RISK FACTORS OF CT-GUIDED PERCUTANEOUS LUNG BIOPSY COMPLICATIONS

Objective To evaluate the complication rate of CT-guided percutaneous lung biopsy and determine the risk factors for complications. MethodsA retrospective investigation of CT-guided percutaneous lung biopsy carried out between 2002 and 2009 was performed. The risk factors for complications were determined by multivariate analysis of variables related to patient demographics, lung lesions, and biopsy procedures. ResultsA total of 281 biopsy procedures were enrolled. The total complication rate was 55.9% with pneumothorax 32.4% (91/281) and bleeding 34.5% (97/281). The risk factors affecting pneumothorax rate were lesion location, lesion depth, and time of pleural pierce; and the risk factors affecting bleeding complications were lesion depth, lesion size, and age. Predictive models for pneumothorax and bleeding were established by logistic regression. The pneumothorax model had a sensitivity of 80.0% with a specificity of 62.4%,and the bleeding model had a sensitivity of 67.4% with a specificity of 88.8%. ConclusionLesion location, lesion depth, and number of pleural passes were independent risk factors for pneumothorax. Lesion size, lesion depth, and age were independent risk factor for bleeding. The predictive models for pneumothorax and bleeding will helpfully reduce the complication of CT-guided lung biopsy.

Diagnostic Value and Safety of CT and US-Guided PTNB for Peripheral Pulmonary Lesions: A Meta-Analysis and Clinical Study

Objective: To evaluate the diagnostic value and safety of CT and ultrasound-guided PTNB for peripheral type of occupying lung lesions by meta-analysis and clinical study. Methods: 1) The target data of randomized controlled trials of CT and ultrasound-guided PTNB for peripheral type of occupying lung lesions were extracted by computer search of foreign PubMed, Embase, the Cochrane Library, Web of Science databases, since the establishment of the database. Cochrane quality assessment criteria were used for evaluation. Statistical analysis was performed using Review Manager 5.3 software. 2) To retrospectively study the diagnosis rate and complication rate of patients, undergoing CT or ultrasound-guided PTNB in the First Affiliated Hospital of Dali University from January 2015 to December 2020. Results: Meta-analysis included 7 papers with a total of 1177 patients including 502 patients in the ultrasound group and 675 patients in the CT group. Meta-analysis results showed that there was no difference in the diagnosis rate of PTNB guided by ultrasound and CT. The incidence of postoperative complications was higher in the CT group than in the ultrasound group. The incidence of postoperative pneumothorax was higher in the CT group than in the ultrasound group, and there was no difference in the incidence of postoperative bleeding. 3) Clinical study results show that the puncture success rate was 100% in both of the ultrasound and CT groups, the pathological diagnosis rate was 85.48% in the ultrasound group and 91.67% in the CT group, and there was no difference in the overall complication rate between the two puncture groups. Conclusion: Either ultrasound or CT-guided PTNB is a safe and effective clinical diagnostic method for the diagnosis of peripheral pulmonary occupations.

Pulmonary benign metastasizing leiomyoma: A case report and review of the literature

BACKGROUND Pulmonary benign metastatic leiomyoma(PBML),which is very rare,is a type of benign metastatic leiomyoma(BML).Here,we report a case of PBML,finally diagnosed through multidisciplinary team(MDT)discussions,and provide a literature review of the disease.CASE SUMMARY A 55-year old asymptomatic woman was found to have bilateral multiple lung nodules on a chest high-resolution computed tomography(HRCT)scan.Her medical history included total hysterectomy for uterine leiomyoma.The patient was diagnosed with PBML,on the basis of her clinical history,imaging manifestations,and computed tomography(CT)-guided percutaneous lung puncture biopsy,via MDT discussions.As the patient was asymptomatic,she received long-term monitoring without treatment.A follow-up of chest HRCT after 6 mo showed that the PBML lung nodules were stable and there was no progression.CONCLUSION For patients with a medical history of hysterectomy and uterine leiomyoma with lung nodules on chest CT,PBML should be considered during diagnosis based on the clinical history,imaging manifestations,CT-guided percutaneous lung puncture biopsy,and MDT discussions.