The aim of this study was to evaluate the risk of pneumothorax and need for chest tube insertion in CT-guided lung biopsies and identify predictors focusing on pulmonary emphysema determined with quantitative computed tomography. To that end, we retrospectively analysed the incidence of pneumothorax and chest tube insertion in 371 CT-guided lung biopsies with respect to the quantitative emphysema score determined with the density mask technique. Other possible impact factors considered were lesion diameter, length of biopsy pathway within the lung parenchyma, lung lobe, needle size, puncture technique, patient positioning and interventionalist’s level of experience. Quantitative emphysema scores of the lung were significantly higher in patients who developed instant pneumothorax (27%, p < 0.0001), overall pneumothorax (38%, p = 0.001) and had chest tube insertion (9%, p = 0.006) compared to those who did not when analysed with the Mann–Whitney U-test. In logistic regression analysis with inclusion of the other possible impact factors, the quantitative emphysema score remained a statistically significant predictor for all three output parameters. This was confirmed with least absolute shrinkage and selection operator (Lasso) regression analysis. In conclusion, quantitatively determined pulmonary emphysema is a positive predictor of the pneumothorax rate in CT-guided lung biopsy and likelihood of chest tube insertion.

这项研究的目的是评估在CT引导的肺活检中气胸的风险和插入胸管的必要性，并确定以定量计算机断层扫描确定的以肺气肿为重点的预测因素。为此，我们回顾性分析了371部CT引导的肺活检中气胸和胸管插入的发生率，并与采用密度罩技术确定的定量肺气肿评分进行了比较。考虑的其他可能的影响因素是病变直径，肺实质内活检路径的长度，肺叶，针头大小，穿刺技术，患者位置和介入医师的经验水平。发生即时气胸的患者肺部肺气肿定量评分显着更高（27％，p <0.0001）， 与未进行Mann–Whitney U检验分析的患者相比，总体气胸（38％，p  = 0.001）和胸管插入（9％，p = 0.006）。在包括其他可能影响因素的逻辑回归分析中，肺气肿的定量评分仍是所有三个输出参数的统计学上显着的预测指标。这是通过最少的绝对收缩和选择算子（Lasso）回归分析确认的。总之，定量确定的肺气肿是CT引导的肺活检中气胸发生率和胸管插入可能性的积极预测指标。