【摘要】 目的 比较CT平扫与增强扫描在经皮肺穿刺活检术(PTNB)中的临床价值。方法 选取396例PTNB患者的临床资料，根据有无行CT增强扫描，分为平扫组236例、增强组160例。比较2组病例在取材满意度、诊断准确率、病灶大小、靶膜距、并发症影响因素方面的情况。结果 2组病例的活检取材满意度均较高。CT增强组在诊断准确率、并发咯血方面与CT平扫组差异有统计学意义(P<0.05);病灶大小及并发气胸方面无统计学意义(P>0.05)。靶膜距(a)经方差分析及两两比较，当a<5 cm时组间比较无统计学意义，a≥5 cm时存在差异。结论 CT平扫及增强均可作为PTNB术前的参考图像。术前做CT增强扫描可提高诊断准确率，降低咯血发生率，对中心性病灶穿刺时，损伤小、安全性高，优于CT平扫扫描。更多还原

【Abstract】 Objective To compare the clinical value of plain scan CT and enhanced CT in percutaneous transthoracic needle biopsy(PTNB).Methods Clinical data of 396 cases with PTNB were selected.According to the absence of enhanced CT scan, all cases were divided into the plain scanning group(236 cases) and the enhanced group(160 cases).The two groups were compared in sampling satisfaction, diagnostic accuracy, lesion size, target film distance and influencing factors of complications.Results The satisfaction of biopsy sampling was high in both group.There were statistically significant differences between the enhanced CT group and the plain CT group in terms of diagnostic accuracy and concurrent hemoptysis(P<0.05),and no statistically significant differences in lesion size and concurrent pneumothorax(P>0.05).After ANOVA analysis and pairwise comparison of target membrane distance(a),there was no statistically significant between the groups when a<5 cm, and there was a significant difference when a≥5 cm.Conclusion Both plain scan CT and enhanced CT can be used as reference images before PTNB.Preoperative enhanced CT scan can improve the diagnostic accuracy and reduce the incidence of hemoptysis.When puncture for central lesions, the injury is small with high safety, which is better than plain CT scan.更多还原