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锥形束CT引导下经支气管肺冷冻活检后的即时及随访影像学表现

Immediate and Follow-up Imaging Findings after Cone-Beam CT-guided Transbronchial Lung Cryobiopsy.

作者信息

Pogatchnik Brian P, Swenson Kai E, Duong Duy Kevin, Shaller Brian, Bedi Harmeet, Guo H Henry

机构信息

Department of Radiology (B.P.P., H.H.G.) and Division of Pulmonology, Allergy, and Critical Care Medicine, Department of Medicine (D.K.D., B.S., H.B.), Stanford University School of Medicine, 300 Pasteur Dr, S072, Stanford, CA 94305; Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.E.S.); and Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA (K.E.S.).

出版信息

Radiol Cardiothorac Imaging. 2023 Mar 23;5(2):e220149. doi: 10.1148/ryct.220149. eCollection 2023 Apr.

Abstract

PURPOSE

To evaluate findings after transbronchial lung cryobiopsy (TBLC) using intraprocedural cone-beam CT (CBCT) and follow-up chest CT examinations.

MATERIALS AND METHODS

A single-center, prospective cohort study was performed with 14 participants (mean age, 65 years ± 13 [SD]; eight male participants) undergoing CBCT-guided TBLC between August 2020 and February 2021 who underwent follow-up chest CT imaging. Intraprocedural CBCT and follow-up chest CT images were interpreted for changes compared with baseline CT images. Statistical analyses were performed using independent samples test and analysis of variance.

RESULTS

A total of 62 biopsies were performed, with 48 in the field of view of CBCT immediately after biopsy. All 48 biopsy sites had evidence of postprocedural hemorrhage, and 17 (35%) had pneumatoceles at the biopsy site. Follow-up CT images showed resolution of these findings. Solid nodules developed at 18 of the 62 (29%) biopsy sites.

CONCLUSION

Postbiopsy hemorrhage and pneumatoceles on intraprocedural CBCT images (which were clinically occult and resolved spontaneously) and new solid nodules on follow-up chest CT images were commonly observed after TBLC. These findings may help alleviate unnecessary follow-up imaging and tissue sampling. Biopsy/Needle Aspiration, CT, Lungs, Lung Biopsy, Interventional Bronchoscopy© RSNA, 2023.

摘要

目的

使用术中锥形束CT(CBCT)和胸部CT随访检查评估经支气管肺冷冻活检(TBLC)后的结果。

材料与方法

进行了一项单中心前瞻性队列研究,纳入了2020年8月至2021年2月期间接受CBCT引导下TBLC并进行胸部CT随访成像的14名参与者(平均年龄65岁±13[标准差];8名男性参与者)。将术中CBCT和胸部CT随访图像与基线CT图像进行对比,解读其变化情况。采用独立样本检验和方差分析进行统计分析。

结果

共进行了62次活检,活检后立即在CBCT视野内有48次。所有48个活检部位均有术后出血迹象,17个(35%)活检部位出现肺气囊。随访CT图像显示这些表现消失。62个活检部位中有18个(29%)出现实性结节。

结论

TBLC术后常见术中CBCT图像上的活检后出血和肺气囊(临床上隐匿且自发消退)以及胸部CT随访图像上的新实性结节。这些发现可能有助于减少不必要的随访成像和组织采样。活检/针吸活检、CT、肺、肺活检、介入性支气管镜检查©RSNA,2023年。

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