Akciğer Nodüllerinden BT Kılavuzluğunda İğne Biyopsisi Gerçekleştirilen 161 Hastada Tanısal Doğruluk ve Komplikasyonlar

Amaç: Transtorasik iğne biyopsisi, akciğer nodüllerinde güvenilirliği kanıtlanmış ve günlük pratikte sıklıkla uygulanan bir tanı yöntemidir. Bilgisayarlı tomografi navigasyonu ile yapılan biyopsilerin tanısal doğruluğu, lezyon boyutları 1 cm'den küçük olsa bile oldukça yüksektir. Bu çalışmada merkezimizde yapılan bilgisayarlı tomografi eşliğinde perkütan transtorasik iğne biyopsisi işleminin tanısal doğruluğunu ve komplikasyonlarını değerlendirmeyi amaçladık. Gereç ve Yöntemler: Ocak 2017-Ocak 2020 tarihleri arasında bilgisayarlı tomografi eşliğinde perkütan transtorasik pulmoner nodül biyopsi işlemi yapılan hastalar çalışmaya dahil edildi. Lezyonların boyutu ve anatomik yerleşimi, plevra ile lezyon arasındaki mesafe, iğnenin plevraya olan açısı, işlem süresi, hasta başına alınan patolojik örnek sayısı, toplam radyasyon dozu, komplikasyonlar ve patoloji sonuçları hastaların bilgisayarlı tomografi görüntüleri ile hasta kayıtlarından analiz edildi. Bulgular: Transtorasik perkütan iğne biyopsi işlemine başvuran 161 hastanın 135'i erkek (ortalama yaş 64.3±11.1 yıl), 26'sı kadın (ortalama yaş 61.3±15.4 yıl) idi. 32 hastanın patolojik değerlendirmesi non-diagnostik olarak raporlandı. BT eşliğinde transtorasik biyopsi tanısal duyarlılığı %80.1 olarak hesaplandı. 10 hastada (%6.2) majör komplikasyon, 60 hastada (%37.2) minör komplikasyon gelişti. Göğüs tüpü takılmasını gerektiren işlem oranı %4.9 idi. Hastaların işlem başına aldıkları ortalama efektif radyasyon dozu 5.26±3.25 mSv (0.12-14.34 aralığında) olarak hesaplandı. Sonuç: Bilgisayarlı tomografi eşliğinde transtorasik biyopsi prosedürü tanısal doğruluk oranı yüksek, komplikasyon oranı düşük ve uygun tüm pulmoner nodüllerde tercih edilebilecek bir yöntemdir.

Anahtar Kelimeler:

Soliter Akciğer Nodülü, İğne Biyopsisi, X-Ray Bilgisayarlı Tomografi, Komplikasyonlar

DIAGNOSTIC ACCURACY AND COMPLICATIONS OF PERCUTANEOUS CT-GUIDED NEEDLE BIOPSY OF LUNG NODULES IN 161 PATIENTS

Objective: Transthoracic needle biopsy is a diagnostic method that has proven its reliability in lung nodules and is frequently applied in daily practice. The diagnostic accuracy of biopsies performed with computed tomography navigation is quite high, even if the lesion sizes are smaller than 1 cm. We aimed to evaluate the diagnostic accuracy and complications of the computed tomography-guided percutaneous transthoracic needle biopsy procedure performed in our center. Material and Methods: Patients who underwent computed tomography guided percutaneous transthoracic pulmonary nodule biopsy procedure between January 2017 and January 2020 were included in the study. The size and anatomic location of lesions, the distance between the pleura and the lesion, the angle of the needle with the pleura, the procedure time, the number of pathologic samples taken per patient, the total radiation dose, complications, and the pathological results of the lesions were analyzed from the patients’ computed tomography images and patients’ records. Results: Among the 161 patients admitted for the transthoracic percutaneous needle biopsy procedure, 135 were male (mean age 64.3±11.1 years) and 26 were females (mean age 61.3±15.4 years). The pathological evaluation of 32 patients were reported as non-diagnostic. The diagnostic accuracy of computed tomography guided transthoracic biopsy was calculated as 80.1%. Major complications occurred in 10 patients (6.2%), and minor complications occurred in 60 patients (37.2%). The rate of procedure requiring chest tube insertion was 4.9%. The mean effective radiation dose of the patients per procedure was calculated as 5.26±3.25 mSv. Conclusion: Computed tomography guided transthoracic biopsy procedure are a method with a high diagnostic accuracy rate, low rate of complications and can be preferred in all appropriate pulmonary nodules.

Keywords:

Solitary Pulmonary nodule, Needle Biopsy, Computed Tomography, Complications,

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