Lung disease, about lung puncture and petct

Percutaneous needle biopsy of the lung is an important part of non-vascular interventional techniques in the lungs. For some lesions that are difficult to be identified by imaging, the cytological histological data obtained through biopsy can make qualitative diagnosis and differential diagnosis, and the choice of treatment options , Formulation and follow-up after treatment, predicting prognosis and other aspects play an important role. Inspection method: First, do a regular lung CT scan, and then measure the distance and angle from the puncture point to the predetermined puncture target on the CT image. The puncture point is routinely disinfected, draped, and local anesthetized. Measure the puncture depth, make the patient hold his breath, and perform the puncture at a predetermined angle. When puncturing, keep the puncture needle in the same scan level as the puncture point, try to use a direction parallel or perpendicular to the ground. After the puncture is in place, perform a CT local scan to determine whether the needle tip is in the lesion. If you need to adjust the direction, make the puncture The needle is retracted to the chest wall and adjusted again, or pulled out and punctured again. When adjusting the puncture needle or removing the needle, ask the patient to hold their breath. When the needle is in the body, let the patient breathe calmly and try to avoid coughing. After the puncture is completed, the puncture needle is withdrawn, the puncture specimen is fixed, and the pathological examination is sent. In recent years, intrapulmonary puncture biopsy has been used more and more widely in the diagnosis and differential diagnosis of clinical diseases. There are many non-vascular guidance methods that can achieve biopsy or treatment purposes. In medical imaging, CT, fluoroscopy, and fluoroscopy are used. Which technique depends on the location, size, and nature of the lesion, as well as the doctor's proficiency, habits, and the patient's proficiency and tolerance. CT-guided percutaneous lung biopsy is relatively simple and has fewer complications. The biggest advantage of CT-guided puncture is: the high resolution of CT image density, it can clearly show the size, cysticity, necrosis, and relationship with surrounding tissues and organs of the lesion. It is not interfered by gas, fat, bone, etc., and the image has no Overlap, thin-layer scanning can be used, the positioning is accurate, and the position of the needle tip can be judged. Therefore, the safety is good, the success rate of biopsy is high, up to 90%, and the treatment effect is also very good. However, CT-guided puncture also has disadvantages: because it is not timely imaging, breathing movement will cause errors in accurate positioning, and the patient must be trained to master the breathing phase. When the puncture needle needs to be at a certain angle with the cross section, the puncture technique has a certain degree of difficulty, and the angle of the gantry can be adjusted.

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