目的：探讨导向器辅助 CT 引导经皮同轴套管切割活检术在腹膜后淋巴瘤中的应用价值及安全性。方法收集2013年6月至2015年5月18例因腹膜后肿块无法行手术取材活检的患者，均在导向器辅助 CT 引导下行经皮同轴套管切割活检术。每例患者至少切取5条以上活检组织，行病理组织学检查及免疫组化染色。另顺铂10～30 mg 通过套管针注射至肿瘤内。结果18例患者均成功实施了导向器辅助 CT 引导下穿刺，取材成功率为100％。操作时间为20～40 min，平均30 min，扫描5～9个序列，45～90幅图片。未发生出血、气胸等并发症。10例诊断为淋巴瘤，6例为弥漫大 B 淋巴瘤，2例为滤泡性淋巴瘤，2例为淋巴母细胞型淋巴瘤；Ann Arbor 分期：Ⅱ期2例、Ⅲ期6例、Ⅳ期2例。治疗采用放化疗结合的模式。结论导向器辅助 CT 引导经皮同轴套管切割活检术创伤小，并发症少，是一种安全、有效的微创诊疗技术，对腹膜后淋巴组织疾病的诊断具有重要意义，值得临床推广应用。%Objective To study the application value and safety of percutaneous coaxial-core needle biopsy via director assis-ted CT guidance in retroperitoneal lymphomas. Methods From June 2013 to May 2015, a total of 18 patients with retroperitoneal mas-ses couldn't undertaking surgercal biopsy were enrolled in this study. The 18 patients received percutaneous coaxial-core needle biopsy via director assisted CT guidance. At least five biopsy samples from different position were taken for pathology and immunohistochemis-try examination. A dosage of 10-30 mg of cisplatin was injected into the lesion by trocar needle. Results Of the 18 patients underwent percutaneous coaxial-core needle biopsy via director assisted CT guidance. The success rate of puncture and biopsy was 100%. Opera-tion time was 20-40 min (average 30 minutes), and 5-9 sequence with 45-90 pictures of scan were used. No complications such as hemorrhage and pneumothorax occurred. Ten cases of retroperitoneal lymphomas were diagnosed, among whom there were 6 cases of diffuse large B lymphoma, 2 cases of follicular lymphoma and 2 cases of lymphoid cell lymphoma. According to Ann Arbor stage,there were 2 of stage Ⅱ, 6 of stage Ⅲ, and 2 of stage Ⅳ. The combination of chemotherapy and radiation was performed on lymphoma pa-tients. Conclusion Percutaneous coaxial core needle biopsy via director assisted CT guidance with minimal invasiveness and fewer complications is a safe and effective minimally invasive technology, worthy of clinical application in the diagnosis of retroperitoneal lym-phoproliferative disease.
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