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CT引导下肺活检中避免气胸的安全区域

Safe Zone to Avoid Pneumothorax in a CT-Guided Lung Biopsy.

作者信息

Maalouf Nour, Abou Mrad Mazen, Lavric Daniela, Vasileva Lora, Mahnken Andreas H, Apitzsch Jonas

机构信息

Department of Radiology and Nuclear Medicine, Helios Hospital Pforzheim, 75175 Pforzheim, Germany.

Department of Anesthesiology, Helios Hospital Pforzheim, 75175 Pforzheim, Germany.

出版信息

J Clin Med. 2023 Jan 17;12(3):749. doi: 10.3390/jcm12030749.

Abstract

Pneumothorax is one of the most frequent complications of computed tomography (CT)-guided lung biopsies. We aim to identify the safe zone of the needle-pleura angle during a CT-guided lung biopsy. Fifty-two patients underwent CT-guided lung biopsies between January 2020 and September 2022 (27 males, 25 females, median age 70 years). Right and left needle angles were measured and correlated to the incidence of pneumothorax. The minimum delta (δ) was calculated as the absolute value of the difference between a 90° angle and the right and left angles. -test -values for δ were conducted. We recorded 29 patients with pneumothorax, including intraprocedural and transient, postprocedural with minimal symptoms, or postprocedural requiring a chest tube insertion. Thirty-two patients had a δ ≥ 10°, while 20 had a δ < 10°. Of the patients with a δ < 10°, 30% experienced pneumothorax compared to 71.8% in patients with δ ≥ 10° ( = 0.0023). The study results show that as the needle's angle deviates from the perpendicular, with an absolute value of more than 10°, the likelihood of pneumothorax increases significantly. A needle-pleura angle between 80° and 100° gives the operator a safe zone to reduce the risk of pneumothorax.

摘要

气胸是计算机断层扫描(CT)引导下肺活检最常见的并发症之一。我们旨在确定CT引导下肺活检过程中针与胸膜夹角的安全区域。2020年1月至2022年9月期间,52例患者接受了CT引导下肺活检(男性27例,女性25例,中位年龄70岁)。测量左右针角,并将其与气胸发生率相关联。最小差值(δ)计算为90°角与左右针角差值的绝对值。对δ进行t检验。我们记录了29例气胸患者,包括术中及短暂性气胸、术后症状轻微的气胸或术后需要插入胸管的气胸。32例患者的δ≥10°,20例患者的δ<10°。δ<10°的患者中,30%发生了气胸,而δ≥10°的患者中这一比例为71.8%(P=0.0023)。研究结果表明,当针的角度偏离垂线,绝对值超过10°时,气胸的可能性显著增加。80°至100°的针与胸膜夹角为操作者提供了一个降低气胸风险的安全区域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e62/9918264/792b0e8444c0/jcm-12-00749-g001.jpg

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