Pneumothorax and Intrapulmonary Hemorrhage in CT-Guided Transthoracic Biopsy

Abstract

Objective: To study the frequency of pneumothorax and intrapulmonary haemorrhage in computed tomography (CT) guided transthoracic needle lung biopsy (NLB) and the factors that affect the development of these complications in Pakistan through a representative limited data obtained from a tertiary care centre.

Study Design: Cross-sectional study.

Place and Duration of Study: Armed Forces Institute of Radiology and Imaging, Rawalpindi, from Jan 2018 to Feb 2019.

Methodology: A total of 68 patients who underwent CT-guided transthoracic biopsy were evaluated for intra- and immediate (within 04 hours) post-procedural pneumothorax and pulmonary haemorrhage. The factors affecting the development of these complications were evaluated.

Results: Complications developed in 30 patients with the frequency of pneumothorax at 26.5 % and frequency of pulmonary haemorrhage at 19.1%. Significant risk factors for the development of pneumothorax were small lesions less than 2.5 cm in diameter (p-value <0.05), increased needle track path within the lung tissue of more than 21 mm (p-value = 0.05), and presence of emphysema in the surrounding lung tissue (p-value <0.05). In addition, smaller lesion size (p-value <0.05) and increased traversed lung parenchyma (p-value <0.05) were also significant factors in the development of intrapulmonary haemorrhage.

Conclusion: Significant risk factors for pneumothorax and intrapulmonary haemorrhage are smaller lesion size and length of puncture path. The presence of emphysema is related to the development of pneumothorax.