title: CT-guided lung biopsy: incidence of pneumothorax after instillation of NaCl into the biopsy track.
abstract: This study was conducted to evaluate whether instillation of NaCl 0.9% solution into the biopsy track reduces the incidence of pneumothoraces after CT-guided lung biopsy. A total of 140 consecutive patients with pulmonary lesions were included in this prospective study. All patients were alternatingly assigned to one of two groups: group A in whom the puncture access was sealed by instillation of NaCl 0.9% solution during extraction of the guide needle (n = 70) or group B for whom no sealing was performed (n = 70). CT-guided biopsy was performed with a 18-G coaxial system. Localization of lesion (pleural, peripheral, central), lesion size, needle-pleural angle, rate of pneumothorax and alveolar hemorrhage were evaluated. In group A, the incidence of pneumothorax was lower compared to group B (8%, 6/70 patients vs. 34%, 24/70 patients; P < 0.001). All pneumothoraces occurred directly post punctionem after extraction of the guide needle. One patient in group A and eight patients in group B developed large pneumothoraces requiring chest tube placement (P = 0.01). The frequency of pneumothorax was independent of other variables. After CT-guided biopsy, instillation of NaCl 0.9% solution into the puncture access during extraction of the needle significantly reduces the incidence of pneumothorax.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Ulm, Robert-Koch-Str. 8, 89081 Ulm, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Billich
authors.forename: Rainer
authors.initials: R
authors.lastname: Muche
authors.forename: Gerhard
authors.initials: G
authors.lastname: Brenner
authors.forename: Stefan A
authors.initials: SA
authors.lastname: Schmidt
authors.forename: Stefan
authors.initials: S
authors.lastname: Krüger
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Brambs
authors.forename: Sandra
authors.initials: S
authors.lastname: Pauls
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000009:adverse effects*; D016009:Chi-Square Distribution; D003287:Contrast Media; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D015641:Radiography, Interventional; D012965:Sodium Chloride / Q000008:administration & dosage*; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D012965:Sodium Chloride