Fluoroscopy-Guided Percutaneous Transthoracic Pleural Forceps Biopsy in Patients With Exudative Pleural Effusion.

IF 4.4 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Korean Journal of Radiology Pub Date : 2024-08-01 Epub Date: 2024-07-15 DOI:10.3348/kjr.2023.0960

Doo Ri Kim, In Chul Nam, Hye Jin Baek, Jeong Jae Kim, Im Kyung Hwang, Jeong Sub Lee, Duk Ju Kim, Chang Lim Hyun, Sung Eun Park, Sung Wook Song

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Abstract

Objective: This study aimed to evaluate the diagnostic performance and procedural characteristics of fluoroscopy-guided percutaneous transthoracic pleural forceps biopsy (PTPFB) in patients with exudative pleural effusion.

Materials and methods: Patients with exudative pleural effusion who underwent PTPFB between May 1, 2014, and February 28, 2023, were included in this retrospective study. The interval between percutaneous catheter drainage (PCD) and PTPFB, number of biopsies, procedural time, and procedure-related complications were evaluated. The sensitivity, specificity, and accuracy of diagnosing malignancy were computed for pleural cytology using PCD drainage, PTPFB, and combined PTPFB and pleural cytology.

Results: Seventy-one patients, comprising 50 male and 21 female (mean age, 69.5 ± 15.3 years), were included in this study. The final diagnoses were benign lesions in 48 patients (67.6%) and malignant in 23 patients (32.4%). The overall interval between PCD and biopsy was 2.4 ± 3.7 days. The interval between PCD and biopsy in the group that underwent delayed PTPFB was 5.2 ± 3.9 days. The mean number of biopsies was 4.5 ± 1.3. The mean procedural time was 4.4 ± 2.1 minutes. Minor bleeding complications were reported in one patient (1.4%). The sensitivity, specificity, and accuracy for pleural cytology, PTPFB, and combined PTPFB and pleural cytology were 47.8% (11/23), 100% (48/48), and 83.1% (59/71), respectively; 65.2% (15/23), 100% (48/48), and 88.7% (63/71), respectively; and 78.3% (18/23), 100% (48/48), and 93.0% (66/71), respectively. The sensitivity and accuracy of cytology combined with PTPFB were significantly higher than those of cytological testing alone (P = 0.008 and 0.001, respectively).

Conclusion: Fluoroscopy-guided PTPFB is an accurate and safe diagnostic technique for patients with exudative pleural effusion, with acceptable diagnostic performance, low complication rates, and reasonable procedural times.

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在透视引导下对渗出性胸腔积液患者进行经皮穿刺胸膜钳活检。

研究目的本研究旨在评估渗出性胸腔积液患者在透视引导下经皮穿刺胸膜镊活检术（PTPFB）的诊断性能和手术特点：这项回顾性研究纳入了2014年5月1日至2023年2月28日期间接受PTPFB的渗出性胸腔积液患者。评估了经皮导管引流术（PCD）和 PTPFB 之间的间隔时间、活检次数、手术时间和手术相关并发症。计算了使用 PCD 引流术、PTPFB 以及联合 PTPFB 和胸膜细胞学检查进行胸膜细胞学检查诊断恶性肿瘤的敏感性、特异性和准确性：本研究共纳入 71 例患者，其中男性 50 例，女性 21 例（平均年龄为 69.5 ± 15.3 岁）。最终诊断为良性病变的患者有 48 人（67.6%），恶性病变的患者有 23 人（32.4%）。PCD 和活检之间的总体间隔时间为 2.4 ± 3.7 天。接受延迟 PTPFB 组的 PCD 和活检之间的间隔为 5.2 ± 3.9 天。活检的平均次数为（4.5 ± 1.3）次。平均手术时间为 4.4 ± 2.1 分钟。一名患者（1.4%）出现轻微出血并发症。胸膜细胞学、PTPFB、PTPFB 和胸膜细胞学联合检查的敏感性、特异性和准确性分别为 47.8%（11/23）、100%（48/48）和 83.1%（59/71）；分别为 65.2%（15/23）、100%（48/48）和 88.7%（63/71）；分别为 78.3%（18/23）、100%（48/48）和 93.0%（66/71）。细胞学联合 PTPFB 的敏感性和准确性明显高于单独的细胞学检测（P = 0.008 和 0.001）：结论：透视引导下的 PTPFB 是针对渗出性胸腔积液患者的一种准确、安全的诊断技术，诊断效果可接受，并发症发生率低，手术时间合理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Korean Journal of Radiology 医学-核医学

CiteScore

10.60

自引率

12.50%

发文量

141

审稿时长

1.3 months

期刊介绍： The inaugural issue of the Korean J Radiol came out in March 2000. Our journal aims to produce and propagate knowledge on radiologic imaging and related sciences. A unique feature of the articles published in the Journal will be their reflection of global trends in radiology combined with an East-Asian perspective. Geographic differences in disease prevalence will be reflected in the contents of papers, and this will serve to enrich our body of knowledge. World''s outstanding radiologists from many countries are serving as editorial board of our journal.