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Japanese Journal of Radiology

, Volume 37, Issue 12, pp 808–816 | Cite as

Perilesional emphysema as a predictor of risk of complications from computed tomography-guided transthoracic lung biopsy

  • Doo Sik Lee
  • So Hyeon BakEmail author
  • Yong Hwan Jeon
  • Sung Ok Kwon
  • Woo Jin Kim
Original Article
  • 64 Downloads

Abstract

Purpose

This study evaluated whether or not patterns of emphysema and their qualitative and quantitative severity can predict the risk of complications with post-computed tomography (CT)-guided transthoracic lung biopsy (TTLB).

Materials and methods

Three hundred and ninety-seven patients who underwent CT-guided TTLB in 2010–2018 were retrospectively reviewed. The severity of emphysema and presence of perilesional emphysema were assessed visually using the Fleischner Society classification. Ninety seven of the 397 patients underwent quantitative analysis of emphysema. Complications, including pneumothorax, chest tube insertion, and hemorrhage, were assessed by post-TTLB CT and radiographic imaging. The grade of hemorrhage was categorized into three groups. Independent risk factors for pneumothorax and hemorrhage were assessed by univariate and multivariate logistic regression analyses.

Results

Pneumothorax occurred in 48.6% of cases and hemorrhage in 70.5%. Perilesional emphysema was significantly associated with pneumothorax (odds ratio 6.720; 95% confidence interval 3.265–13.831, p < 0.001) and hemorrhage (odds ratio 3.877; 95% confidence interval 1.796–8.367; p = 0.001). The severity of visual and quantitative emphysema was not a significant risk factor for pneumothorax or hemorrhage (p > 0.05). Perilesional emphysema was significantly associated with the grade of hemorrhage (p < 0.001).

Conclusion

Perilesional emphysema can estimate the risk of iatrogenic complications from CT-guided TTLB.

Keywords

Emphysema Biopsy Pneumothorax Hemorrhage 

Notes

Funding

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF 2018R1D1A1B07049670).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics statement

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

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Copyright information

© Japan Radiological Society 2019

Authors and Affiliations

  1. 1.Department of Radiology, Kangwon National University HospitalKangwon National University School of MedicineChuncheonRepublic of Korea
  2. 2.Biomedical Research InstituteKangwon National University HospitalChuncheonRepublic of Korea
  3. 3.Department of Internal Medicine and Environmental Health Center, School of MedicineKangwon National UniversityChuncheonRepublic of Korea

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