Comparison Of Safety And Efficacy Between Ultrasound-guided And Ct-guided Transthoracic Needle Biopsy: A Meta-analysis

Objective: Transthoracic needle biopsy(TTNB)is an important method to diagnose chest diseases.Image-guided transthoracic needle biopsy plays an important role in diagnostic performance,but few works of literature report the safety and effectiveness of transthoracic lung biopsy guided by ultrasound(US)and computed tomography(CT)currently.The purpose of this article is to use meta-analysis to evaluate the difference between image-guided methods(ultrasound and CT)on transthoracic needle biopsy,explore the safety and effectiveness of transthoracic needle biopsy,provide a reference for the selection of clinical diagnosis strategies.Methods: Eligible studies were retrieved from the Pub Med,EMBASE,Cochrane Library,Web of Science,and CNKI databases.The retrieval time is from database establishment to April 31,2020.The data of diagnosis rate,lesion size,operation time,and complication rate of the ultrasound group and CT group were independently extracted by two people.After a cross-review of the literature and quality evaluation,Rev Man5.3 software was used for statistical analysis.Results: This meta-analysis includes 10 studies,and includes 1905 results information about transthoracic needle biopsy.In this analysis results: the overall diagnostic rate of transthoracic needle biopsy,ultrasound group is higher than CT group(OR = 2.24,95% CI: 1.52 ～ 3.30,p <0.0001);the adherent lesions diagnostic rate of transthoracic needle biopsy,ultrasound group is higher than CT group(OR=1.63,95%CI: 1.04～2.57,p=0.03);the operation time of ultrasound group was lower than CT group(MD =-12.08,95% CI:-14.01 ～-10.14,p <0.00001);postoperative pneumothorax complication rate of CT group higher than that ultrasound group(OR = 0.24,95% CI: 0.15 ～ 0.36,p <0.00001);postoperative bleeding of CT group higher than ultrasound group(OR = 0.29,95% CI: 0.12 ～ 0.70,p = 0.006);the ultrasound group lesion size(MD=4.98,95%CI: 1.23～8.74,p=0.009)is higher than that CT group,and the number of punctures(MD =-0.09,95% CI:-0.12 ～ 1.03,p = 0.88)is not statistically different in two groups.Conclusion: Ultrasound group has a higher overall diagnosis rate in transthoracic needle biopsy than CT group.ultrasound group has a higher diagnostic rate in adherent lesions transthoracic needle biopsy than CT group,ultrasound group can reduce the incidence of postoperative pneumothorax and bleeding complication.Ultrasound group can reduce operation time.the ultrasound group lesion size is higher than that CT group,the number of punctures is not statistically different in two groups.