Application Of Ultrasound-guided Percutaneous Lung Biopsy For Peripheral Pulmonary Disease

Objective: The purpose of this study was to investigate the application of ultrasound-guided percutaneous lung biopsy for peripheral pulmonary disease.We compare the diagnostic effects of core needle biopsy(CNB)and fine needle aspiration(FNA)on peripheral lung diseases and compare the clinical value of color Doppler ultrasound and CT-guided percutaneous lung biopsy in the diagnosis of pulmonary disease.The diagnostic efficacy and unique advantages of two puncture methods and two guiding methods for different types of lung peripheral diseases were obtained.Materials and methods: A Retrospective analysis of 324 cases of lung biopsy between December 2015 and July 2018 was performed with confirmed final diagnoses.The patients were divided into two groups,the ultrasound-guided group(US group)and the CT-guided group(CT group).The US group was divided into US-CNB group and US-FNA group.We Obtained the patient’s pathological results,counted complications and the time to get the pathological diagnosis.The final diagnosis results was according to surgical pathology or follow-up results.The diagnostic accuracy of different biopsy needles was compared.To analysis the rate of complications,all comlications was counted.In addition,in order to analyze the difference in diagnostic efficacy and complications between the two guiding methods,the CT group and US-CNB were compared.Compared.Patient’s puncture pathological results and all complications was obtained.The final diagnosis results was according to surgical pathology or follow-up results to compared diagnostic accuracy.To analysis the rate of complications,all comlications was counted.Results: There were 141 cases in the US group,132 cases in the CNB and 86 cases in the FNA.The time to get the pathological diagnosis was(3.29±2.51)days and(1.89±1.60)days(P<0.05).The diagnostic accuracy of CNB and FNA for malignant lesions were 97.0%(62/64)and 77.1%(27/35),respectively(P<0.05).The correct rate of diagnosis for benign lesions was 94.1%(64/68)and 54.9%(28/51),respectively(P < 0.05).There were 55 patients with CNB alone,4 patients with complications,9 patients with FNA alone,1 complication,77 patients with both CNB and FNA,and 6 complications.There was no significant difference in the incidence of complications among CNB,FNA alone,and CNB and FNA(P>0.05).There were 132 cases in the US-CNB group and 183 cases in the CT-guide group.The correct rate of diagnosis of malignant tumors in the two groups was 97.0% and 97.3%,respectively(P>0.05).There was no significant difference between the two groups.The correct rate of diagnosis of benign lesions was 94.1% and 100%,respectively(P> 0.05),the difference was not statistically significant.There were no serious complications such as hemothorax,needle metastasis and respiratory failure in the two groups.The incidence of complications of US-CNB and CT was 7.3%(4/55),19.7%(36/183).The difference between the two groups was statistically significant(P<0.05).The CT group was divided into two groups,the group with complications and without complication.The average depth of two groups was(6.25±2.01)cm and(5.42±1.59)cm(P>0.05),the difference was not statistically significant.Conclusions: The diagnostic accuracy of CNB for malignant lesions and benign lesions is higher than that of FNA,and the difference of benign lesions is more obvious.However,the time for diagnosis of FNA is significantly shorter,and a higher diagnostic accuracy rate can be obtained for malignant lesions,which is conductive to early treatment.There is no significant difference in the incidence of three puncture complications.US-CNB group and CT-guided percutaneous lung biopsy both have a high diagnostic accuracy for the diagnosis of peri-pulmonary diseases.The incidence of US-CNB group complications is significantly lower than that of CT guidance,and the ultrasound operation is convenient and inexpensive.Ultrasound-guided percutaneous lung biopsy is preferred for clear lesions,while CT-guided lung biopsy is performed with ultrasound showing unsatisfactory or undetectable lesions.