The Diagnostic Value And Complications Of CT-guided Percutaneous Lung Biopsy Under Vacuum Bag Fixation

Objective: To analyze the diagnostic accuracy value of vacuum bag fixation for CT-guided percutaneous lung biopsy(CT-GPLB) in pulmonary lesions. To observe the complications and to discuss the related factors influencing the biopsy results and complications.Methods: Total 288 cases who accepted vacuum bag fixation for CT-GPLB from November 2013 to December 2014 in first affiliated hospital of Chongqing Medical University were collected. Retrospectively analyzed the puncture diagnostic rate of CT-guided transthoracic needle biopsy for lung lesions, and the related factors affecting the diagnostic sensitivity by Chi-square test. Analyzed the incidence of complications such as pneumothorax and hemorrhage. and the influence factors by Chi-square test and Logistic test.Result: Diagnostic accuracy of CT-guided percutaneous lung biopsy was 92.0%, the sensitivity and specificity to malignant tumor were 86.9%and 100%,respectively. The false negative rate was 13.1%.And the gender,age, lesion size and depth of the lesion were not the related factors affecting the diagnostic sensitivity(p > 0.05). The complications included thepneumothorax accounting for 17.4%(50/288), hemorrhage 10.1%(29/288),and with no needle tract implantation metastases or air embolism. The incidence of pneumothorax was correlated with the existence of emphysema(p=0.022), the number of puncture(p=0.038), and lesion size(p=0.025).The independent risk factors of hemorrhage were the length of the needle path(p=0.016)and lesion size(p=0.014). The diagnostic accuracy and complications of lung biopsy under the vacuum bag fixation were superior to the traditional method.Conclusion: CT-guided percutaneous lung biopsy is the main biopsy method of the diagnosis for pulmonary lesions. Pneumothorax and hemorrhage are the common complications of transthoracic needle biopsy.The occurrence of complications is related to many factors. The independent risk factors of pneumothorax were the existence of emphysema, the number of puncture and lesion size.And the length of the needle path and lesion size were the independent risk factors of hemorrhage.Vacuum bag fixation for CT-GPLB can further improve the accuracy of lung biopsy, reduce the incidence of complications, and is worth popularizing.