Preliminary study on CT perfusion imaging in guiding biopsy of pulmonary lumps

KANG Li-qing; SONG Zhao-wei; LI Zhong-xin; YU Shu-jing; LIU Feng-hai; CHEN Yue-feng; XING Rong-ge

摘要

Background CT perfusion imaging (CTP) has been proved to be a powerful functional imaging technique.This study aimed to evaluate the value of CTP in guiding biopsy of pulmonary lumps.Methods A total of 147 patients with pulmonary lumps who had CT guided biopsies were enrolled in this study from February 2005 to June 2007.The patients were assigned to 3 groups:33 cases guided by CTP as group Ⅰ,45 cases guided by contrast-enhanced scan of CT as group Ⅱ,and 69 cases guided by plain scan of CT as group Ⅲ.Each group was subdivided into central and peripheral types according to the location of the lumps.The achievement ratio of biopsy,the accuracy in grouping,and grading of lung cancer,and the incidence of complication were compared.Results The total achievement ratios of biopsy from group Ⅰ to Ⅲ were 100% (33/33),91% (41/45),and 80% (55/69)respectively,and the difference was statistically significant between group Ⅰ and Ⅲ (P ＜0.05).For the central type,they were 100% (18/18),88% (15/17),and 79% (11/14) respectively,and the difference was also statistically significant between group Ⅰ and Ⅲ (P ＜0.05).For the peripheral type,they were 100% (15/15),93% (26/28),and 80% (44/55) espectivelies,and the difference was not statistically significant among the three groups.The total accuracies in grouping and grading of lung cancer from group Ⅰ to Ⅲ were 100% (27/27),91% (31/34),and 72% (33/46) respectively,and the difference was statistically significant between group Ⅰ and Ⅲ and between group Ⅱ and III (P ＜0.05).For the central type,they were 100% (16/16),94% (16/17),and 70% (8/12) respectively,and the difference was statistically significant between group Ⅰ and Ⅲ (P ＜0.05).For the peripheral type,they were 100% (11/11),88% (15/17),and 72%(26/36) respectively,and the difference was statistically significant between group Ⅰ and Ⅲ (P ＜0.05).The total incidence of complication from group Ⅰ to Ⅲ were 15% (5/33),27% (12/45),and 43% (30/69) respectively,and the difference was statistically significant between group Ⅰ and Ⅲ (P ＜0.01 ).For the central type,they were 11% (2/18),24% (4/17),and 57%(8/14) respectively,and the difference was statistically significant between group Ⅰ and Ⅲ (P ＜0.01).For the peripheral type,they were 20% (3/15),29% (8/28),and 40% (22/55) respectively,and no statistically significant difference was found among the three groups.Conclusions CTP guided biopsy of pulmonary lumps using multi-detector row CT has the potential to improve the accuracy of histopathological diagnosis with a lower risk and higher achievement ratio.More research and technical improvements are needed before it is widely used.

机译：背景技术CT灌注成像（CTP）被证明是一种功能强大的功能成像技术。本研究旨在评估CTP在引导性肺肿块活检中的价值。方法共纳入147例接受CT引导性活检的肺肿块患者。本研究自2005年2月至2007年6月。将患者分为3组：CTP引导下为Ⅰ组33例，CT对比增强扫描为Ⅱ组45例，CT平扫引导69例。作为Ⅲ组。每组根据肿块的位置分为中央型和周围型。比较活检的成功率，分组的准确性和分级以及并发症的发生率。 Ⅰ，Ⅲ组的活检率分别为100％（33/33），91％（41/45）和80％（55/69），Ⅰ，Ⅲ组之间的差异有统计学意义（P ＜0.05））。对于中心型，它们分别为100％（18/18），88％（15/17）和分别为79％（11/14）和Ⅰ组与Ⅲ组之间的差异具有统计学意义（P ＜0.05）。外围类型分别为100％（15/15），93％（26/28），分别为80％（44/55），三组间差异无统计学意义。Ⅰ组至Ⅲ组肺癌分组和分级的总准确率分别为100％（27/27），91％（31 / 34）和72％（33/46），且Ⅰ和Ⅲ组之间以及Ⅱ和III组之间的差异具有统计学意义（P ＜0.05）。中枢型为100％（16/16）），分别为94％（16/17）和70％（8/12），在Ⅰ组和Ⅲ组之间的差异具有统计学意义（P ＜0.05）。对于外围类型，它们是100％（11/11）），分别为88％（15/17）和72％（26/36），且Ⅰ组和Ⅲ组之间的差异具有统计学意义（P ＜0.05）。Ⅰ组至Ⅲ组并发症的总发生率为15％（5/33），27％（12/45）和43％（30/69），差异是统计上的Ⅰ，Ⅲ组间差异有统计学意义（P ＜0.01）。中心型分别为11％（2/18），24％（4/17）和57％（8/14），差异为Ⅰ，Ⅲ组间差异有统计学意义（P ＜0.01）。外周型分别为20％（3/15），29％（8/28）和40％（22/55），无统计学意义。三组之间存在差异。结论CTP引导下多排行CT肺肿块活检有望以较低的风险和较高的成功率提高组织病理学诊断的准确性，因此需要更多的研究和技术改进。广泛使用。

Preliminary study on CT perfusion imaging in guiding biopsy of pulmonary lumps

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