Khosla Rahul, McLean Anna W, Smith Jessica A
Department of Pulmonary and Critical Care, Veteran Affairs Medical Center, George Washington University, Washington, DC, USA.
Department of Pulmonary and Critical Care, Veterans Affairs Medical Center, George Washington University, Washington, DC, USA.
Lung India. 2016 Sep-Oct;33(5):487-92. doi: 10.4103/0970-2113.188961.
Computed tomography (CT) guided biopsies have long been the standard technique to obtain tissue from the thoracic cavity and is traditionally performed by interventional radiologists. Ultrasound (US) guided biopsy of pleural-based lesions, performed by pulmonologists is gaining popularity and has the advantage of multi-planar imaging, real-time technique, and the absence of radiation exposure to patients. In this study, we aim to determine the diagnostic accuracy, the time to diagnosis after the initial consult placement, and the complications rates between the two different modalities.
A retrospective study of electronic medical records was done of patients who underwent CT-guided biopsies and US-guided biopsies for pleural-based lesions between 2005 and 2014 and the data collected were analyzed for comparing the two groups.
A total of 158 patients underwent 162 procedures during the study period. 86 patients underwent 89 procedures in the US group, and 72 patients underwent 73 procedures in the CT group. The overall yield in the US group was 82/89 (92.1%) versus 67/73 (91.8%) in the CT group (P = 1.0). Average days to the procedure was 7.2 versus 17.5 (P = 0.00001) in the US and CT group, respectively. Complication rate was higher in CT group 17/73 (23.3%) versus 1/89 (1.1%) in the US group (P < 0.0001).
For pleural-based lesions the diagnostic accuracy of US guided biopsy is similar to that of CT-guided biopsy, with a lower complication rate and a significantly reduced time to the procedure.
计算机断层扫描（CT）引导下的活检长期以来一直是从胸腔获取组织的标准技术，传统上由介入放射科医生进行。由肺科医生进行的超声（US）引导下的胸膜病变活检越来越受欢迎，它具有多平面成像、实时技术以及患者无辐射暴露的优势。在本研究中，我们旨在确定两种不同方式的诊断准确性、初次会诊后至诊断的时间以及并发症发生率。
对2005年至2014年间接受CT引导活检和US引导活检的胸膜病变患者的电子病历进行回顾性研究，并对收集的数据进行分析以比较两组。
在研究期间，共有158例患者接受了162次手术。US组86例患者接受了89次手术，CT组72例患者接受了73次手术。US组的总体成功率为82/89（92.1%），而CT组为67/73（91.8%）（P = 1.0）。US组和CT组手术的平均天数分别为7.2天和17.5天（P = 0.00001）。CT组的并发症发生率更高，为17/73（23.3%），而US组为1/89（1.1%）（P < 0.0001）。
对于胸膜病变，US引导活检的诊断准确性与CT引导活检相似，并发症发生率较低，且手术时间显著缩短。
