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| CT-guided percutaneous biopsy for lung nodules(≤30 mm): investigatethe factors influencing accuracy rate and puncture security |
| ZHAO Gang1, SHI Xiao-bao2, LU Zai-ming1 |
| 1. Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, China;2. Department of Radiology, No.4 Hospital of China Medical University, Shenyang 110032, China) |
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Abstract Objective: To analyze the factors influencing the accuracy rate of CT-guided percutaneous biopsy and the security for lung nodules(≤30 mm): to facilitate the clinical application. Methods: The study has been allowed by the IRB in Shengjing hospital. Retrospectively analyze the clinical and pathological data of 155 patients who had undergone CT-guided percutaneous biopsy and with lung nodules(≤30 mm). The factors which influence the success rate such as gender, age, smoking history, whether the lesion and pleural adhesion, lesion size, puncture depth, times of percutaneous biopsy and the incidence of major complications such as hemorrhage, pneumothorax, will be analyzed. Two senior radiology physicians redetermine whether patients have pneumothorax, bleeding and other complications. If there is disagreement, a third radiologist will make a final diagnosis. Results: Among 155 cases, the accuracy rate of percutaneous biopsy was 90.32%(140/155). For the largest lesion diameter ≤10 mm, ＞10～20 mm and ＞20～30 mm, the accuracy rate was 85.71%(6/7）, 85.00%(68/80) and 97.06%(66/68), separately, differences reach statistic significance(χ2=6.293, P<0.05). The accuracy rate of lesions with or without lesion and pleural adhesion was 100%(31/31) and 87.90%(109/124), differences reach statistic significance(χ2=4.152, P<0.05). The incidence of pneumothorax and hemorrhage during 4～6 times puncture is much more than that during 3 times or even low, and the difference was statistically significant. The smaller the diameter, the greater the depth of the puncture, the more the times of puncture, the more prone to bleeding, and the difference was statistically significant. Age, gender, smoking history, times of percutaneous biopsy and puncture depth had no impact on the accuracy rate. One hundred and fourteen cases of pulmonary adenocarcinoma, 10 cases of squamous cell carcinoma, 4 cases of pulmonary chronic inflammation, 4 cases of metastatic lung cancer, 3 cases of pulmonary tuberculosis, 1 case of alveolar cell carcinoma insitu, 1 case of pulmonary coccidioidomycosis, 1 case of adenosquamous carcinoma of the lung, 1 case of small cell lung cancer, 1 case of malignant mesothelioma, 15 cases of lung tissue and necrotic tissue. Conclusion: The nodule size and whether with pleural adhesions have a greater impact on lung nodule(≤30 mm) accuracy of CT-guided puncture. With the increase in the times of puncture patients are more likely to have major complications, but all the above two points have no significant correlation between nodule size, nodules whether with pleural adhesions, age, gender, smoking history, depth of the puncture. CT guided percutaneous lung biopsy in diameter less than 30 mm nodules has high accuracy rate, simple operation, safe and practical advantages, which can be used as a major diagnosis method of less than 30 mm lung nodules. Mastering the puncture skills of pulmonary nodules can effectively improve the accuracy rate, and worth promoting in clinical application.
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Received: 20 November 2014
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Corresponding Authors:
LU Zai-ming
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2015, Vol. 26 
