CT fluoroscopy-guided biopsy of pulmonary lesions contacting the interlobar fissure: An analysis of 72 biopsies
CT fluoroscopy-guided biopsy of pulmonary lesions contacting the interlobar fissure: An analysis of 72 biopsies
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CT 透视引导下接触叶间裂的肺部病变活检：72 例活检的分析
DOI：
10.1016/j.diii.2022.01.008
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发表时间：
2022
影响因子：
5.5
通讯作者：
Hiraki Takao
中科院分区：
文献类型：
--
作者：
Iguchi Toshihiro;Matsui Yusuke;Tomita Koji;Uka Mayu;Umakoshi Noriyuki;Munetomo Kazuaki;Hiraki Takao
目的回顾性评价CT透视引导下肺内叶间裂接触病灶活检的安全性和诊断率。材料与方法72例肺内叶间裂接触病灶72例患者（男33例，女39例;平均年龄，69.7 ± 10.3 [SD]岁;年龄范围：37-91岁）。对多个变量进行了评估，以确定诊断失败和气胸的风险因素。此外，将这些变量在这72个病变和随机选择的对照之间进行比较（即，结果14例经肺裂穿刺活检成功，23例经肺裂穿刺活检成功，35例经肺裂穿刺活检成功，23例经肺裂穿刺活检成功。68例（94.4%）手术诊断成功，4例（5.6%）手术失败。有27例I级气胸（37.5%）、1例（1.4%）II级出血和5例（6.9%）IIIa级气胸需要放置胸管。有气胸组和无气胸组在患者、病变或手术相关变量方面无显著差异。诊断率和气胸发生率与叶间裂接触和controls.ConclusionCT荧光镜引导下活检肺病变叶间裂接触之间没有显着差异是一个安全的程序，诊断率高。此外，由于潜在的并发症，只有在不可能有更安全的途径时才应使用经裂隙途径。
PurposeThe purpose of this study was to evaluate retrospectively the safety and diagnostic yield of computed tomography (CT) fluoroscopy-guided biopsy for pulmonary lesions with interlobar fissure contact.Materials and methodsSeventy-two lesions showing interlobar fissure contact (mean size, 15.2 ± 5.3 [SD] mm [range: 5.3–27.0 mm]; mean length of interlobar fissure contact, 8.9 ± 3.6 [SD] mm [range: 2.6–17.5 mm] in 72 patients (33 men, 39 women; mean age, 69.7 ± 10.3 [SD] years; age range: 37–91 years) were evaluated. Multiple variables were assessed to determine the risk factors for diagnostic failure and pneumothorax. Additionally, these variables were compared between these 72 lesions and randomly selected controls (i.e., non-contact lesions).ResultsAll biopsies were technically successful using the transfissural (n= 14) or conventional routes (the route into the lung lobe with the target) with (n= 35) or without (n= 23) possible risk of needle insertion into the interlobar fissure after penetrating the target lesion. Sixty-eight (94.4%) procedures succeeded diagnostically and four (5.6%) failed. There were 27 grade I pneumothorax (37.5%), one (1.4%) grade II bleeding, and five (6.9%) grade IIIa pneumothorax requiring chest tube placement. Groups with and without pneumothorax did not differ significantly in patient-, lesion-, or procedure-related variables. Diagnostic yields and pneumothorax occurrence showed no significant differences between lesions with interlobar fissure contact and controls.ConclusionCT fluoroscopy-guided biopsy of pulmonary lesions with interlobar fissure contact is a safe procedure with a high diagnostic yield. Furthermore, because of potential complications, the transfissural route should be used only when a safer route is not possible.