Fukushima A, Ashizawa K, Aso N, Takao M, Hayashi H, Nagaoki K, Sakamoto I, Hayashi K
Department of Radiology, Nagasaki University School of Medicine.
Nihon Igaku Hoshasen Gakkai Zasshi. 2001 Feb;61(3):96-9.
To analyze factors influencing the risk of complications associated with CT-guided percutaneous needle biopsy for lung lesions.
Sixty patients, aged 24-85 years (37 men and 23 women), underwent CT-guided needle biopsy. A definite diagnosis was made in 49 of 60 cases (81.7%), including 38 of 43 malignant lesions (88.4%) and 11 of 17 benign lesions (64.7%). Complications associated with biopsy were observed in 35 patients (58.3%). Major complications included pneumothorax (n = 26) and pulmonary hemorrhage (n = 20). Chest tube placement was needed in 5 (19.2%) of 26 pneumothorax cases (8.3% of all biopsies).
The high frequency of pneumothorax (43.3%) in this series had several contributing factors, including the presence of pulmonary emphysema, lesion size, and traversal of aerated lung. Chest tube replacement was necessary more frequently in patients with pulmonary emphysema. The number of pleural passes, location of lesions, and size of needles were not correlated with the incidence of pneumothorax.
The presence of pulmonary emphysema, lesion size, and traversal of aerated lung are the predominant risk factors for pneumothorax in patients with CT-guided lung biopsy.
分析影响CT引导下经皮肺穿刺活检术相关并发症风险的因素。
60例年龄在24 - 85岁之间的患者（37例男性，23例女性）接受了CT引导下经皮肺穿刺活检术。60例中有49例（81.7%）获得明确诊断，其中43例恶性病变中有38例（88.4%），17例良性病变中有11例（64.7%）。35例患者（58.3%）观察到与活检相关的并发症。主要并发症包括气胸（n = 26）和肺出血（n = 20）。26例气胸中5例（19.2%）需要放置胸腔闭式引流管（占所有活检的8.3%）。
本研究系列中气胸发生率高（43.3%）有几个促成因素，包括肺气肿的存在、病变大小以及穿刺经过含气肺组织。肺气肿患者更频繁地需要更换胸腔闭式引流管。胸膜穿刺次数、病变位置和穿刺针大小与气胸发生率无关。
肺气肿的存在、病变大小以及穿刺经过含气肺组织是CT引导下肺穿刺活检患者发生气胸的主要危险因素。
