CT 유도하의 경피적 폐생검 : 임상적 의의 및 합병증에 관한 연구 A Study of Clinical Significance and Complication = CT-guided Transthoracic Needle Biopsy

다국어 초록 (Multilingual Abstract)

Purpose : To determine the diagnostic accuracy and predicting factor of pneumothorax on CT-guided percutaneous transthoracic needle biopsy.
Materials and Methods : Using automated biopsy devices, 107 CT-guided percutaneous needle biopsies of pulmonary lesions were performed. Final diagnosis was made with operation or other methods. We retrospectively analyzed the frequency of complications and diagnostic yields of 107 biopsies. The clinical features, treatment, and courses of complications were reviewed, and risk factors of pneumothorax such as depth and size of lesion, CT emphysema score of whole lung and pathway of needle, and the result of pulmonary function test were analyzed.
Result : 96 biopsies(89.7%) yielded sufficient tissue for pathologic evaluation. For cases of malignant and benign disease, sensitivity was 91.5% and 87.5% respectively; the corresponding figures for diagnostic accuracy were 88.1% and 77.1%. So, sensitivity and diagnostic accuracy of percutaneous transthoracic needle biopsy was 89.7% and 83.2%. Eighteen(16.8%) of 107 patients developed pneumothorax and 3 of these required application of chest tube or percutaneous catheter drainage. In the group with pneumonthorax, the lesion was significantly smaller(p=0.029) and higher CT emphysema score of pathway of needle(p=0.032). But there were no significant difference between two groups(with or without pneumothorax) for depth of lesion, pulmonary function test(% predictive value of FEV1 and FEV1/FVC) and CT emphysema score of whole lung.
Conclusion : CT-guided transthoracic needle biopsy of the pulmonary lesions is safe and easy method of obtaining specimens of good quality and quantity. It may be an useful procedure in the diagnosis of localized pulmonary lesions. For the prediction of pneumothorax, size of lesion and CT emphysema score of pathway of a needle are significant risk factors.