿刺活檢準確率的影響因素及其安全性.中國臨床醫學影像雜志, 2015, 26:391-394.
10. Yamagami T, Iida S, Kato T, et al. Combining fine-needle aspiration and core biopsy under CT fluoroscopy guidance:a better way to treat patients with lung nodules? Am J Roentgenol, 2003, 180:811-815.
11. 張磊, 莊平, 張晉, 等. CT引導下經皮肺活檢術診斷正確率及并發癥的影響因素.臨床腫瘤學雜志, 2011, 16:342-345.
12. Hung WH, Chang CC, Ho SY, et al. Systemic air embolism causing acute stroke and myocardial infarction after percutaneous transthoracic lung biopsy-a case report. J Cardiothorac Surg, 2015, 10:121-123.
13. 倪穎夢, 時國朝, 萬歡英, 等. CT引導下經皮肺穿刺的安全性及其影響因素.中國呼吸與危重監護雜志, 2011, 10:162-167.
14. Khan MF, Straub R, Moghaddam SR, et al. Variables affecting the risk of pneumothorax and intrapulmonal hemorrhage in CT-guided transthoracic biopsy. Eur Radiol, 2008, 18:1356-1363.

Chinese Journal of Respiratory and Critical Care Medicine

Diagnostic Value of CT-Guided Percutaneous Lung Biopsy in Pulmonary Diseases

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