Department of Radiology, Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
Eur Radiol. 2019 Jul;29(7):3372-3378. doi: 10.1007/s00330-018-5991-0. Epub 2019 Jan 21.
To determine the frequency and causes of canceled or aborted CT-guided interventions (biopsies, cytological aspirations, hookwire localizations, and catheter drainages), associations with patient and procedural variables, and subsequent management.
This study included 3052 consecutive CT-guided interventions (2487 biopsies, 80 cytological aspirations, 223 hookwire localizations, and 262 catheter drainages) performed in a single institution within a 13-year period.
Fifty-two of 3052 CT-guided interventions were canceled or aborted, corresponding to a frequency of 1.7% (95% confidence interval [CI] 1.3-2.2%). Main causes in order of decreasing frequency included pain, lack of a safe window for intervention, impossibility to position the co-axial or biopsy needle in or near the target, inability to lie still, dyspnea and low oxygen saturation levels, non-discontinuation of anticoagulant therapy, impossibility to aspirate fluid or pus when attempting drainage, and impossibility to advance the drainage catheter in a fluid collection or abscess. On multivariate analysis, only catheter drainages and head-neck interventions were significantly at risk (p = 0.019 and p = 0.004) to be canceled or aborted, with odds ratios of 2.677 (95% CI 1.178-6.083) and 6.956 (95% CI 1.883-25.691), respectively. Of 52 canceled or aborted CT-guided interventions, 14 (26.9%) were repeated, 19 (36.5%) underwent a different non-CT-guided interventional procedure on the same target, and 19 (36.5%) did not undergo any subsequent intervention.
The frequency of canceled or aborted CT-guided interventions is low, but is not negligible. Awareness of causes and circumstances under which they are more likely to occur may reduce the number of canceled or aborted CT-guided interventions.
• Approximately 1.7% of CT-guided interventions, for which the patient physically shows up at the CT room and which are considered useful by the radiologist, are eventually canceled or aborted. • Main causes (of which some may be prevented) are pain, lack of a safe window, impossibility to position the co-axial or biopsy needle, inability to lie still, dyspnea, non-discontinuation of anticoagulant therapy, and impossibility to aspirate liquid or advance the catheter when attempting drainage. • CT-guided catheter drainages and head-neck interventions are particularly prone to being canceled or aborted.
确定 CT 引导介入（活检、细胞学抽吸、钩丝定位和导管引流）中取消或中断的频率和原因，及其与患者和操作变量的关联，并确定后续管理。
本研究纳入了 13 年内在一家机构进行的 3052 例连续 CT 引导介入（2487 例活检、80 例细胞学抽吸、223 例钩丝定位和 262 例导管引流）。
3052 例 CT 引导介入中有 52 例被取消或中断，占 1.7%（95%置信区间 [CI] 1.3-2.2%）。按频率降序排列的主要原因包括疼痛、介入无安全窗口、同轴或活检针无法定位到或靠近目标、无法保持静止、呼吸困难和低氧饱和度、抗凝治疗未中断、尝试引流时无法抽吸液体或脓液、以及在液体积聚或脓肿中无法推进引流导管。多变量分析显示，仅导管引流和头颈部介入显著有被取消或中断的风险（p=0.019 和 p=0.004），其比值比分别为 2.677（95%CI 1.178-6.083）和 6.956（95%CI 1.883-25.691）。在 52 例取消或中断的 CT 引导介入中，14 例（26.9%）被重复，19 例（36.5%）在同一目标上进行了不同的非 CT 引导介入操作，19 例（36.5%）未进行任何后续介入。
取消或中断的 CT 引导介入的频率虽然较低，但不容忽视。了解更有可能发生的原因和情况，可能会减少取消或中断的 CT 引导介入数量。
约有 1.7%的 CT 引导介入，患者实际上已到达 CT 室，且放射科医生认为这些介入有用，但最终被取消或中断。
主要原因（其中一些原因可预防）包括疼痛、缺乏安全窗口、同轴或活检针无法定位、无法保持静止、呼吸困难、抗凝治疗未中断、尝试引流时无法抽吸液体或推进导管。
CT 引导的导管引流和头颈部介入尤其容易被取消或中断。
