Clinical value of CT-guided percutaneous needle biopsy assisted by IG4 electromagnetic navigation system in diagnosing pulmonary lesions

doi:10.3877/cma.j.issn.1674-6880.2020.04.005

Abstract

Abstract:

Objective

To explore the application value of CT-guided percutaneous needle biopsy assisted by the IG4 electromagnetic navigation system in diagnosing pulmonary lesions.

Methods

A total of 125 patients with pulmonary lesions to undergo CT-guided percutaneous needle biopsy were randomly divided into a control group (62 patients) and a magnetic group (63 patients). Patients in the control group were performed conventional CT-guided percutaneous needle biopsy, and patients in the magnetic group received CT-guided percutaneous needle biopsy assisted by the IG4 electromagnetic navigation system. The white blood cell count, platelet count (PLT), international normalized ratio (INR), activated partial thromboplastin time (APTT), prothrombin time (PT), alanine aminotransferase (ALT), serum creatinine, creatine kinase-MB (CK-MB), C-reactive protein (CRP), and lung cancer related markers of neuronspecific enolase (NSE) and serum squamous cell carcinoma antigen (SCCA) before the piercing were recorded. The positioning time, needle adjustment times, scanning times, radiation dose [dose length product (DLP)], pathological diagnosis sensitivity and incidence of complications such as pneumothorax and bleeding were compared between the two groups.

Results

The levels of white blood cell count, PLT, INR, APTT, PT, ALT, serum creatinine, CK-MB, CRP, NSE and SCCA before puncture all showed no significant differences between the two groups (all P > 0.05). Meanwhile, the positioning time [(9.5 ± 2.6) min vs. (13.6 ± 4.1) min, t = 6.584, P < 0.001], needle adjustment times [(3.0 ± 1.3) times vs. (3.8 ± 1.8) times, t = 2.662, P = 0.009], scanning times [(3.9 ± 1.2) times vs. (5.8 ± 1.8) times, t = 6.853, P < 0.001] and DLP [(291 ± 167) mGy × cm vs. (407 ± 307) mGy × cm, t = 2.622, P = 0.010] in the magnetic group were significantly better than those in the control group. The incidence of pneumothorax [15.87% (10/63) vs. 33.87% (21/62), χ² = 5.204, P = 0.023] and bleeding [20.63% (13/63) vs. 38.71% (24/62), χ² = 4.899, P = 0.027] in the magnetic group was significantly lower than that in the control group. However, there was no statistically significant difference in the pathological diagnosis sensitivity between the two groups [89.66% (52/58) vs. 96.36% (53/55), χ² = 1.931, P = 0.165].

Conclusion

The CT-guided percutaneous needle biopsy assisted by the IG4 electromagnetic navigation system is significantly superior to conventional CT-guided lung biopsy in terms of safety and degree of injury to patients, and has high clinical application value.

Key words: IG4 electromagnetic navigation system, CT-guided percutaneous lung puncture, pulmonary lesions, Lung neoplasms

Hui Zeng, Zhewei Zhang, Xing Yan, Guoliang Shao. Clinical value of CT-guided percutaneous needle biopsy assisted by IG4 electromagnetic navigation system in diagnosing pulmonary lesions[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2020, 13(04): 264-269.

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组别	例数	性别（男/女）	年龄（岁， ± s）	病灶大小（cm）						病灶距皮肤距离（cm）
组别	例数	性别（男/女）	年龄（岁， ± s）	<1	≥1~<2	≥2~<3	≥3~<4	≥4~<5	≥5	>0 ~ ≤ 5	>5 ~ ≤ 10
对照组	62	39/23	64 ± 11	3	11	23	13	7	5	25	37
磁导组	63	40/23	62 ± 8	1	15	11	19	9	8	20	43
t/χ²值		0.005	0.683	7.910						0.998
P值		0.946	0.496	0.161						0.318

组别	例数	性别（男/女）	年龄（岁， ± s）	病灶大小（cm）						病灶距皮肤距离（cm）
组别	例数	性别（男/女）	年龄（岁， ± s）	<1	≥1~<2	≥2~<3	≥3~<4	≥4~<5	≥5	>0 ~ ≤ 5	>5 ~ ≤ 10
对照组	62	39/23	64 ± 11	3	11	23	13	7	5	25	37
磁导组	63	40/23	62 ± 8	1	15	11	19	9	8	20	43
t/χ²值		0.005	0.683	7.910						0.998
P值		0.946	0.496	0.161						0.318

组别	例数	白细胞计数（× 10⁹/L， ± s）	PLT（× 10⁹/L， ± s）	INR	APTT（s， ± s）	PT（s， ± s）	ALT（U/L）	血肌酐（μmol/L）	CK-MB（μmol/L， ± s）	CRP（mg/L）	NSE（mg/L， ± s）	SCCA（μg/L）
对照组	62	6.6 ± 1.2	248 ± 62	0.96（0.93，1.02）	27.8 ± 3.3	11.6 ± 0.8	16.5（9.0，30.5）	69.5（61.5，78.8）	19 ± 6	6.4（3.1，20.1）	19 ± 6	1.2（0.9，1.5）
磁导组	63	6.3 ± 1.7	217 ± 90	1.02（0.96，1.05）	28.2 ± 2.8	11.9 ± 0.8	14.0（12.2，22.0）	66.5（60.2，75.8）	19 ± 8	3.1（0.7，24.0）	18 ± 10	1.1（0.8，2.3）
t/H值		0.779	1.268	1.737	0.393	1.172	0.420	0.244	0.287	0.765	0.352	0.250
P值		0.441	0.212	0.086	0.696	0.248	0.678	0.820	0.775	0.451	0.727	0.806

组别	例数	白细胞计数（× 10⁹/L， ± s）	PLT（× 10⁹/L， ± s）	INR	APTT（s， ± s）	PT（s， ± s）	ALT（U/L）	血肌酐（μmol/L）	CK-MB（μmol/L， ± s）	CRP（mg/L）	NSE（mg/L， ± s）	SCCA（μg/L）
对照组	62	6.6 ± 1.2	248 ± 62	0.96（0.93，1.02）	27.8 ± 3.3	11.6 ± 0.8	16.5（9.0，30.5）	69.5（61.5，78.8）	19 ± 6	6.4（3.1，20.1）	19 ± 6	1.2（0.9，1.5）
磁导组	63	6.3 ± 1.7	217 ± 90	1.02（0.96，1.05）	28.2 ± 2.8	11.9 ± 0.8	14.0（12.2，22.0）	66.5（60.2，75.8）	19 ± 8	3.1（0.7，24.0）	18 ± 10	1.1（0.8，2.3）
t/H值		0.779	1.268	1.737	0.393	1.172	0.420	0.244	0.287	0.765	0.352	0.250
P值		0.441	0.212	0.086	0.696	0.248	0.678	0.820	0.775	0.451	0.727	0.806

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