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《China Journal of Modern Medicine》 2009-18
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Clinical study of transthoracic needle biopsy with CT guidance for mediastinal masses

YU Lei, FENG Guosheng, LIU Yuheng, HUANG Min, XU Zhiyong (Department of Oncology, People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi 530021, P.R.China)  
【Objective】To investigate the method of CT guiding percutaneous transthoracic needle biopsy and evaluate of different biopsy needle for mediastinal masses. 【Methods】CT-guided 16 gauge needle biopsy of mediastinal tumors was performed in 26 patients, 14 males and 12 females, aged 39.5, and CT-guided 18 gauge needle biopsy was performed in 24 patients, 14 males and 10 females, aged 42.1. Pathological examinations were done in all cases, and immunohistochemical methods were used in 38 cases. The final diagnosis was based on the post-oper- ative pathological examination and/or the results of 6-month follow-up. 【Results】The location of lesions: in anteriormediastinum (n =33), in middlemediastinum (n =10), in posteriormediastinum (n =7). Pathological diagnosis was established in 43 cases, including thymoma (n =13), lymphoma (n =12), adenocacinoma (n =5), squamouscarcinoma (n =4), small cell carcinoma (n =4), teratoma (n =1), germ cell tumor (n =1), neurofibroma (n =1), malignant neurilemmoma (n =1), small round cell tumor (n =1). Uncertain diagnosis by pathology in 7 cases included clinically suspect- ed lymphoma (n =3) and tuberculosis (n =2); 1 thymoma, 1 adenocacinoma was confirmed by surgical and pathologi- cal findings respectively. The diagnostic accuracy of percutaneous biopsy was 86.0%, and the false negative rate was 14.0%. In the CT-guided 16 G needle biopsy, 39 passes were performed with an average of 1.5 pass, a sensitivity rate of 96.2%, and a specificity rate of 100%, and pneumothorax occurred in 2 cases, and bloodysputum occurred in 1 case. In the CT-guided 18 G needle biopsy, 49 passes were performed with an average of 2.0 passes, a sensitivity rate of 75.0%, and a specificity rate of 100%, and pneumothorax occurred in 1 case, and bloodysputum occurred in1 case. The number of pass of the 16 G was significantly less than that of the 18 G group (P=0.003). The sensitivity rate of the 16 G needle biopsy was significantly higher than that of the 18 G group (P=0.033). There was no statistic significance in the complications rate between the two groups (P=0.709).【Conclusions】Transthoracic needle biopsy of mediastinal masses with CT guidance is a safe and valuable diagnostic procedure by accurate process. CT-guided 16 gauges core needle biopsy is more sensitive than the 18 G biopsy for the diagnosis of mediastinal masses.
【CateGory Index】: R734.5
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