Johansen Katrine Bitsch, Valtersson John, Laursen Christian B, Mussmann Bo, Rasmussen Benjamin, Graumann Ole, Pietersen Pia Iben
UNIFY - Research and Innovation Unit of Radiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark.
Acta Radiol Open. 2025 Mar 20;14(3):20584601251326485. doi: 10.1177/20584601251326485. eCollection 2025 Mar.
Computerized tomography-guided transthoracic needle biopsy (CT-TTNB) plays an important role in the diagnostic work-up of lung lesions. The literature reports varying results on complication rates, severity of complications, and diagnostic yield.
To evaluate CT-TTNB as a radiological outpatient clinic procedure and explore diagnostic yield and complication rates.
Between January 2017 and October 2019, a total of 559 patients underwent CT-TTNB. Patient records and CT scans were retrospectively reviewed and patient characteristics, lesion characteristics, biopsy procedure, and per- and post-procedural complications, as well as pathological diagnosis, were registered.
Of 559 patients included, 511 had biopsies performed. Thereby, 48 biopsies (8.6%) were discontinued because of patient compliance issues and/or the occurrence of pneumothorax before the biopsy was performed. The overall pneumothorax rate was 49.2% ( = 275 of 559 patients). Insertion of a drainage catheter was needed in 85 of the 275 patients with pneumothorax. Parenchymal bleeding was seen in 26.5% of the patients and haemoptysis in 5.5%. No cases of bleeding or haemoptysis required intervention or admission. Small mean lesion size and increased distance from pleura to the lesion were associated with a higher occurrence of complications. A conclusive pathological diagnosis was obtained in 278 of 511 (54.4%) biopsies. No patients were re-admitted after the two-hour observational period in the radiological department.
CT-TTNB as an outpatient clinic procedure is feasible but has a moderate diagnostic yield and relatively high complication rates for minor complications.
计算机断层扫描引导下经胸针吸活检术（CT-TTNB）在肺部病变的诊断检查中发挥着重要作用。文献报道了并发症发生率、并发症严重程度及诊断率的不同结果。
评估CT-TTNB作为放射科门诊手术的情况，并探讨诊断率和并发症发生率。
2017年1月至2019年10月期间，共有559例患者接受了CT-TTNB。对患者记录和CT扫描进行回顾性分析，记录患者特征、病变特征、活检过程、术前及术后并发症以及病理诊断。
在纳入的559例患者中，511例进行了活检。其中，48例（8.6%）活检因患者依从性问题和/或活检前发生气胸而中断。总体气胸发生率为49.2%（559例患者中有275例）。275例气胸患者中有85例需要插入引流导管。26.5%的患者出现实质内出血，5.5%的患者出现咯血。没有出血或咯血病例需要干预或住院。平均病变较小以及从胸膜到病变的距离增加与较高的并发症发生率相关。511例活检中有278例（54.4%）获得了确定性病理诊断。在放射科两小时观察期后，没有患者再次入院。
CT-TTNB作为门诊手术是可行的，但诊断率中等，轻微并发症的发生率相对较高。
