Chest
Clinical InvestigationsNeedles and CathetersThe Incidence and the Risk of Pneumothorax and Chest Tube Placement After Percutaneous CT-Guided Lung Biopsy: The Angle of the Needle Trajectory Is a Novel Predictor
Section snippets
Eligibility
This study included 289 consecutive lung biopsies under CT guidance performed in our institution from January 1998 to December 1999. Patients in this series had a pulmonary mass or nodule and negative bronchofiberscopic examination results, including transbronchial lung biopsy and transbronchial aspiration cytology with fluoroscopic guidance. Informed consent was obtained before the procedure in all cases.
Methods
All patients underwent chest CT before CT-guided lung biopsy at the time of the biopsy to
Results
The study included 169 men (58.5%) and 120 women (41.5%). The mean age (± SD) of the population was 64.0 ± 11.4 years (range, 25 to 93 years). The lesion was in the upper lung field in 111 patients (38.4%) and lower lung field in 178 patients (61.6%). The mean lesion size was 21.0 ± 14.2 mm (range, 3.0 to 90.0 mm). The average depth from the pleura to the lesion was 16.1 ± 14.9 mm (range, 1.0 to 65.0 mm). The mean angle of the needle path was 23.5 ± 15.9° (range, 1.0 to 65.0°). Among the
Discussion
Pneumothorax remains the most common complication of CT-guided lung biopsy, despite improved techniques. The rate of pneumothorax following lung biopsy with CT guidance reported in the literature ranges from 19 to 60%.2,3,4,5,6,7,8,9 In our study, the rate of pneumothorax was 26.6%, and that of chest tube placement was 14.2%, which were similar to rates observed in other studies.15,16,17,18,19,20,21,22 Many authors reported that various items influence this rate, including patient factors (age,
ACKNOWLEDGMENT
We thank Toshiya Onoda, Tatsuo Ohira, Kiyoshi Ogata, and Masaharu Nomura for assistance and comments. The authors thank Professor J. Patrick Barron of the International Medical Communications Center of Tokyo Medical University for his review of this article.
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