The influence of needle-pleural angle in pneumothorax rate of lung biopsy

WANG Pei-yuan; WANG Xia; ZHANG Lin; WANG Xu; LI Yan-jun; ZHANG Zuo-bing

Journal of China Clinic Medical Imaging ›› 2008, Vol. 19 ›› Issue (12) : 879-882.

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The influence of needle-pleural angle in pneumothorax rate of lung biopsy

WANG Pei-yuan1, WANG Xia2, ZHANG Lin1, WANG Xu1, LI Yan-jun1, ZHANG Zuo-bing1

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Abstract

Objective: By retrospectively analysis the complications of 828 cases CT-guided transthorax needle biopsies(TNB), to study the potential factors that may influence the incidence rate of pneumothorax, especially needle-pleural angle. Materials and Methods: In 828 patients, 1113 coaxial TNB were performed under CT-guidance. The possible factors of patients’ characteristics, lesions and procedure variables were calculated. The minimal angle between needle and pleural was measured in CT imaging during the procedure. The variables were correlated with incidence of pneumothorax. Results: There were 109(13.16%) cases of pneumothorax in the study, 25(5%) biopsies treated with chest tube placement, and 13 cases with pleural punctural aspiration. Needle-pleural angles(＜75°) and dwelling time were associated with higher pneumothorax rate. The size of lesions(＜30mm), location(close to the base of lung and the diaphragm), puncture site(in the lateral or oblique chest wall) and the needle path length(＞40mm), were associated with higher pneumothorax rates significantly. The pleural contact of lesions, pleural thickening and pleural or thorax invasion of lesions were associated with lower pneumothorax rate. Conclusion: A small puncture needle pleural angle and lung dwelling time may increase the pneumothorax rate significantly.

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Biopsy / needle / Pneumothorax / Tomography / X-ray computed

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WANG Pei-yuan;WANG Xia;ZHANG Lin;WANG Xu;LI Yan-jun;ZHANG Zuo-bing. The influence of needle-pleural angle in pneumothorax rate of lung biopsy[J]. Journal of China Clinic Medical Imaging. 2008, 19(12): 879-882