Author/Editor		Koren, Igor; Rainer, Saša
Title		CT vodene pertorakalne punkcije sprememb v prsnem košu
Translated title		CT-guided transthoracic needle biopsy of focal thoracic lesions
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 70, št. 7-8
Publication year		2001
Volume		str. 395-8
Language		slo
Abstract		Background. The retrieval of cytological material from small pulmonary lesions and most hilar and mediastinal masses has been made possible by the introduction of computed tomography as guidance for transthoracic needle biopsy. Material and methods. in a prospective trial we analyzed 12 patients with pulmonary or mediastinal masses inaccessible with the help of fiberoptic bronchoscopy and/or TNB guided fluoroscopically. With the help of CT device we determined the optimal puncture point and the minimal or/and optimal distance to reach the desired lesion. The retrieved material was stained by May-Groenwald-Giemsa stain. Results. Among 12 patients were 10 men (83%). We confirmed 4 lung cancers (33%), 2 mediastinal tumors (16%), 4 benign lesions of lungs (33%), 1 benign lesion of mediastinum (8%) and 1 undetermined lung lesion (8%). The sensitivity of CT-guided TNB of lungs and mediastinum was estimated 84.6%. The procedures were complicated with 4 pneumothoraces (31%). The radiation dose on the body surface of CT guided procedure was 8 times higher that fluorroscopic guided one. Conclusions. CT guided TNB is as a replacement procedure to evaluate intrathoracic masses, especially small ones and those in the "shadow" of big mediastinal vessels and heart. Because of higher rate of complications and high radiation dose on the body surface, it should be used only as an upgrade and not change for fluoroscopic TNB.
Summary		Izhodišča. Pertorakalna punkcija pljuč (PPP) in pertorakalna punkcija mediastinuma (PPM) pod kontrolo računalniške tomografije (CT) sta omogočili citološko in/ali histološko potrditev večine manjših pljučnih sprememb, hilarnih in mediastinalnih tvorb. Material in metode. Prospektivno smo analizirali 12 bolnikov s spremembami v prsnem košu, ki jih bronhoskopsko z upogljivim instrumentom in/ali z PPP oziroma PPM, vodeno fluoroskopsko oziroma ultrazvočno, nismo uspeli opredeliti. S pomočjo CT naprave smo določili vbodno mesto, ki je optimalno vodilo do želenega cilja. Dobljeni punkcijski material smo posušili in obravnavali z metodo po May-Groenwald-Giemsi. Rezultati. Med 12 bolniki je bilo 10 moških (83%). Potrdili smo štiri pljučne karcinome (33%), dva tumorja medpljučja (16%), Štiri benigne spremembe pljuč (33%), eno benigno maso medpljučja (8%), in eno neopredeljeno pljučno spremembo (8%). Občutljivost CT vodenih PPP in PPM je bila 84,6%. Imeli smo štiri pnevmotorakse (31%), le eden je zahteval plevralno drenažo. Skupna radiacijska doza na površini telesa je bila pri CT vodenih posegih 8-krat višja od fluroskopsko vodenih. Zaključki. CT vodene PPP in PPM so posegi, ki včasih zamenjajo fluroskopsko ali ultrazvočno vodene preiskave. Primerni so predvsem za opredeljevanje manjših sprememb in tistih, ki ležijo v "senci" večjih mediastinalnih žil oziroma srca. Zaradi višje stopnje zapletov in do 8-krat več sevanja na površini telesa je CT vodena preiskava le nadgradnja fluroskopsko vodenih posegov in omejena za natančno določene indikacije.
Descriptors		TOMOGRAPHY, X-RAY COMPUTED LUNG NEOPLASMS MEDIASTINAL NEOPLASMS BIOPSY, NEEDLE RADIATION DOSAGE