Purpose

To assess the impact of cardiac motion during percutaneous computed tomography (CT)-guided core needle biopsy (PCT-CNB) of small lung lesions near pericardium, focusing on safety and diagnostic accuracy.

Materials and methods

Seventy-eight PCT-CNBs were performed between March 2010 and June 2018 in 78 patients with small (≤ 20 mm) lung nodules, each within 10 mm of pericardium. Shifts in distance and length of interface separating lesions from pericardium were calculated and compared by cardiac chambers (left atrium, left ventricle, right atrium, or right ventricle). Risk factors for complications were subjected to univariate analysis, and diagnostic accuracy was assessed.

Results

The respective mean values were 0.8 ± 1.1 mm (range 0–5.1 mm) for shifts in distance and 1.5 ± 2.1 mm (range 0–10.8 mm) for length of interface. Neither parameter shifted significantly with respect to cardiac chambers (p > 0.05, both). Pneumothorax ensued in 28 patients (35.9%), and pulmonary hemorrhage occurred in 41 (52.6%). The overall sensitivity, specificity, and accuracy of PCT-CNB were 91.2%, 100%, and 93.2%, respectively.

Conclusion

Our data indicate that cardiac motion has no impact on either the incidence of complications or the diagnostic accuracy of PCT-CNB in patients with small (≤ 20 mm) lung lesions near pericardium.

中文翻译：

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在心包附近的小（≤ 20 毫米）肺结节的经皮计算机断层扫描引导活检中，心脏运动无影响。

目的

评估心脏运动对心包附近小肺部病变的经皮计算机断层扫描 (CT) 引导的空芯针活检 (PCT-CNB) 的影响，重点关注安全性和诊断准确性。

材料和方法

2010 年 3 月至 2018 年 6 月期间，对 78 名具有小（≤ 20 毫米）肺结节的患者进行了 78 次 PCT-CNB，每名患者均在心包 10 毫米范围内。通过心腔（左心房、左心室、右心房或右心室）计算和比较将病灶与心包分开的界面的距离和长度的变化。对并发症的危险因素进行单变量分析，并评估诊断准确性。

结果

距离变化的各自平均值为 0.8 ± 1.1 毫米（范围 0-5.1 毫米），界面长度为 1.5 ± 2.1 毫米（范围 0-10.8 毫米）。相对于心腔 ，这两个参数都没有显着变化（p > 0.05，两者）。28 名患者 (35.9%) 随后发生气胸，41 名患者 (52.6%) 发生肺出血。PCT-CNB 的总体敏感性、特异性和准确度分别为 91.2%、100% 和 93.2%。

结论

我们的数据表明，心脏运动对心包附近有小的（≤ 20 毫米）肺部病变的患者的并发症发生率或 PCT-CNB 的诊断准确性没有影响。