대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제79권3호
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  • Pages.129-138
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  • 2018
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  • 1738-2637(pISSN)
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  • 2288-2928(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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폐 흡인 조직검사 시 PET/CT의 임상적 유용성 및 위음성 결과와 관련 있는 인자

Study of the Efficacy of PET/CT in Lung Aspiration Biopsy and Factors Associated with False-Negative Results

  • 손일완 (부산대학교병원 영상의학과) ;
  • 이지원 (부산대학교병원 영상의학과) ;
  • 정연주 (부산대학교병원 영상의학과) ;
  • 김아롱 (부산대학교병원 병리과) ;
  • 서희붐 (부산대학교병원 영상의학과) ;
  • 이지원 (부산대학교병원 영상의학과)
  • Son, Il Wan (Department of Radiology, Pusan National University Hospital) ;
  • Lee, Ji Won (Department of Radiology, Pusan National University Hospital) ;
  • Jeong, Yeon Joo (Department of Radiology, Pusan National University Hospital) ;
  • Kim, Ahrong (Department of Pathology, Pusan National University Hospital) ;
  • Suh, Hie Bum (Department of Radiology, Pusan National University Hospital) ;
  • Lee, Geewon (Department of Radiology, Pusan National University Hospital)
  • 투고 : 2018.02.01
  • 심사 : 2018.05.15
  • 발행 : 2018.09.01
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 우리는 폐종양의 경피적 침흡입생검을 시행했을 때 positron emission tomography/computed tomography (이하 PET/CT) 정보의 유무가 결과에 끼치는 영향을 비교하고, 조직학적 위음성에 영향을 끼치는 인자를 조사하였다. 대상과 방법: 총 291명의 환자중에서 161명은 PET/CT 없이 경피적 침흡입생검을 시행하였고, 130명은 PET/CT를 시행 후 경피적 침흡입생검을 시행하였다. 두 군 사이에서의 임상 특징, 시술 변수, 병리 결과 그리고 진단 성공률을 비교하였다. 병리 결과가 초기 음성(비특이적 양성)이 나온 환자에서 두 군 사이의 영상소견을 비교하고, 위음성의 예측 인자를 평가하였다. 결과: PET/CT의 유무에 따른 임상 특징, 시술 변수, 그리고 병리 결과는 차이가 없었다. 두 군 사이의 진단 성공률도 의미 있는 차이가 없었다(p = 0.818). 병리 결과가 초기 음성인 환자에서, 두 군 사이의 영상 소견도 차이가 없었다. 다변량 분석에서 괴사의 존재(p = 0.005)와 간유리음영(p = 0.011)은 의미 있는 변수였으며, 경피적 침흡입생검시 초기 위음성률을 증가시켰다. 결론: 폐종양의 경피적 침흡입생검을 시행하는 환자에서 관습적인 PET/CT는 추가적 이득이 없었다. 괴사 및 간유리음영의 존재는 병리 결과의 위음성률을 증가시켰다.

Purpose: We compared the outcomes of percutaneous transthoracic needle aspiration biopsy (PCNA) of lung masses in cases with and without prior positron emission tomography/computed tomography (PET/CT) information, and investigated the factors associated with false-negative pathological results. Materials and Methods: From a total of 291 patients, 161 underwent PCNA without prior PET/CT imaging, while 130 underwent PET/CT before PCNA. Clinical characteristics, procedural variables, pathological results, and diagnostic success rates were compared between the 2 groups. Among patients with initial negative (non-specific benign) PCNA results, the radiological findings of these groups were compared to evaluate the predictors of false-negative lesions. Results: No significant difference was found in the clinical characteristics, procedural characteristics, and pathological results of the 2 groups, nor was the diagnostic rate significantly different between them (p = 0.818). Among patients with initial negative PCNA results, radiological characteristics were similar in both the groups. In multivariate analysis, the presence of necrosis (p = 0.005) and ground-glass opacity (GGO) (p = 0.011) were the significant characteristics that indicated an increased probability of initial false-negative results in PCNA. Conclusion: Routine PET/CT did not have any additional benefit in patients undergoing PCNA of lung masses. The presence of necrosis or GGO could indicate an increased probability of false-negative pathological results.

키워드

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