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Objective:To compare the clinical value of contrast-enhanced ultrasound (CEUS) - and CT-guided percutaneous puncture biopsy in the diagnosis of peripheral lung masses.Methods:The clinical data of 90 patients with peripheral lung masses who underwent puncture biopsy in Tumor Hospital Affiliated to Nantong University from October 2019 to December 2021 were retrospectively analyzed. According to different puncture guidance methods, patients were divided into CEUS-guided percutaneous puncture biopsy group (CEUS group, n=40) and the CT-guided percutaneous puncture biopsy group (CT group, n=50) , and the differences in puncture success rates, complication rates and other factors between the two groups were evaluated. Meanwhile, the correlations between microvascular density (MVD) and CEUS parameters were detected. Results:The puncture success rate in the CEUS group was higher than that in the CT group, but there was no statistically significant difference [97.5% (39/40) vs. 92.0% (46/50) , P=0.337], and the complication rate in the CEUS group was significantly lower than that in the CT group [0 (0/40) vs. 12.0% (6/50) , P=0.032]. Compared with the CT group, the CEUS group has fewer punctures [ (2.0±1.6) times vs. (2.8±1.2) times, t=-2.43, P=0.018], shorter duration [ (7.6±2.5) min vs. (15.3±2.6) min, t=-8.86, P<0.001] and lower cost of surgery [ (1 308.4±545.6) yuan vs. (2 046.4±645.3) yuan, t=-2.01, P=0.046]. The MVD, CEUS peak intensity and enhancement index of lung adenocarcinoma were higher than those of squamous cell carcinoma [ (25.4±4.9) /HP) vs. (16.6±7.3) /HP, t=3.43, P=0.002; (46.9±6.5) db vs. (36.8±5.4) db, t=4.12, P<0.001; 5.2±1.4 vs. 4.1±1.2, t=3.27, P=0.006]. The peak intensity and intensity index of CEUS in lung adenocarcinoma or squamous cell carcinoma were positively correlated with itself MVD (squamous cell carcinoma: r=0.66, P<0.001; r=0.56, P<0.001; adenocarcinoma: r=0.62, P<0.001; r=0.70, P<0.001) . Conclusion:Although CEUS-guided percutaneous puncture biopsy does not achieve a higher puncture success rate in the diagnosis of peripheral lung masses compared to CT, it really decreases the complication rate, and has the advantages of less time, low cost, no radiation and real-time dynamic monitoring, which is worth promoting in clinic. Moreover, there are correlations between CEUS quantitative parameters of adenocarcinoma and squamous cell carcinoma of the lung and MVD, which may be useful for diagnosis.
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Wegener' granulomatosis is an autoimmune diseases, often involving the lung and kidney, has a high mortality rate in nontreatment patients. The low incidence and nonspecific features, often lead to misdiagnosis and delayed treatment. This paper reported the diagnosis and treatment of a 55-year-old female patient with primary Wegener' granuloma of the lung diagnosed by percutaneous lung biopsy of pulmonary nodules, and reviews the relevant literature. .
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Female , Humans , Middle Aged , Granulomatosis with Polyangiitis/drug therapy , Lung Neoplasms , PneumoniaABSTRACT
BACKGROUND@#To investigate the diagnostic significance of percutaneous lung puncture for solid pulmonary nodules (diameter ≤15 mm).@*METHODS@#This study retrospectively included 20 patients with solid pulmonary nodules who underwent percutaneous puncture from January 2014 to December 2018, including 11 males and 9 females. The diameter of the lesion is between 0.5 cm-1.5 cm, excluding severe organ dysfunction, and patients with coagulopathy.@*RESULTS@#All 20 patients were successfully selected, and 19 patients were diagnosed with pathological diagnosis. Among them, 11 patients found malignant tumor cells, which were clearly malignant tumors of the lungs, 5 cases of chronic inflammation of the lungs, 2 cases of fibrous tissue hyperplasia, and 1 case of lung cartilage tissue, no tumor cells were found in 1 case. One patient with a small amount of pneumothorax after puncture and one patient with a small amount of pleural effusion on the puncturesite.@*CONCLUSIONS@#Percutaneous lung puncture has a high effectiveness and safety for the diagnosis of solid pulmonary nodules.
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Objective@#To investigate the safety and influencing factors of ct-guided percutaneous lung biopsy in pneumoconiosis patients.@*Methods@#The data of 63 patients with pneumoconiosis who underwent ct-guided percutaneous lung biopsy in our hospital were studied to analyze the incidence of complications and influencing factors of percutaneous lung biopsy.@*Results@#63 cases of pneumoconiosis patients received CT guided percutaneous lung biopsy. There were 29 cases of complications (46.03%) , including 20 pneumothorax (37.75%) , 12 bleeding (19.05%) , and 3 cases of liquid pneumothorax (4.76%) . The single factor chi square analysis showed that there were significant differences in age, depth of focus, puncture position and puncture times (P<0.05) , and there was significant difference between the occurrence of hemorrhage and age, type of focus, size of focus, and the location of puncture site (P<0.05) . The unconditional LogisticL multiple factor regression analysis showed that the depth of the lesion was an independent risk factor for concurrency pneumothorax, and the size of the lesion was an independent risk factor for bleeding.@*Conclusion@#Complications of CT-guided percutaneous pulmonary biopsy are mainly pneumothorax and hemorrhage. Age, focus type, focus size, focus depth, puncture site, and puncture times are all the factors of complications.
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Objective To investigate the efficiency and application value of CT-guided percutaneous puncture biopsy in the diagnosis of lung disease.Methods The clinical and imaging data of 60 patients with CT-guided percutaneous lung biopsy were analyzed retrospectively.Results Among all the 60 patients, 57 had finally to be proved by pathological diagnosis, including 47 primary lung cancer (21 squamous cell carcinoma, 18 adenocarcinoma, 3 small cell lung cancer and 5 bronchioloalveolar carcinoma), 7 metastatic lung cancer and 3 tuberculosis.In addition, 3 cases were chronic inflammation and did not make a definite diagnosis, in which 2 were proved to be caseous pneumonia and 1 was proved to be fungus infection by postoperative pathology.The successful rate of punctures,the diagnostic accuracy and the total complications rate of lung puncture biopsy in 60 cases was 100%, 95.0% and 21.7% [11.7% pneumothorax (7/60), 8.3% hemoptysis (5/60) and 1.7% needle bleeding(1/60)].Conclusion CT-guided percutaneous puncture biopsy is a safe, accurate and significant clinical method in the diagnosis and differential diagnosis of lung lesions.
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Purpose To study the cytopathologic features of CT-guided percutaneous lung biopsy samples and to evaluate the role of cytopathology in the diagnosis and staging of lung carcinomas, as compared to histopathology. Methods Four-hundred twenty-five specimens were collected by CT-guided percutaneous lung biopsy which were also confirmed by histological diagnosis. Direct smears were performed for each case. Cytological and histological examination was carried out. Results The sensitivity, specificity, false positive rate, false negative rate and accuracy of cytopathology in diagnosing lung carcinomas by CT-guided percutaneous lung biopsy was 86. 6% (264/305), 100% (120/120), 0 (0/120), 13. 4% (41/305), 90. 4% (384/425), respectively. Overall 51. 1%(135/264) of the cases were precisely typed, including 77. 6% (83/107) of adenocarcinoma, 76. 9% (40/52) of squamous cell car-cinoma and 75. 0% (9/12) of small cell carcinoma. Conclusions Cytopathology of CT-guided percutaneous lung biopsy specimens is sensitive and accurate for diagnosing pulmonary carcinomas. In some cases, the lung carcinoma can be precisely typed. Therefore, it is useful for diagnosing and staging lung carcinomas.
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No abstract available.
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Aged , Humans , Male , Abscess/diagnosis , Anti-Bacterial Agents/therapeutic use , Biopsy, Needle/adverse effects , Drainage , Gram-Positive Bacterial Infections/diagnosis , Image-Guided Biopsy/adverse effects , Lung/pathology , Peptostreptococcus/isolation & purification , Thoracic Wall/microbiology , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Objective To discuss the clinical value of improved percutaneous lung biopsy under CT guidance.Methods Reviewed the clinical data of 80 cases of improved percutaneous lung biopsy under CT guidance,which were confirmed by surgery or pathology.When took the operation,18 G semi-automatic cutting biopsy needle (made in American Cook's company) was used to improve the ways of positioning scan,two-step method of insert the needle,and the cutting technique of coaxial in each direction.Results All of the 80 patients were successfully completed pathological biopsy,successful rate was 100.0％ (80/80),and diagnosis rate was 98.8％ (79/80),incidence of complication was 10.0 ％ (8/80),all of these patients were recovered after treatment 2-5 d.Conclusion The method of improved percutaneous lung biopsy under CT guidance is safe,effective,simple and practical,which has high successful rate and low complication rate,the generalizability is certain.
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Objective To investigate the CT imaging features of pneumonic type Bronchio-loalveolar carcinoma(BAC) and the value of CT-guided percutaneous puncture biopsy in pneumonic type BAC.Methods Twenty-five cases of suspected pneumonic type BAC were biopsied with CT-guided percutaneous puncture.GE 64-slices plain and post contrast CT scans were performed in all patients.Two radiologists finished imaging determination.Site of puncture was selected in suspicious areas of the tumor.The negative pressure aspiration needle were used to be biopsy in the ideal location after vertically into the needle and again performed CT scanning were performed to observe the complications such as hemorrhage,pneumothorax.Specimens were fixed by formalin.Results Twenty-five samples were successfully got from 25 patients.Pathology data showed that 14 cases were pneumonia with BAC,6 cases with pneumonia,2 cases with offungus infection,and 3 cases with caseous pneumonia.Of 14 cases (71.4％) with pneumonia type BAC,CT images of 10 cases showed air bronchogram of lung tissue,5 cases(35.7％) with alveolar gas cavity or cavity of lung tissue,5 cases(35.7％) with ground glass opacity and multiple nodules.Enhanced CT scanning the area of consolidation showed that 11 cases(78.6％) were with mixed low density area angiography and the mean peak time was 90 s,9 cases (64.2％) were with the time density curve of speed up and slow down type.Conclusion The method of CT guided lung biopsy combined with typical imaging findings can enhance early diagnosis rate of pneumonia type BAC.Meanwhile CT feature of pneumonia type BAC shows honeycomb air cavity,void,angiographic sign,dead branches syndrome,multiple peripheral acinar nodules and ground glass density.Enhanced scan area of consolidation shows visible angiogran sign,slow drop type of time density curve of a fast rise.
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Objective To evaluate the clinical application value of percutaneous lung biopsy by CT fluoroscopy.Methods we analysed 31 cases of percutaneous lung biopsy by CT fluoroscopy which were proved by operation or pathology,with the puncture needle produced by Cook Co..The main point are: choose the best layer,point,angle,depth,draw and obtaining at many points.Results In these 31 cases,accurate diagnosis is 29 cases,include 9 cases of adenocarcinoma,6 cases of SqCa,2 cases of small cell carcinoma,1 case of metastatic carcinoma,1 case of alveolar cell carcinoma,5 cases of TB,4 cases of infection,1 case of inflammatory pseudotumor.The diagnosis accurate rate is 93.5%.2 cases were not diagnosed accurately,2cases of pneumothoras,complication rate is 6.5%.Conclusion The percutaneous lung biopsy by CT fluoroscopy was high diagnosis accurate rate,less of complication,this is a safe,effective,simple and practical way for diagnosing lung diseases.
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Objective To explore the diagnostic value of transbronchial lung biopsy(TBLB), CT-guided percutaneous lung biopsy and sputum cytology for unknown lung mass. Methods The clinical data of 101 inpatients with unknown lung mass were retrospectively analyzed. Results Among the 101 cases, 73 cases underwent fibrous bronchoscopic examination, 18 cases underwent CT-guided percutaneous lung biopsy, and 10 cases underwent both of them.The diagnostic coincident rate of the two methods was 70%. 54 cases were diagnosed lung carcinoma by pathology. The sensitivity and specificity of TBLB for diagnosing central type of tumor were 88% and 100%, respectiely, and those for diagnosing peripheral type of tumor were 43% and 100%, respectively. The sensitivity of CT-guided percutaneous lung biopsy was 80%,while the specificity was 100%. Complication frequency in the CT-guided percutaneous lung biopsy was 22%, and much higher than that (12%) in the TBLB. Only 30% cases underwent sputum cytology examination, and the positive rat was 6%. Conclusion Sputum cytologic examination is a convenient and cheap method, but its diagnostic rate is relatively low. TBLB was the first choice for examining central type of lung mass. For the peripheral type of lung mass, examination method was selected based on the location and size of the mass.
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Objective To study the effect of percutaneous CT-guided lung biopsy on the patients with peripheral lung focus.Methods Percutaneous CT-guided lung biopsy was performed in 38 patients with peripheral lung focus who were admitted to the Affiliated Hospital,Armed Police Medical College from Feb.2002 to Jan.2005.Results A total of 38 patients were studied,including 30 patients with lung cancer,2 patients with pulmonary tuberculosis,5 patients with benign pulmonary diseases and 1 patient with negative result.The positive rate was 97.36% in the 38 cases with a slight side effect.Conclusion This method is simple,safe and effective,and it is very important in diagnosis of patients with peripheral lung focus.
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Scrofuloderrna results from a direct extension of an underlying tuberculous focus such as the lymph nodes, bone or joint to he overlying skin, and is often associated with pulmonary tuberculosis. A 59-year-old male pai ient presented with an asymptomatic, flesh colored, 0.8 x 1.0 cm sized, solitary nodule on the left, middle back area. He had a CT-guided percutaneous lung biopsy 3 weeks before, for the evaluation of a round focal inhomogenous mass in the left lower lung field on radiologic study. An cxcisional biopsy specimen from the skin lesion showed granulomatous infiltration, composed of pithelioid cells, mononuclear cells and Langhans giant cells in the deep dermis and the suhcutaruous fat layer. Caseation necrosis within the tubercles was marked and numerous acid-fast bacilli were identified on AFB staining. Here we report an unusual case of scrofuloderma occurring after a percutaneous lung biopsy.