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[1]王 城,王春梅,王雪梅,等.99mTc-3PRGD2 SPECT/CT显像联合3D打印模板引导下经皮肺穿刺对孤立性肺结节诊断意义[J].中华肺部疾病杂志,2021,(05):569-572.[doi:10.3877/cma.j.issn.1674-6902.2021.05.005]
 Wang Cheng,Wang Chunmei,Wang Xuemei,et al.Clinical research of 99mTc-3PRGD2 SPECT/CT imaging combined with 3D printing template guided percutaneous lung puncture in the diagnosis of solitary pulmonary nodules[J].,2021,(05):569-572.[doi:10.3877/cma.j.issn.1674-6902.2021.05.005]
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99mTc-3PRGD2 SPECT/CT显像联合3D打印模板引导下经皮肺穿刺对孤立性肺结节诊断意义(PDF)

《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2021年05期
页码:
569-572
栏目:
论著
出版日期:
2021-10-20

文章信息/Info

Title:
Clinical research of 99mTc-3PRGD2 SPECT/CT imaging combined with 3D printing template guided percutaneous lung puncture in the diagnosis of solitary pulmonary nodules
作者:
王 城王春梅王雪梅邬心爱
010050 内蒙古,内蒙古医科大学附属医院核医学科
Author(s):
Wang Cheng Wang Chunmei Wang Xuemei Wu Xinai.
Department of Nuclear Medicine, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China
关键词:
99mTc-3PRGD2 SPECT/CT显像 孤立性肺结节 活组织检查
Keywords:
99mTc-3PRGD2 SPECT/CTimaging SPN Biopsy
分类号:
R563
DOI:
10.3877/cma.j.issn.1674-6902.2021.05.005
摘要:
目的 分析99mTc-3PRGD2 SPECT/CT显像联合3D打印模板引导下经皮肺穿刺对孤立肺结节(SPN)的诊断意义。方法 收集2015年1月至 2019年12月在内蒙古医科大学附属医院呼吸科就诊79例SPN患者,男51例,女28例。年龄43~81岁,平均年龄(62.39±8.99)岁。分析99mTc-3PRGD2 SPECT/CT显像对SPN的诊断价值及联合3D打印模板经皮肺穿刺术后并发症的相关因素。结果 79例患者均顺利完成SPECT/CT显像及穿刺活检操作。SPN直径为8~30 mm,平均直径为(20.18±5.66)mm。42例SPN(直径≤20 mm)患者采用1根定位针,37例SPN(20 mm<直径≤30 mm)患者未采用定位针; 同轴套管活检针穿刺1次52例,穿刺2次21例,穿刺3次6例。所有患者应用同轴套管针进行2次活检。病理学诊断有3例患者因取材不满意而无阳性结果,穿刺活检取材成功率96.2%(76/79),99mTc-3PRGD2 SPECT/CT显像良性49例,恶性30例。穿刺病理结果良性56例,恶性23例。穿刺并发症:针道出血、气胸或“针道出血+气胸”发生率与性别、结节直径、结节深度、肺气肿及穿刺次数有关,差异均有统计学意义(P<0.05)。结论 99mTc-3PRGD2 SPECT/CT显像联合3D打印模板引导下经皮肺穿刺对孤立性肺结节诊断将精准功能影像应用到穿刺中,具有良好的临床应用前景。
Abstract:
Objective To explore the value of 99mTc-3PRGD2 SPECT/CT imaging combined with 3D printing template in the diagnosis of solitary pulmonary nodules. Methods All of 79 patients with SPN were enrolled in the respiratory department of the Affiliated Hospital of Inner Mongolia Medical University in the January 2015 to December 2019, they were 51 males and 28 females, the average age of 62.39±8.99 years old. To analyze the value of 99mTc-3PRGD2 SPECT/CT imaging in the diagnosis of SPN and the related factors of complications after percutaneous pulmonary puncture with 3D printing template. Results All 79 patients successfully completed SPECT/CT imaging and biopsy. SPN diameter is 8-30 mm, average diameter is(20.18±5.66)mm. 42 patients with SPN(diameter≤20 mm)were punctured with one positioning needle.37 patients with SPN(20 mm<diameter≤30 mm)did not use positioning needle. 52 patients who puncture once by coaxial cannula biopsy needle. 21 patients who puncture twice. 6 patients who puncture the three times. All patients by biopsied twice with coaxial trocar. There were 3 patient,s pathological diagnosis without positive results because unsatisfied sampling. The success rate of biopsy was 96.2%(76/79). 49 patients were benign and 30 patients were by 99mTc-3PRGD2 SPECT/CT imaging. 56 patients were benign and 23 patients were by Puncture pathology. Complications of puncture including needle bleeding, pneumothorax or needle bleeding and pneumothorax,The incidence was related to sex, nodule diameter, nodule depth, emphysema and puncture times. The difference was statistically significant(P<0.05). Conclusion 99mTc-3PRGD2 SPECT/CT imaging combined with 3D printing template guided percutaneous pulmonary puncture in the diagnosis of solitary pulmonary nodules, It apply accurate functional image to puncture. It has good clinical application feasibility and prospect.

参考文献/References:

1 付 丽, 徐 岩, 李 丽, 等. 低剂量CT动态监测孤立性肺结节调查研究[J]. 临床和实验医学杂志, 2020, 19(2): 212-215.
2 Tian Y. Application of CT and MRI in the identification of solitary pulmonary nodeles[J]. Systems Med, 2016, 1(8): 96-99.
3 苏 蕾, 董军强, 胡丽丽, 等. 优化CT引导下穿刺活检技术在肺部亚厘米结节中的应用[J]. 医学影像学杂志, 2019, 29(3): 410-413.
4 郑 勇, 黄 佳, 庄丁勤, 等. 18F-FDG PET/CT双时相显像结合高分辨率CT诊断孤立性肺结节的临床观察[J]. 新医学, 2020, 51(1): 48-52.
5 蒋红芳, 王 杰, 马文江, 等. CT引导下肺孤立结节经皮肺穿刺的诊断价值及其影像学特征[J]. 现代实用医学, 2017, 29(6): 773-775.
6 Zhu ZH, Miao WB, Li QW, et al.99mTc-3PRGD2 for inergrin recepter imaging of lung cancer: a multicenter[J]. J Nucl Med, 2012,(53): 716-722.
7 黄卓琼, 周 进, 李 镛. 容积再现技术在孤立性肺结节鉴别诊断中的价值[J]. 临床肺科杂志, 2019, 24(2): 222-225.
8 周 进, 张柏膺, 严峻海, 等. 81例恶性肺微小结节的影像学征象分析[J]. 内科理论与实践, 2017, 12(3): 191-193.
9 陈国强, 苏 福, 王卫星, 等. 18F-FDG PET/CT联合薄层螺旋CT三维重建诊断孤立性肺结节[J]. 中国医学影像技术, 2020, 36(1): 86-90.
10 申镐源, 庞小溪, 刘 敏, 等. 99Tcm-c(RGD)2在荷不同肿瘤裸鼠体内的生物分布及显像研究[J]. 标记免疫分析与临床, 2018, 25(10): 1499-1503.
11 Zhang H, Gao S, Chen B, et al. Comparison of the accuracy of 99mTc-3PRGD2 SPECT and CT in diagnosing solitary pulmonary nodules[J]. Oncol Lett, 2016, 12(4): 2517-2523.
12 胡玉娜, 施裕新. 恶性孤立性肺结节的CT征象及其诊断价值[J]. 中国临床医学, 2011, 18(4): 567-568.
13 王 冠, 陈宝明, 张玉卫, 等. 3D打印共面穿刺模板辅助CT引导下肺原发小微结节穿刺临床研究[J]. 癌症进展, 2017, 15(9): 1003-1007.
14 余 翔, 张 敏, 刘建光. 孤立性肺结节影像学特征的Logistic回归分析[J]. 蚌埠医学院学报, 2019, 44(7): 936-939.
15 Takeshita J, Masago K, Kato R, et al. CT-guided fine-needle aspiration and core needle bio-psies of pulmonary lesions: A single center experience with 750 biopsies in Japan[J]. AJR Am J Roentgenol, 2015, 204(1): 29-34.
16 李茹恬, 任 伟, 孔炜伟, 等. 液性撤退法联合同轴法减少CT引导下经皮肺穿刺活检气胸并发症[J]. 现代肿瘤医学, 2016, 24(4): 558-561.
17 王 琴, 张庭秀, 马李杰, 等. CT引导下经皮肺穿刺活检术114例临床分析[J/CD]. 中华肺部疾病杂志(电子版), 2020, 13(3): 388-390.

备注/Memo

备注/Memo:
基金项目: 内蒙古自治区自然科学基金(2018LH08028)
通信作者: 王春梅,Email: wangchunmei0222@163.com
更新日期/Last Update: 2021-10-20