CT-guided percutaneous transthoracic aspiration biopsy of lung lesions: factors influencing the diagnostic accuracy / 介入放射学杂志

ABSTRACT

Objective To investigate the factors influencing the diagnostic accuracy in CT-guided percutaneous transthoracic aspiration biopsy of lung lesions. Methods CT-guided percutaneous transthoracic biopsy was performed in 435 patients with surgical pathologic confirmation or clinical follow-up.Univariant statistical analysis and multivariant stepwise Logistic regression analysis were used to study the influence of lesion-related factors(benignancy or malignancy,size,location,depth,presence of cavity),procedure factors(laser-guidence,position of patient) and patient-related factors(sex,age,presence of emphysema);with the accuracy of the diagnosis. Results ① 289 lesions were diagnosed as malignant ones and 146 as benign ones.The accuracy of CT-guided biopsy was(83.4%)(363/435).Univariant analysis showed that the diagnostic accuracies for malignant and benign lesions were(88.9%)(257/289) and(72.6%)(106/146),respectively(?~2=(18.71),P=(0.00002)).Laser-group was superior to non-laser group((88.4%) versus(80.9%),respectively,?~2=(4.00),P=(0.0456)).Mean diameters of lesions in correct diagnostic group and non-correct diagnostic group were(3.78)?(1.64) cm and(3.02)?(1.26) cm,respectively((F=)(13.79),P=(0.0002)).②Multivariant stepwise Logistic regression analysis showed that among the various factors influencing the final benign or malignant diagnoses(Wald ?~2=(14.01),P=(0.0002)) and using laser-guidence(Wald ?~2=(3.92),P=(0.0477)) were significantly associated with the diagnostic accuracy. Conclusions Final correct diagnoses(benign,malignant) are closely related to the application of laser-guidence for determining the diagnostic accuracy in CT-guided transcutaneous thoracic needle aspiration biopsy.