Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Shanghai Institute of Medical Imaging, Shanghai, China.
BMC Pulm Med. 2024 Jan 13;24(1):33. doi: 10.1186/s12890-023-02822-9.
This study aimed to assess the incidence and clinical significance of pneumothorax (PTX) and pulmonary hemorrhage (PH) after percutaneous transthoracic lung biopsy (PTLB) guided by C-arm cone-beam computed tomography (CBCT). Furthermore, this study aimed to examine the relationships between PTX and PH with demographics, clinical characteristics, imaging, and PTLB parameters.
A retrospective analysis was conducted on 192 patients who underwent PTLB at our hospital between January 2019 and October 2022. Incidences of PTX and PH were recorded. PTX was considered clinically significant if treated with chest tube insertion (CTI), and PH if treated with bronchoscopes or endovascular treatments. The various factors on PTX and PH were analyzed using the Chi-squared test and Student t-test. Logistic regression analyses were then used to determine these factors on the correlation to develop PTX and PH.
PTX occurred in 67/192 cases (34.9%); CTI was required in 5/67 (7.5%). PH occurred in 63/192 cases (32.8%) and none of these cases required bronchoscopes or endovascular treatments. Lesion diameter (OR = 0.822; OR = 0.785), presence of pulmonary emphysema (OR = 2.148), the number of samples (OR = 1.834), the use of gelfoam (OR = 0.474; OR = 0.341) and ablation (OR = 2.351; OR = 3.443) showed statistically significant correlation to PTX and PH.
CBCT-guided PTLB is a safe and effective method for performing lung biopsies. The use of gelfoam has been shown to reduce the occurrence of PTX and PH. However, caution should be exercised when combining radiofrequency ablation with PTLB, as it may increase the risk of PTX and PH.
本研究旨在评估 C 臂锥形束 CT（CBCT）引导下经皮经胸肺活检（PTLB）后气胸（PTX）和肺出血（PH）的发生率及临床意义。此外，本研究还旨在探讨 PTX 和 PH 与人口统计学、临床特征、影像学和 PTLB 参数之间的关系。
对 2019 年 1 月至 2022 年 10 月在我院行 PTLB 的 192 例患者进行回顾性分析。记录 PTX 和 PH 的发生率。如果需要胸腔管插入（CTI）治疗，则认为 PTX 具有临床意义；如果需要支气管镜或血管内治疗，则认为 PH 具有临床意义。采用卡方检验和学生 t 检验分析 PTX 和 PH 的各种因素。然后使用 logistic 回归分析确定这些因素与 PTX 和 PH 的相关性。
192 例患者中，PTX 发生 67 例（34.9%），其中 5 例（7.5%）需要 CTI 治疗。PH 发生 63 例（32.8%），均无需支气管镜或血管内治疗。病灶直径（OR=0.822；OR=0.785）、肺气肿存在（OR=2.148）、样本数量（OR=1.834）、使用明胶海绵（OR=0.474；OR=0.341）和消融（OR=2.351；OR=3.443）与 PTX 和 PH 具有统计学显著相关性。
CBCT 引导下的 PTLB 是一种安全有效的肺活检方法。使用明胶海绵可降低 PTX 和 PH 的发生。然而，在 PTLB 中联合使用射频消融时应谨慎，因为这可能会增加 PTX 和 PH 的风险。
