Factors Related to the Complications in CT-Guided Percutaneous Lung Automated Cutting Needle Biopsy
LIAO Meiyan1,ZHOU Yunfeng2,TIAN Zhixiong1,ZHANG Zaipeng1,Xu Liying1,LUO Rui11Dept. of Radiology,2Dept. of Radio-Chemotherapy,Zhongnan Hospital of Wuhan University,Wuhan 430071,China
Objective:To evaluate the complication rate of CT-guided percutaneous lung automated core needle biopsies (ACNB) with extrapleural locating method (EPL) and to analyze the impact of multiple factors on the incidence of pulmonary hemorrhage and pneumothorax. Methods:The signs of complication after 352 cases of CT-guided ACNB with EPL were observed and their relationship with multiple factors were analyzed by a multiple logistic regression model. Results:The final diagnostic accuracy was made in 334 cases (94.9%). Mean puncture time was (16.0±2.0) min. Eighty (22.7%) cases presented pulmonary hemorrhage and 18 (5.1%) presented hemoptysis. Single variate analysis showed that the sign of hemorrhage related to lesion diameter,pulmonary atelectasis,length of intrapulmonal biopsy path,and number of pleural needle passes. The multivariate logistic regression analysis showed that pulmonary atelectasis was protective factors (OR=0.321) of pulmonary hemorrhage. Sixty (17.0%) cases presented pneumothorax including 5 cases of later pneumothorax,2 (0.6%) cases required chest tube insertions. Single variate analysis showed that the sign of hemorrhage related to lesion size,chronic obstructive pulmonary disease (COPD),length of intrapulmonal biopsy path,and number of pleural needle passes. The multivariate logistic regression analysis showed that COPD and lesion diameter were risk factors of pneumothorax (OR=11.224,2.556 respectively). One case with pulmonary cryptococcus presented pleural reaction,and one case had the insistent pain. The total number of severe complications was 5 (1.4%) cases. Conclusion:ACNB with EPL is an accurate method for diagnosing pulmonary lesions. Pulmonary atelectasis could reduce bleeding rate. Patients with COPD and smaller lesion diameter significantly increase the risk of pneumothorax. Later and severe complications should be considered during the procedure.