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題名 | Ultrasound-Guided Fine Needle Aspiration Biopsy of Small Pulmonary Nodules Abutting to the Chest Wall=以超音波導引細針抽吸術評估緊臨胸壁的小肺結節 |
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作者 | 陳志強; 徐武輝; 黃枝梅; 許正園; 江自得; Chen, Chi-chiang; Hsu, Wu-huei; Huang, Chih-mei; Hsu, Jeng-Yuan; Chiang, Chi-der; |
期刊 | 中華醫學雜誌 |
出版日期 | 19960200 |
卷期 | 57:2 1996.02[民85.02] |
頁次 | 頁106-111 |
分類號 | 415.43 |
語文 | eng |
關鍵詞 | 細針抽吸術; 肺結節; 超音波; Fine needle aspiration biopsy; Pulmonary nodules; Ultrasound; |
中文摘要 | 背景 以超音波導引針刺切片來診斷肺周邊病變已在近十年來被廣泛 應用,但這些肺病變大都是較大的病灶。這篇研究主要是評估單以超音波導引 細綑針抽吸術來診斷緊臨胸壁的小肺結節。 方法 40位胸部X光發現有小於5公分的周邊肺結節的病人接受胸部超音波檢 查及超音波導引細針抽吸術。這些病人中有6位沒有確定診斷,其餘34位病人 以肺結節的大小分為三群,分別為直徑小於1公分的細小肺結節有4個,介於 1至2公分的有11個及介於2至3公分的有19個,隨後,我們評估超音波導引 細針抽吸術的診斷率及併發症發生率和肺結節大小或本質的關係。 結果 在接受超音波導引細針抽吸術來診斷緊臨胸壁的小肺結節的40位病人 中,有6位失去追蹤且沒有確定診斷,其餘34位有病理及臨床診斷的病人,其 診斷率達到88%,包括惡性腫瘤96%(26/27)及良性病變57%(4/7)。根據肺結節的 大小來評估,診斷率在細小肺結節可達到100%(4/4),介於1至2公分的肺結節 91%(10/11)及介於2至3公分的肺結節84%(16/19);只有一位胸部X光有2.5公 分肺結節的病人在接受超音波導引細針抽吸術後發生氣胸。 結論 針對緊臨胸壁的小肺結節,超音波導引細針抽吸術是一種可靠且安全的 檢查工具。我們發現是肺結節的本質而非其大小影響最後的診斷率及併發症發 生率。 |
英文摘要 | Background. Ultrasound(US)-guided needle biopsies in peripheral pulmonary lesions are widely applied. Most pulmonary lesions had a large size. We report our results in evaluating the availability of US-guided fine needle aspiration biopsy (US-guided FNAB) in diagnosing small pulmonary nodules abutting to the chest wall. Methods. Forty patients, whose chest radiographs showed peripheral pulmonary nodules of diameter smaller than 3.0cm, received chest sonographic examination and US-guided FNAB. Of those, six patients had no definite diagnoses; the remaining 34 patients with pulmonary nodules, we divided into three groups. There were four tiny nodules of diameters smaller than l.Ocm, 11 nodules between 1.1 and 2.0cm, and 19 nodules between 2.1 and 3.0cm. We evaluated the diagnostic yields and rates of complication in relation to the size or nature of the nodule. Results. In the enrolled 40 patients, six were lost to surveillance and had indeterminate diagnoses. Of the remaining 34 patients with proven pathological diagnoses and compatible clinical conditions, the diagnostic yields of US-guided FNAB achieved 88% (30/34) which include 96% (26/27) in malignancies and 57% (4/7) in benign nodules. According to the nodular size, the diagnostic rate achieved 100% (4/4) in tiny nodules, 91% (10/11) in nodules between 1.1 and 2.0cm, and 84% (16/19) in nodules between 2.1 and 3.0cm. Only one patient with a 2.5-cm nodule developed pneumothorax after the US-guided FNAB procedure. Conclusions. US-guided FNAB is a useful and safe diagnostic tool for small pulmonary nodules abutting to the chest wall. The nodular nature, but not size, affects the diagnostic yields and rates of complication. |
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