폐 소결절 환자를 대상으로 한 CT-guided Wire Marking Procedure에 대한 유용성 평가

Usefulness of CT-guided Wire Marking Procedure of Small Pulmonary Nodule

Purpose To prospectively assess the safety and effectiveness of computed tomography(CT)-guided marking using a wire before video-assisted thoracoscopic surgery for small pulmonary nodules, with characteristics and excision methods of pulmonary nodule suspicious to primary lung cancer. Materials and methods For June 2008 to July 2009, 35 patients(13 men, 22 women; range 34-75, mean age, 56 years) with Surgical removal for small pulmonary nodules were included in prospective study. With 4 channel CT scanner, the guided material was used 10 mm long, 21 gauge spring-hook type wire. Results The average CTDIVOL, effective close for each procedure were 7.80⊕3.16 mGy, 3.71⊕1.4 mSv respectively. Needle tip were completely targeted in nodule at 12(34.3%) out of 33 persons, at 13 persons(37%) into the direction of pleura and at 10 persons(28.6%) into the parenchyma rather than nodule. The mean diameter of the nodules, measured by CT scans, was 10.2⊕4.9 mm and ranged 0.3 mm to 2.8 mm. The distance of the nodules to visceral of pleura was 16.3⊕7.7 mm and ranged 4mm to 35 mm. From lesion characteristics of ground-glass opacity, pathological findings of adenocarcinoma was 29(82.8%). Metastatic cancer and immflamation were 3 persons (8.6%) respectively. In the procedure there was no complication in 19 persons(57.1%). tiny pneumothorax and hemorrhage were 13 persons(37.1%) and 2 persons(5.8%) respectively. And additional intervention was not required. Conclusion CT-guided marking wire procedure was very efficient with low radiation close, and minimizing to patients unrest in terms of low complications and simple procedure. Also it was useful study which could help minimizing resection of lung parenchyma including the nodule.