Boskovic Tatjana, Stanic Jelena, Pena-Karan Slobodanka, Zarogoulidis Paul, Drevelegas Kostas, Katsikogiannis Nikolaos, Machairiotis Nikolaos, Mpakas Andreas, Tsakiridis Kosmas, Kesisis Georgios, Tsiouda Theodora, Kougioumtzi Ioanna, Arikas Stamatis, Zarogoulidis Konstantinos
1 Institute for pulmonary diseases of Vojvodina, Center for Radiology, Faculty of Medicine, University of Novi Sad, Sremska Kamenica,Vojvodina, Serbia; 2 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Radiology Department, "Thiagenio" Cancer Hospital, Thessaloniki, Greece ; 4 Surgery Deparment (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 5 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 6 Cardiothoracic Surgery Department, 7 Oncology Department, "Saint Luke" Private Hospital, Thessaloniki, Panorama, Greece ; 8 Internal Medicine Department, "Thiagenio" Cancer Hospital, Thessaloniki, Greece.
J Thorac Dis. 2014 Mar;6 Suppl 1(Suppl 1):S99-S107. doi: 10.3978/j.issn.2072-1439.2013.12.08.
Transthoracic needle biopsy (TTNB) is done with imaging guidance and most frequently by a radiologist, for the aim is to diagnose a defined mass. It is integral in the diagnosis and treatment of many thoracic diseases, and is an important alternative to more invasive surgical procedures. FNAC is a method of aspiration cytopathology, which with transthoracic biopsy ("core biopsy") is a group of percutaneous minimally invasive diagnostic procedures for exploration of lung lesions. Needle choice depends mostly upon lesion characteristics and location. A recent innovation in biopsy needles has been the introduction of automatic core biopsy needle devices that yield large specimens and improve the diagnostic accuracy of needle biopsy. Both computed tomography and ultrasound may be used as imaging guidance for TTNB, with CT being more commonly utilized. Common complications of TTNB include pneumothorax and hemoptysis. The incidence of pneumothorax in patients undergoing TTNB has been reported to be from 9-54%, according to reports published in the past ten years, with an average of around 20%. Which factors statistically correlate with the frequency of pneumothorax remain controversial, but most reports have suggested that lesion size, depth and the presence of emphysema are the main factors influencing the incidence of pneumothorax after CT-guided needle biopsy. On the contrary, gender, age, and the number of pleural passes have not been shown to correlate with the incidence of pneumothorax. The problem most responsible for complicating outpatient management, after needle biopsy was performed, is not the presence of the pneumothorax per se, but an increase in the size of the pneumothorax that requires chest tube placement and patient hospitalization. Although it is a widely accepted procedure with relatively few complications, precise planning and detailed knowledge of various aspects of the biopsy procedure is mandatory to avert complications.
经胸针吸活检（TTNB）在影像引导下进行，多数情况下由放射科医生操作，目的是诊断明确的肿块。它在许多胸部疾病的诊断和治疗中不可或缺，是侵入性更强的外科手术的重要替代方法。细针穿刺抽吸活检（FNAC）是一种针吸细胞病理学方法，与经胸活检（“芯针活检”）一样，是一组用于探查肺部病变的经皮微创诊断程序。针的选择主要取决于病变特征和位置。活检针的一项最新创新是引入了自动芯针活检针装置，该装置能获取大标本并提高针吸活检的诊断准确性。计算机断层扫描（CT）和超声均可用作TTNB的影像引导，其中CT更为常用。TTNB的常见并发症包括气胸和咯血。根据过去十年发表的报告，接受TTNB的患者气胸发生率据报道为9% - 54%，平均约为20%。哪些因素与气胸发生频率存在统计学关联仍存在争议，但大多数报告表明，病变大小、深度以及肺气肿的存在是影响CT引导下针吸活检后气胸发生率的主要因素。相反，性别、年龄和胸膜穿刺次数与气胸发生率并无关联。针吸活检后，使门诊管理复杂化的最主要问题并非气胸本身的存在，而是气胸扩大，这需要放置胸管并让患者住院。尽管这是一种广泛接受且并发症相对较少的操作，但为避免并发症，必须进行精确规划并详细了解活检操作的各个方面。
