18게이지 자동생검총을 이용한 전산화단층촬영 유도하 경피적 폐조직 절단생검: 진단적 유용성과 안전성에 관한 고찰 = CT-guided Transthoracic Needle Biopsy with an 18-Guage Automated Cutting Needle: Diagnostic benefits and safety

다국어 초록 (Multilingual Abstract)

Purpose: We wanted to evaluate the diagnostic benefits and safety of performing CT-guided transthoracic needle biopsy (TTNB) with using an18-gauge automated cutting needle.
Materials and Methods: We retrospectively reviewed the medical records of 332 patients who underwent CTguided transthoracic biopsy with an automated 18-gauge cutting needle for 341 thoracic lesions. The histopathologic results, diagnostic accuracy and complication rate were determined.
Results: 316 (92.7%) of 34l lesions were histopathologically diagnosed by CT-guided TTNB. The lesions were malignant in 172 patients and benign in 144 patients. The diagnostic accuracy was 92.9%. The sensitivity and specificity for malignant lesions were 93% and 92.3%, respectively. The sensitivity and specificity for benign lesions were 92.3% and 93%, respectively. TTNB induced complications developed for 54 of 341 (15.8%) procedures. The most frequent complication was pneumothorax (41/341, 12%). Nine patients with pneumothorax (9/41, 22%) required chest tube placement.
Conclusion: CT-guided TTNB with an 18-gauge automated cutting needle could be useful for making the histopathologic diagnosis of malignant and benign pulmonary lesions as the technique provides a big enough tissue sample for histopathologic examination. The procedure-related complication rate was acceptably low.

국문 초록 (Abstract)

목적: 18 게이지 자동 생검총을 이용한 전산화단층촬영 유도하 경피적 절단 조직 생검의 성적과 이에 따른 합병증 등을 분석하여 이의 진단적 유용성과 안전성에 대하여 알아보고자 하였다.
대상과 방법: 전산화단층촬영 유도하에서 18 게이지(Gauge) Magnum needle을 사용한 자동생검총을 이용하여 경피적 절단 조직 생검술을 시행 받은 332명의 환자 341병소를 대상으로 하였다. 조직 생검 후 조직학적 진단 결과와 진단율 그리고 생검 후 발생한 합병증에 대하여 후향적으로 분석하였다.
결과: 총 341예 중 조직학적 진단이 가능했던 경우는 316예(92.7%)이었으며, 이중 172예에서 악성 병변으로 그리고 144예에서는 양성 병변으로 진단되었다. 진단의 정확도는 92.9% 이었다. 악성 질환에 대해서 민감도는 93%, 특이도는 92.3%이었고, 양성 질환에 대한 민감도는 92.3%, 특이도는 93%이었다. 시술 후 합병증은 54예에서 발생하여 15.8%의 발생률을 보였으며, 이중 기흉이 41예(12%)로 가장 높은 발생률을 보였으며, 기흉이 발생한 환자 중 시술 후 처치가 필요한 경우는 9예 이었다.
결론: 흉부 전산화단층촬영 유도하의 자동 생검총을 이용한 경피적 절단 조직 생검은 간단하면서 비교적 낮은 합병증 발생률로 조직학적 진단에 필요한 충분한 조직을 얻을 수 있어 악성은 물론 양성 폐질환 진단의 정확도를 높여 줄 수 있는 유용한 검사 방법으로 생각된다.

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