Zhao Yanfeng, Wang Xiaoyi, Wang Yong, Zhu Zheng
Department of Diagnostic Radiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Department of Ultrasound, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
J Thorac Dis. 2017 Nov;9(11):4750-4757. doi: 10.21037/jtd.2017.09.47.
Pneumothorax is the most common complication of computed tomography (CT)-guided needle biopsy. The purpose of this study was to investigate independent risk factors of pneumothorax, other than emphysema, after CT-guided needle biopsy and to establish a risk prediction model.
A total of 864 cases of CT-guided needle biopsy with an 18-gauge cutting needle were enrolled in this study. The relevant risk factors associated with pneumothorax included age, sex, emphysema, short-axis size of the lesion, depth of the lesion, body position, and the number of pleural punctures. Several independent risk factors of pneumothorax were found, and a predictive model for pneumothorax was established using univariate and multivariate logistic regression analyses.
Pneumothorax occurred in 31.4% (271/864) of cases. Univariate analysis showed that significant risk factors of pneumothorax included age, emphysema, small lesion size, no contact between the lesion and the pleura, prone or lateral body position, and multiple punctures. Independent risk factors of pneumothorax in the multivariate logistic regression analysis included emphysema (P=0.000), no contact between the lesion and the pleura (P=0.000), prone or lateral body position (P=0.002), and the number of pleural punctures (P=0.000). The sensitivity, specificity, and accuracy of the predictive model for pneumothorax were 56.8%, 79.6%, and 72.5%, respectively.
Pneumothorax is a common complication of CT-guided lung biopsy. Independent risk factors of pneumothorax include emphysema, no contact between the lesion and the pleura, and prone or lateral body position. The predictive model developed in this study was highly accurate in predicting the incidence of pneumothorax.
气胸是计算机断层扫描（CT）引导下经皮肺穿刺活检最常见的并发症。本研究旨在探讨CT引导下经皮肺穿刺活检后除肺气肿外气胸的独立危险因素，并建立风险预测模型。
本研究共纳入864例采用18G切割针进行CT引导下经皮肺穿刺活检的患者。与气胸相关的危险因素包括年龄、性别、肺气肿、病灶短径、病灶深度、体位及胸膜穿刺次数。发现了几个气胸的独立危险因素，并采用单因素和多因素逻辑回归分析建立了气胸预测模型。
864例患者中，气胸发生率为31.4%（271/864）。单因素分析显示，气胸的显著危险因素包括年龄、肺气肿、病灶较小、病灶与胸膜无接触、俯卧位或侧卧位及多次穿刺。多因素逻辑回归分析显示，气胸的独立危险因素包括肺气肿（P=0.000）、病灶与胸膜无接触（P=0.000）、俯卧位或侧卧位（P=0.002）及胸膜穿刺次数（P=0.000）。气胸预测模型的敏感度、特异度和准确度分别为56.8%、79.6%和72.5%。
气胸是CT引导下肺穿刺活检的常见并发症。气胸的独立危险因素包括肺气肿、病灶与胸膜无接触、俯卧位或侧卧位。本研究建立的预测模型对气胸发生率的预测准确性较高。
