OBJECTIVES To evaluate frequency and severity of complications after CT-guided lung biopsy using the Society of Interventional Radiology (SIR) classification, and to assess risk factors for overall and major complications. MATERIALS AND METHODS 311 consecutive biopsies with a non-coaxial semi-automated 18 gauge biopsy system were retrospectively evaluated. Complications after biopsy were classified into minor SIR1-2 and major SIR3-6. Studied risk factors for complications were patient-related (age, sex and underlying emphysema), lesion-related (size, location, morphologic characteristic, depth from the pleura and histopathology), and technique-related (patient position during procedure, thoracic wall thickness at needle path, procedure time length and number of procedural CT images, number of pleural passes, fissure penetration and needle-to-blood vessel angle). Data were analyzed using logistic and ordinal regression. RESULTS Complications were pneumothorax and pulmonary hemorrhage. The complications were minor SIR1-2 in 142 patients (45.6%), and major SIR3-4 in 25 patients (8%). SIR5-6 complications were not present. Emphysema, smaller deeply located lesion, increased puncture time length and number of procedural CT images, multiple pleural passes and fissure puncture were significant risk factors for complication severity in univariate analysis. Emphysema (OR = 8.8, p<0.001), lesion depth from the pleura (OR = 1.9 per cm, p<0.001), and fissure puncture (OR = 9.4, p = 0.01) were the independent factors for major complications in a multiple logistic regression model. No statistical difference of complication rates between the radiologists performing biopsies was observed. CONCLUSIONS Knowledge about risk factors influencing complication severity is important for planning and performing CT-guided lung biopsies.

中文翻译：

---

CT引导的肺活检与非同轴半自动18针活检系统的并发症：发生频率，严重程度和危险因素。

目的使用介入放射学会（SIR）分类评估CT引导的肺活检后并发症的发生频率和严重程度，并评估总体和主要并发症的危险因素。材料与方法回顾性分析了采用非同轴半自动18号活检系统进行的311次连续活检。活检后的并发症分为次要SIR1-2和主要SIR3-6。研究的并发症危险因素是患者相关的（年龄，性别和潜在的肺气肿），病变相关的（大小，位置，形态特征，距胸膜的深度和组织病理学）和技术相关的（手术过程中的患者位置，胸壁厚度）在针路径，手术时间长度和手术CT图像数量，胸膜穿刺次数，裂缝渗透和针头到血管的角度）。使用逻辑回归和序数回归分析数据。结果并发症为气胸和肺出血。并发症为142例患者为轻度SIR1-2（45.6％），而25例患者为严重SIR3-4（8％）。不存在SIR5-6并发症。肺气肿，较小的深部病变，穿刺时间长度增加和程序CT图像数量，多次胸膜穿刺和裂隙穿刺是单因素分析中并发症严重程度的重要危险因素。肺气肿（OR = 8.8，p <0.001），距胸膜的病变深度（OR = 1.9 / cm，p <0.001）和裂隙穿刺（OR = 9.4，p = 0.01）是造成多个主要并发症的独立因素逻辑回归模型。在进行活检的放射科医生之间，未观察到并发症发生率的统计学差异。结论有关影响并发症严重程度的危险因素的知识对于计划和进行CT引导的肺活检很重要。