Bilgisayarlı tomografi eşliğinde yapılan perkütan transtorasik biyopsinin tanı doğruluğu ve olası komplikasyonlarının değerlendirilmesi

Year 2021, Volume: 46 Issue: 1, 11 - 21, 31.03.2021

Sarhun Zirek , Kaan Esen , Rabia Bozdoğan Arpacı , Gurbet Yanarateş

Abstract

Amaç: Bu çalışmanın amacı, bilgisayarlı tomografi kılavuzluğunda yapılan perkütan transtorasik biyopsinin (PTB) komplikasyon oranlarını, tanı doğruluğunu ve komplikasyon oluşumunu etkileyen faktörlerin değerlendirilmesidir.
Gereç ve Yöntem: Bilgisayarlı tomografi eşliğinde biyopsi işlemi yapılan 153 hastayı retrospektif olarak değerlendirdik. On hastaya tekrar biyopsi yapıldığı için çalışmaya 163 PTB işlemi dahil edilmiştir..
Bulgular: Çalışmada 163 PTB işleminin 142’sinde (%87,1) tanısal sonuç sağlanmıştır. Biyopsi işlemi sırasında ve sonrasında 30 (%18,4) hastada pnömotoraks, 21 (%12,8) hastada parankimal kanama, 2 (%1,2) hastada hemoptizi gerçekleşmiştir. Pnömotoraks gelişimi ile hastanın yaşı, lezyonun nekroz içermesi, lezyon boyutu ve geçilen parankim mesafesi arasında anlamlı ilişki saptanmıştır. Parankimal kanama ile lezyon boyutu ve geçilen parankim mesafesi arasında istatistiksel olarak anlamlı ilişki saptanmıştır
Sonuç: Bilgisayarlı tomografi kılavuzluğunda uygulanan PTB, toraks kitlelerinin histopatolojik tanısını elde etmede etkili, yüksek doğruluk ve düşük komplikasyon oranlarına sahip, invaziv olan cerrahi işlemlere duyulan ihtiyacı azaltan güvenilir bir yöntemdir.

Keywords

transtorasik biyopsi, komplikasyon, bilgisayarlı tomografi

Evaluation of diagnostic accuracy and possible complications of computed tomography guided percutaneous transthoracic biopsy

Abstract

Purpose: The purpose of this study is to determine the diagnostic accuracy, the complication rates and the factors affecting the complications of computed tomography (CT) guided percutaneous transthoracic lung biopsy (PTB).
Materials and Methods: We retrospectively evaluated 153 patients who underwent transthoracic CT-guided biopsy. Re-biopsy were performed in 10 patients so that 163 transthoracic CT-guided biopsy were included in this study.
Results: Diagnostic results were achieved in 142 of 163 biopsy procedure (87.1%). During or after a biopsy procedure pneumothorax, parenchymal hemorrhage and hemoptysis were developed in 30 (18.4%), 21 (12.8%) and 2 (1.2%) patients respectively. A significant relationship was found between development of pneumothorax with the age of patient, the necrosis inclusion of the lesion, the size of the lesion and the parenchymal distance that was passed. There was a statistically significant correlation between parenchymal hemorrhage with the size of the lesion and the passed parenchymal distance.
Conclusion: Computed tomography-guided PTB is a reliable method that reduces the need of invasive surgical procedures with high accuracy and low complication rates in the histopathological diagnosis of thoracic masses.

Keywords

biopsy, computed tomography

References

• 1. Janssen-Heijnen MLG, Coebergh JWW. The changing epidemiology of lung cancer in Europe. Lung Cancer 2003; 41: 245-258.
• 2. Huhti E, Sutinen S, Reinila A, Poukkula A, Saloheimo M. Lung cancer in a defined geographical area: History and histological types. Thorax 1980; 35: 660-667.
• 3. Loubeyre P, Copercini M, Dietrich P-Y. Percutaneous CT-Guided Multisampling Core Needle Biopsy of Thoracic Lesions. AJR 2005; 185: 1294–1298.
• 4. Manhire A, Chairman, Charig M, Clelland C, Gleeson F, Miller R, et al. BTS Guidelines, Guidelines for radiologically guided lung biopsy. Thorax 2003; 58: 920–936.
• 5. Kazerooni EA, Lim FT, Mikhail A, Martinez FJ. Risk of pneumothorax in CT-guided transthoracic needle aspiration biopsy of the lung. Radiology 1996; 198: 371-375.
• 6. Topal U, Berkman YM. Effect of needle tract bleeding on occurrence of pneumothorax after transthoracic needle biopsy. European Journal of Radiology 2005; 53: 495–499.
• 7. Yeow K-M, Su I-H, Pan K-T, Tsay P-K, Lui K-W, Cheung Y-C, et al. Risk Factors of Pneumothorax and Bleeding: Multivariate Analysis of 660 CT-Guided Coaxial Cutting Needle Lung Biopsies. Chest 2004; 126: 748–754.
• 8. Geraghty PR, Kee ST, McFarlane G, Razavi MK, Sze DY, Dake MD. CT-guided transthoracic needle aspiration biopsy of pulmonary nodules: needle size and pneumothorax rate. Radiology 2003; 229: 475-481.
• 9. Topal U, Ediz B. Transthoracic needle biopsy: factors effecting risk of pneumothorax. EJR 2003; 48: 263–7.
• 10. Cox JE, Chiles C, McManus CM, Aquino SL, Choplin RH. Transthoracic needle aspiration biopsy: variables that affect risk of pneumothorax. Radiology 1999; 212: 165–168.
• 11. Miller KS, Fish GB, Stanely JH, Schabel SI. Prediction of pneumothorax rate in percutaneous needle aspiration of the lung. Chest 1988; 93: 742–5.
• 12. Anderson JM, Murchison J, Patel D. CT-guided Lung Biopsy: factors influencing diagnostic yield and complication rate. ClinRadiol 2003; 58: 791-797.
• 13. Aykut RA, Gözlek E, Yazkan R, Yilmaz O, Kayan M, Demirtas H, et al. Transthoracic biopsy of lung masses: Non technical factors affecting complication occurrence. Thorac cancer 2015; 6: 151-158.
• 14. Gümüştaş S, Çiftçi E. Akciğer Kanseri Tanısında Perkütan Biyopsiler. Türk Radyoloji Seminerleri, TrdSem 2014; 2: 354-363.
• 15. Satoh S, Ohdama S, Matsubara O. CT-guided Automated Cutting Needle Biopsy by a Combined Method for Accurate Specific Diagnosis of Focal Lung Lesions. Radiation Medicine 2005; 23(1):30–36.
• 16. Li Y, Dua Y, Yang HF, Yu JH, Xu XX. CT-guided percutaneous core needle biopsy for small (<20 mm) pulmonary lesions. Clinical radiology 2013; 68: 43-48.
• 17. Khan MF, Straub R, Moghaddam SR, Maataoui A, Gurung J, Wagner TOF, et al. Variables affecting the risk of pneumothorax and intrapulmonal hemorrhage in CT-guided transthoracic biopsy. EurRadiol 2008; 18: 1356–1363.
• 18. Tsukada H, Satou T, Iwashima A, Souma T. Diagnostic Accuracy of CT-Guided Automated Needle Biopsy of Lung Nodules. AJR 2000; 175: 239–243.
• 19. Lee KH, Lim KY, Suh YJ, Hur J, Han DH, Kang MJ, et al. Diagnostic Accuracy of Percutaneous Transthoracic Needle Lung Biopsies: A Multicenter Study. Korean J Radiol. 2019; 20: 1300-1310.