Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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CT Fluoroscopy-Guided Core Biopsy for Diagnosis of Small ($\leq$ 20 mm) Pulmonary Nodules

CT 투시촬영 유도하 중심부바늘생검을 이용한 폐 소결절($\leq$ 20 mm)의 진단

  • Lee, Hye-Larn (Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Kim, Yoon-Kyung (Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Woo, Ok-Hee (Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Yong, Hwan-Seok (Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Kang, Eun-Young (Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Kim, Hyun-Koo (Department of Thoracic Surgery, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Shin, Bong-Kyung (Department of Pathology, Korea University Guro Hospital, Korea University College of Medicine)
  • 이혜란 (고려대학교 의과대학 구로병원 영상의학과학교실) ;
  • 김윤경 (고려대학교 의과대학 구로병원 영상의학과학교실) ;
  • 우옥희 (고려대학교 의과대학 구로병원 영상의학과학교실) ;
  • 용환석 (고려대학교 의과대학 구로병원 영상의학과학교실) ;
  • 강은영 (고려대학교 의과대학 구로병원 영상의학과학교실) ;
  • 김현구 (고려대학교 의과대학 구로병원 흉부외과학교실) ;
  • 신봉경 (고려대학교 의과대학 구로병원 병리과학교실)
  • Published : 2011.10.01
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Abstract

Purpose: To evaluate the efficacy of CT fluoroscopy-guided core biopsy of small pulmonary nodules. Materials and Methods: This study included 62 patients (35 men, 27 women; age range, 36-85 years) that had a small ($\leq$ 20 mm) pulmonary nodule and underwent CT fluoroscopy-guided core biopsy. The overall diagnostic accuracy and complication rate were calculated. The diagnostic accuracy was compared between two groups according to the nodule size ($\leq$ 10 mm vs. > 10 mm), and nodule density (solid vs. subsolid). Results: Malignant or premalignant lesions were finally diagnosed in 39 patients; 36 true-positive and three false-negative findings (sensitivity, 92%). A benign lesion was finally diagnosed in 23 patients, with no false-positive results (specificity, 100%). The overall diagnostic accuracy was 95%. The sensitivity and diagnostic accuracy were 85% and 91% for nodules $\leq$ 10 mm, and 96% and 97% for nodules > 10 mm (p > 0.05). The sensitivity and diagnostic accuracy were 93% and 96% in the solid group and 90% and 92% in the subsolid group (p > 0.05). Seventeen (27%) patients had a pneumothorax and two (3%) required a closed thoracostomy. Conclusion: CT fluoroscopy-guided core biopsy of small pulmonary nodules yields high diagnostic accuracy with acceptable complication rates.

목적: 폐 소결절($\leq$ 20 mm)의 진단에 있어 CT 투시촬영 유도하 중심부바늘생검의 유용성에 대해 알아보고자 하였다. 대상과 방법: 폐 소결절($\leq$ 20 mm)에 대하여 CT 투시촬영 유도하 중심부바늘생검을 시행 받은 62명의 환자를 대상으로 진단적 정확도와 합병증에 대해 알아보았다. 조직검사 결과와 수술(n = 35) 또는 추적검사(n = 27)로 확인된 최종 결과를 비교하여 진단적 정확도를 계산하였으며, 진단적 정확도는 소결절의 크기($\leq$ 10 mm 대 > 10 mm)와 결절의 밀도(고형결절 대 아 고형결절)에 따라 차이가 있는지 알아보았다. 결과: 최종적으로 39명의 환자에서 악성 또는 전암 병소가 확인되었다. CT 투시촬영 유도하 중심부바늘생검을 통해 이중 36명은 진양성, 3명은 가음성으로 나왔다(민감도, 92%). 23명의 환자들은 양성 병소로 밝혀졌으며 가양성 결과는 없었다(특이도, 100%). CT 투시촬영 유도하 폐 결절 중심부바늘생검의 진단적 정확도는 95%였다. 10 mm 이하의 폐 결절의 민감도와 진단적 정확도는 각각 85%와 91%였으며, 10 mm보다 큰 폐 결절의 민감도와 진단적 정확도는 각각 96%와 97%였다(p > 0.05). 고형 폐 결절의 민감도와 진단적 정확도는 각각 93%와 96%였으며, 아 고형 폐 결절의 민감도와 진단적 정확도는 각각 90%와 92%였다(p > 0.05). 17명의 환자(27%)에서 기흉이 발생하였으며 이 중 2명(3%)은 흉강 배액관 삽입을 시행하였다. 결론: CT 투시촬영 유도하 중심부바늘생검은 폐 소결절($\leq$ 20 mm) 진단에 있어 비교적 정확하고 안전한 검사이다.

Keywords

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