Maalouf Nour, Lavric Daniela, Vasileva Lora, Lamadé Wolfram, Apitzsch Jonas
Department of Radiology and Nuclear Medicine, Helios Hospital Pforzheim, 75175 Pforzheim, Germany.
Department of General and Visceral Surgery, Helios Hospital Pforzheim, 75175 Pforzheim, Germany.
J Clin Med. 2022 Apr 1;11(7):1958. doi: 10.3390/jcm11071958.
The purpose of this study is to assess the effect of nine covariates on the occurrence or absence of stable or symptomatic pneumothorax. Forty-three patients underwent CT-guided lung biopsies from January 2020 to January 2022 (24 m, 19 f, median age 70 years). All the interventions were carried out with a semi-automatic 18G needle and a 17G trocar in a prone or supine position. Different covariates were measured and correlated to the rate and severity of the pneumothoraces observed. Nominal two-sided -test -values for the continuous variables and Fisher's exact test results for the categorical variables were conducted. The data included the lesion size, distance to the pleura, needle-pleura angle, age, gender, position during the procedure, and the presence of chronic obstructive pulmonary disease. Patients with an observed pneumothorax had an average angle between the needle and the pleura of 74.00° compared to 94.68° in patients with no pneumothorax (-value = 0.028). A smaller angle measurement correlated with a higher risk of pneumothorax development. The needle-pleural angle plays a vital role in the outcome of a CT-guided lung biopsy. Correctly adjusting the needle-pleural angle can diminish the pneumothorax risk associated with a CT-guided lung biopsy. The study results show that as the needle's angle deviates from the perpendicular, the pleural surface area experiencing trauma increases, and pneumothorax is more likely to occur.
本研究的目的是评估九个协变量对稳定型或症状性气胸发生与否的影响。2020年1月至2022年1月期间,43例患者接受了CT引导下的肺活检(24例男性,19例女性,中位年龄70岁)。所有干预操作均使用半自动18G穿刺针和17G套管针,患者取俯卧位或仰卧位。测量了不同的协变量,并将其与观察到的气胸发生率和严重程度进行相关性分析。对连续变量进行了双侧检验,对分类变量进行了Fisher精确检验。数据包括病变大小、距胸膜的距离、针与胸膜的角度、年龄、性别、操作过程中的体位以及慢性阻塞性肺疾病的存在情况。观察到气胸的患者,针与胸膜的平均角度为74.00°,而无气胸的患者为94.68°(P值=0.028)。较小的角度测量值与气胸发生风险较高相关。针与胸膜的角度在CT引导下肺活检的结果中起着至关重要的作用。正确调整针与胸膜的角度可以降低CT引导下肺活检相关的气胸风险。研究结果表明,随着针的角度偏离垂线,受到创伤的胸膜表面积增加,气胸更易发生。