Department of Radiology, Hospital A. C. Camargo, São Paulo, SP, Brazil.
Clinics (Sao Paulo). 2010;65(9):847-50. doi: 10.1590/s1807-59322010000900006.
Distinct aspects can influence the complication rates of computed tomography-guided percutaneous fine needle aspiration biopsy of lung lesions. The purpose of the current study is to determine the influence of radiological techniques and clinical characteristics in predicting complications from this procedure.
A retrospective study was developed involving 340 patients who were submitted to a consecutive series of 362 computed tomography-guided fine needle aspiration biopsies of lung lesions between July 1996 and June 2004, using 22-gauge needles (CHIBA). Variables such as the radiological characteristics of the lesions, secondary pulmonary radiological findings, co-morbidities, and aspects concerning the procedure were studied.
The diameters of the lung lesions varied from 9 to 140 mm, with a mean of 51.5 ± 24.3 mm and median of 40mm. The depth of the lesions varied from 10 mm to 130 mm, with a mean of 44 ± 20.9mm, and median median of 52 mm. Complications occurred in 52 (14.4%) cases, pneumothorax being the most frequent, with 40 (11.1%) cases, followed by hemoptisis with 7 (1.9%) cases, and hematoma with 4 (1.1%) cases. Lesions that did not contact the pleura, with normal pulmonary tissue interposition between lesion and pleura, had higher complication rates, with 22 (22%) cases, than lesions that contact the pleura, with 6 (9%) cases, with a statistically significant difference (p = 0.03).
CT-guided percutaneous fine needle aspiration biopsy of lung lesions had a lower rate of complications in our study and presented more rates of complications on lesions that lack pleural contact.
不同方面会影响 CT 引导下经皮肺穿刺活检的并发症发生率。本研究的目的是确定影像学技术和临床特征对预测该操作并发症的影响。
本回顾性研究纳入了 1996 年 7 月至 2004 年 6 月间 340 例连续接受 22Gauge（CHIBA）针 CT 引导下肺穿刺活检的患者。研究了病变的影像学特征、继发性肺部影像学发现、合并症以及与操作相关的方面等变量。
肺病变的直径范围为 9 至 140mm，平均为 51.5±24.3mm，中位数为 40mm。病变的深度范围为 10 至 130mm，平均为 44±20.9mm，中位数为 52mm。52 例（14.4%）发生了并发症，其中气胸最为常见，有 40 例（11.1%），其次是咯血 7 例（1.9%）和血肿 4 例（1.1%）。未与胸膜接触、病变与胸膜之间有正常肺组织间隔的病变，并发症发生率较高，有 22 例（22%），而与胸膜接触的病变，有 6 例（9%），差异有统计学意义（p=0.03）。
在我们的研究中，CT 引导下经皮肺穿刺活检的并发症发生率较低，且在缺乏胸膜接触的病变中并发症发生率更高。
