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目的：评价肺小结节ＣＴ导引经皮穿刺术的准确性、并发症及应用价值。材料与方法：选择１９９１年８月至１９９８年５月的１９０例经皮肺穿刺术患者中肺部结节直径＜３．０ｃｍ并经病理或随访证实的５０例（５０个结节），共做了５８次穿刺，均做细胞学和组织学检查。病灶直径最小０．５ｃｍ（平均２．４ｃｍ）。结果：５０例中恶性肿瘤３４例（原发支气管肺癌２７例，转移癌７例），穿刺确诊３０例，２３例穿刺与手术病理一致，７例找到癌细胞，无假阳性；穿刺１６例为良性病变，并经手术和随访证实。有假阴性４例，假阴性率８％（４／５０）。阳性和阴性预测值分别为１００％（３０／３０）和８０％（１６／２０）。共有７例发生气胸，占１４％（７／５０），但仅２例（４％）经插管处理。结论：ＣＴ引导经皮肺穿刺术对直径小于３ｃｍ的结节也有较高的准确性，并发症较低，与较大结节或肿块比临床价值更大，值得推广。
Objective: To evaluate the accuracy, complication and application value of CT guided percutaneous puncture of pulmonary nodules. MATERIALS AND METHODS: Fifty cases (50 nodules) confirmed by pathology or follow-up were selected from 190 patients with percutaneous pulmonary puncture between August 1991 and May 1998 Fifty-eight punctures were performed, both cytology and histology. The lesion diameter of the smallest 0.5cm (average 2.4cm). Results: Of the 50 cases, 34 were malignant tumors (primary bronchogenic carcinoma in 27 and metastatic carcinoma in 7), 30 were diagnosed by puncture, 23 were punctured according to pathology, 7 were found cancerous without false positive; 16 were Benign lesions, and confirmed by surgery and follow-up. There were 4 cases of false negative, false negative rate of 8% (4/50). The positive and negative predictive values were 100% (30/30) and 80% (16/20), respectively. A total of 7 pneumothorax occurred, accounting for 14% (7/50), but only 2 (4%) were intubated. Conclusion: CT-guided percutaneous lung paracentesis has high accuracy for nodules less than 3 cm in diameter with lower complication, which is worth more than clinical value in larger nodules or masses.