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经皮穿刺肺活检时活检针穿过病变中央部位会增加咯血风险吗?

Does biopsy needle traversing through central portion of lesion increase the risk of hemoptysis during percutaneous transthoracic needle biopsy?

机构信息

Department of Radiology, Mackay Memorial Hospital, Taipei Branch, No. 92, Sec. 2, Zhongshan N. Rd., Taipei, 10449, Taiwan.

Department of Medicine, Mackay Medical College, Taipei, Taiwan.

出版信息

Jpn J Radiol. 2018 Mar;36(3):231-237. doi: 10.1007/s11604-018-0719-2. Epub 2018 Jan 19.

Abstract

PURPOSE

To evaluate whether traversal through the central part of a pulmonary lesion by a biopsy needle, and other factors, increases the risk of hemoptysis in patients undergoing CT-guided percutaneous transthoracic needle biopsy (PTNB).

MATERIALS AND METHODS

From July 2012 to November 2016, 227 patients undergoing 233 procedures were recruited as our study population. Patients were classified according to the occurrence of hemoptysis. Radiological assessments were performed by reviewing multiplanar reconstructed CT images. Other factors complicating PTNB-related hemoptysis were classified into (1) patient-related variables: age, gender, presence of emphysema; (2) lesion-related variables: size, location, distance to pleura, characteristics, presence of and degree of enhancement, histopathology of biopsy results; and (3) procedure-related variables: lesion depth, patient's body position.

RESULTS

Twenty-two cases (9.4%) experienced hemoptysis. Univariate analysis revealed that subsolid lesions (p = 0.031) and lesion depth > 1 cm (p = 0.049) were risk factors. Traversal through the central part of the lesion by the biopsy needle was not a risk factor.

CONCLUSION

Traversal through the central part of the lesion by the biopsy needle is not a risk factor of PTNB-related hemoptysis, but subsolid lesions and lesion depth > 1 cm increase the risk of hemoptysis.

摘要

目的

评估活检针穿过肺部病变中央部位以及其他因素是否会增加 CT 引导经皮穿刺活检(PTNB)患者发生咯血的风险。

材料与方法

2012 年 7 月至 2016 年 11 月,我们招募了 227 例 233 次接受 CT 引导下经皮穿刺活检的患者作为研究对象。根据是否发生咯血对患者进行分类。通过回顾多平面重建 CT 图像进行影像学评估。将与 PTNB 相关的咯血相关的其他因素分为(1)患者相关变量:年龄、性别、肺气肿存在情况;(2)病变相关变量:大小、位置、距胸膜的距离、特征、强化程度、活检结果的组织病理学;(3)操作相关变量:病变深度、患者体位。

结果

22 例(9.4%)发生咯血。单因素分析显示,亚实性病变(p=0.031)和病变深度>1cm(p=0.049)是风险因素。活检针穿过病变中央部位不是风险因素。

结论

活检针穿过病变中央部位不是 PTNB 相关咯血的危险因素,但亚实性病变和病变深度>1cm 会增加咯血的风险。

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