Ultrasonografi ve bilgisayarlı tomografi eşliğinde koaksiyel teknik ile transtorasik akciğer biyopsisi yapılan hastaların biyopsi sonuçlarının ve komplikasyonlarının değerlendirilmesi
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Tarih
2023
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Hatay Mustafa Kemal Üniversitesi
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info:eu-repo/semantics/openAccess
Özet
Amaç:Ultrasonografi (US) ve bilgisayarlı tomografi (BT) eşliğinde koaksiyel biyopsi tekniği ile transtorasik akciğer biyopsisi yapılan hastalarda biyopsi sonuçlarını, komplikasyonlarını ve komplikasyonlara etki eden faktörleri belirlemektir. Gereç ve Yöntem:Kliniğimizde 01.01.2015 ile 30.12.2021 tarihleri arasında US ve BT eşliğinde koaksiyel biyopsi tekniği ile transtorasik akciğer biyopsisi yapılan 375 hastaya ait veriler değerlendirildi. Hastaların demografik bilgileri ve patoloji sonuçları kaydedildi. Koaksiyel biyopsi işlemi sırasında alınan US ve BT görüntüleri kullanılarak lezyon yerleşim yeri, lezyon karakteri, lezyon boyutu ve geçilen akciğer parankim uzunluğudeğerlendirildi. Yapılan biyopsiler sonucunda gelişen komplikasyonlar ve bunlara etki eden faktörler değerlendirildi. Bulgular:Bu çalışmada yer alan 375 hastaya US ve BT eşliğinde koaksiyel teknik ile 397 transtorasik akciğer biyopsisi yapıldı. 206 (%51,9) hastada bilgisayarlı tomografi, 191 (%48,1) hastada ise ultrasonografi eşliğinde koaksiyel biyopsi yapıldı. Lezyon boyutlarının ortanca değeri 4,2 cm (min:1–maks:13) idi. Tüm biyopsi sonuçlarını değerlendirdiğimizde; 253 (%67,5) lezyonun patoloji sonucu malign, 94 (%25,1) lezyonun benign, 3 (%0,8) lezyonun premalign ve 25 (%6,7) lezyonun sonucu da nondiagnostik idi. Geçilen parankim uzunluğunun ortanca değeri 1,1 cm (min:0–maks:7) idi. Bu çalışmada 57 (%27,6) hastada görülen pnömotoraks en çok rastlanan komplikasyon oldu. En sık rastladığımız ikinci komplikasyon ise parankimal hemoraji idi. 56 hastada (%27,1) parankimal hemoraji gözlendi. Lezyonun nodül yapıda olması (p=0,038) vesağ akciğer orta lobda yerleşim göstermesi (p=0,016)ile pnömotoraks arasında istatiksel olarak anlamlı fark bulundu. Kadın cinsiyet (p=0,042), lezyonun nodül yapıda olması (p<0,001), lezyon boyutunun 3 cm ve altında olması (p<0,001) ve geçilen akciğer parankim uzunluğunun 3 cm ve üzerinde olması (p<0,001) ile parankimal hemoraji arasında istatiksel olarak anlamlı fark bulundu. Komplikasyonlar CIRSE sınıflamasına göre değerlendirildiğinde tedavi gerektirmeyen, gözlem süresinde hafif uzamaya neden olan (Grade 2) komplikasyon oranı %9,2, ek tedavi gerektiren ve gözlem süresinde uzamaya neden olan (Grade 3) komplikasyon oranı %3,4 olarak izlendi. Sekele ve mortaliteye neden olan komplikasyon izlenmedi. Sonuç:US ve BT eşliğinde koaksiyel biyopsi tekniği ile yapılan transtorasik akciğer biyopsileriakciğer kitlelerinin patolojik tanısını elde etmede etkili vekabul edilebilir düşük komplikasyon oranlarıyla akciğer lezyonlarının tanısında güvenle kullanılabilecek bir yöntemdir.
Aim:The aim of this studyto determine biopsy results, complications and factors affecting complications in patients who underwent transthoracic lung biopsy with coaxial biopsy technique accompanied by ultrasonography (US) and computed tomography (CT). Materials and Methods:Data of 375 patients who underwent transthoracic lung biopsy with coaxial biopsy technique between 01.01.2015 and 30.12.2021 in our clinic were evaluated. Pathology results and demographic information of the patients were recorded. Using US and CT images taken during the biopsy procedure, the lesion location, lesion character, lesion size and the length of the lung parenchyma passed were evaluated. Complications that developed as a result of biopsies and the factors affecting them were evaluated. Results:In the 375 patients included in this study, 397 transthoracic lung biopsies were performed using the coaxial technique under US and CT guidance. Coaxial biopsy was performed under the guidance of computed tomography in 206 (51.9%) patients and under the guidance of ultrasonography in 191 (48.1%) patients.The median value of the lesion size was 4,2 cm (min:1–max:13).When we evaluate all biopsy results the pathology result of 253 (67.5%) lesions was malignant, 94 (25.1%) lesions was benign, 3 (0.8%) lesions was premalignant, and 25 (6.7%) lesions was nondiagnostic. The median value of the distance passed parenchyma was 1,1 cm (min:0–max:7). In this study, pneumothorax seen in 57 patients (27.6%) was the most common complication. The second most common complication hemorrhage we encountered was. Hemorrhage was observed in 56 patients (27.1%). A statistically significant difference was found between pneumothorax and the lesion being nodule (p=0.038) and localized in the right lung middle lobe (p=0.016). There was a statistically significant difference between parenchymal hemorrhage in female gender (p=0.042), the lesion being a nodule (p<0.001), the lesion size being 3 cm or less (p<0.001), and the lung parenchyma length being 3 cm or more (p<0.001). When complications are evaluated according to CIRSE classification; the complication rate that did not require treatment and caused a slight prolongation of the observation period (Grade 2) was 9.2%, and the complication rate that required additional treatment and caused a prolongation of the observation period (Grade 3) was 3.4%.Complications causing sequelae and mortality were not observed. Conslusion:Transthoracic lung biopsies performed with coaxial biopsy technique accompanied by US and CT are effective in obtaining the pathological diagnosis of lung masses and can be used safely in the diagnosis of lung lesions with acceptably low complication rates. Key words:Ultrasonography, Computed Tomography, Lung Biopsy, Co-Axial, Tru-Cut
Aim:The aim of this studyto determine biopsy results, complications and factors affecting complications in patients who underwent transthoracic lung biopsy with coaxial biopsy technique accompanied by ultrasonography (US) and computed tomography (CT). Materials and Methods:Data of 375 patients who underwent transthoracic lung biopsy with coaxial biopsy technique between 01.01.2015 and 30.12.2021 in our clinic were evaluated. Pathology results and demographic information of the patients were recorded. Using US and CT images taken during the biopsy procedure, the lesion location, lesion character, lesion size and the length of the lung parenchyma passed were evaluated. Complications that developed as a result of biopsies and the factors affecting them were evaluated. Results:In the 375 patients included in this study, 397 transthoracic lung biopsies were performed using the coaxial technique under US and CT guidance. Coaxial biopsy was performed under the guidance of computed tomography in 206 (51.9%) patients and under the guidance of ultrasonography in 191 (48.1%) patients.The median value of the lesion size was 4,2 cm (min:1–max:13).When we evaluate all biopsy results the pathology result of 253 (67.5%) lesions was malignant, 94 (25.1%) lesions was benign, 3 (0.8%) lesions was premalignant, and 25 (6.7%) lesions was nondiagnostic. The median value of the distance passed parenchyma was 1,1 cm (min:0–max:7). In this study, pneumothorax seen in 57 patients (27.6%) was the most common complication. The second most common complication hemorrhage we encountered was. Hemorrhage was observed in 56 patients (27.1%). A statistically significant difference was found between pneumothorax and the lesion being nodule (p=0.038) and localized in the right lung middle lobe (p=0.016). There was a statistically significant difference between parenchymal hemorrhage in female gender (p=0.042), the lesion being a nodule (p<0.001), the lesion size being 3 cm or less (p<0.001), and the lung parenchyma length being 3 cm or more (p<0.001). When complications are evaluated according to CIRSE classification; the complication rate that did not require treatment and caused a slight prolongation of the observation period (Grade 2) was 9.2%, and the complication rate that required additional treatment and caused a prolongation of the observation period (Grade 3) was 3.4%.Complications causing sequelae and mortality were not observed. Conslusion:Transthoracic lung biopsies performed with coaxial biopsy technique accompanied by US and CT are effective in obtaining the pathological diagnosis of lung masses and can be used safely in the diagnosis of lung lesions with acceptably low complication rates. Key words:Ultrasonography, Computed Tomography, Lung Biopsy, Co-Axial, Tru-Cut
Açıklama
Anahtar Kelimeler
Radyoloji ve Nükleer Tıp, Radiology and Nuclear Medicine, Ultrasonografi, Bilgisayarlı Tomografi, Akciğer Biyopsi, Ko-Aksiyel, Tru-Cut
