Objective:To investigate the value of application of low-dose and optimized length CT scan on puncture results,complications and patients’radiation dosage during CT-guided percutaneous biopsy of pulmonary nodules(PTN...Objective:To investigate the value of application of low-dose and optimized length CT scan on puncture results,complications and patients’radiation dosage during CT-guided percutaneous biopsy of pulmonary nodules(PTNB).Methods:A total of 231 patients with PTNB under CT guidance were collected.Low dose scanning utilized tube current of 20 mA as compared with 40 mA in conventional dosage.Optimized length in CT is defined as intentionally narrowing the range of CT scanning just to cover 25 mm(5 layers)around the target layer during needle adjustment.According to whether low-dose scans and optimized length scans techniques were utilized,patients were divided into three groups:conventional group(conventional sequence+no optimization),optimized length group(conventional sequence+optimized length),and low-dose optimized length group(low dose sequence+optimized length).The ED(effective dose),the DLP(dose length product),the average CTDIvol(Volume CT dose index),total milliampere second between subgroups were compared.Results:Compared with the conventional group,ED,intraoperative guidance DLP,total milliseconds and operation time in the optimized length group were reduced by 18.2%(P=0.01),37%(P=0.003),17.5%(P=0.013)and13.3%(P=0.021)respectively.Compared with the optimized length group,the ED was reduced by 87%,preoperative positioning,intraoperative guidance and postoperative review DLP were also reduced by 88%,total milliampere second was reduced by 79%,with an average CTDIvol was reduced by 86%,in the low-dose optimized length group(P<0.001 for all).Conclusion:Optimizing the length during CT scanning can effectively reduce the intraoperative radiation dose and reduce the operation time compared with conventional plan;low-dose and optimized length CT scan can further reduce the total radiation dose compared with optimized length group with no differences on intraoperative complications,biopsy results and operation time.展开更多
Objective To investigate the incidencee and influencing factors of pneumothorax in elderly patients(aged≥65 years)undergoing CT-guided percutaneous lung biopsy(PLB).Methods A prospective cohort study was conducted,en...Objective To investigate the incidencee and influencing factors of pneumothorax in elderly patients(aged≥65 years)undergoing CT-guided percutaneous lung biopsy(PLB).Methods A prospective cohort study was conducted,enrolling elderly patients who underwent CT-guided PLB at Beijing Hospital from January 2017 to December 2023.Pneumothorax occurrence was assessed through two CT scans performed immediately post-procedure and at 48 hours post-PLB.Based on pneumothorax status,patients were categorized into a pneumothorax group and a non-pneumothorax group.Baseline clinical and procedural data were compared between the two groups,and multivariate logistic regression analyses were conducted to identify factors associated with pneumothorax.Results Among the 647 elderly patients who underwent PLB,1522cases(23.5%,152/647)developed pneumothorax,with 101 cases(15.6%)presenting with minor pneumothorax and 51 cases(7.9%)with major pneumothorax.Compared with the non-pneumothorax group,patients in the pneumothorax group had a higher incidence of chronic obstructive pulmonary disease(COPD),higher frailty proportion,smaller lesions,lesions located further from the chest wall,more frequent bronchial involvement,and a higher rate of puncture depth≥5 cm(all P<0.05).Multivariate logistic regression analysis revealed the following as significant risk factors for minor pneumothorax:COPD(OR=1.256,95%CI:1.014-1.558,P=0.033),lesion size≤2 cm(0R=1.345,95%Cl:1.075-1.659,P=0.022),lesion-to-chest-wall distance≥2 cm(OR=1.372,95%CI:1.105-1.703,P=0.007),presence of pulmonary bullae or emphysema(OR=1.524,95%CI:1.223-1.899,P<0.001),groundglass opacity density(0R=1.313,95%Cl:1.072-1.839,P=0.014),bronchial involvement(OR=1.211,95%CI:1.047-1.694,P=0.038),and needle insertion depth≥5 cm(OR=1.312,95%Cl:1.024-1.749,P=0.038).For major pneumothorax,significant risk factors included age(OR=1.286,95%CI:1.021-1.819,P=0.041),COPD(0R=1.248,95%CI:1.098-1.753,P=0.035),heart failure(0R=1.312,95%CI:1.027-1.956,P=0.042),frailty(0R=1.301,95%CI:1.063-1.981,P=0.036),lesion size≤2 cm(0R=1.345,95%CI:1.040-1.872,P=0.039),lesion-to-chest-wall distance≥2 cm(0R=1.482,95%CI:1.116-1.738,P=0.032),presence of bullae or emphysema(OR=1.705,95%CI:1.316-2.431,P=0.024),and puncture depth≥5 cm(0R=1.343,95%CI:1.058-1.763,P=0.037).Conclusion Elderly patients undergoing CT-guided PLB have a high risk of pneumothorax.Personalized predictive strategies are necessary to reduce the risk of pneumothorax,particularly major pneumothorax.展开更多
基金supported by grants from National Natural Science Foundation of China(No.81801804).
文摘Objective:To investigate the value of application of low-dose and optimized length CT scan on puncture results,complications and patients’radiation dosage during CT-guided percutaneous biopsy of pulmonary nodules(PTNB).Methods:A total of 231 patients with PTNB under CT guidance were collected.Low dose scanning utilized tube current of 20 mA as compared with 40 mA in conventional dosage.Optimized length in CT is defined as intentionally narrowing the range of CT scanning just to cover 25 mm(5 layers)around the target layer during needle adjustment.According to whether low-dose scans and optimized length scans techniques were utilized,patients were divided into three groups:conventional group(conventional sequence+no optimization),optimized length group(conventional sequence+optimized length),and low-dose optimized length group(low dose sequence+optimized length).The ED(effective dose),the DLP(dose length product),the average CTDIvol(Volume CT dose index),total milliampere second between subgroups were compared.Results:Compared with the conventional group,ED,intraoperative guidance DLP,total milliseconds and operation time in the optimized length group were reduced by 18.2%(P=0.01),37%(P=0.003),17.5%(P=0.013)and13.3%(P=0.021)respectively.Compared with the optimized length group,the ED was reduced by 87%,preoperative positioning,intraoperative guidance and postoperative review DLP were also reduced by 88%,total milliampere second was reduced by 79%,with an average CTDIvol was reduced by 86%,in the low-dose optimized length group(P<0.001 for all).Conclusion:Optimizing the length during CT scanning can effectively reduce the intraoperative radiation dose and reduce the operation time compared with conventional plan;low-dose and optimized length CT scan can further reduce the total radiation dose compared with optimized length group with no differences on intraoperative complications,biopsy results and operation time.
文摘Objective To investigate the incidencee and influencing factors of pneumothorax in elderly patients(aged≥65 years)undergoing CT-guided percutaneous lung biopsy(PLB).Methods A prospective cohort study was conducted,enrolling elderly patients who underwent CT-guided PLB at Beijing Hospital from January 2017 to December 2023.Pneumothorax occurrence was assessed through two CT scans performed immediately post-procedure and at 48 hours post-PLB.Based on pneumothorax status,patients were categorized into a pneumothorax group and a non-pneumothorax group.Baseline clinical and procedural data were compared between the two groups,and multivariate logistic regression analyses were conducted to identify factors associated with pneumothorax.Results Among the 647 elderly patients who underwent PLB,1522cases(23.5%,152/647)developed pneumothorax,with 101 cases(15.6%)presenting with minor pneumothorax and 51 cases(7.9%)with major pneumothorax.Compared with the non-pneumothorax group,patients in the pneumothorax group had a higher incidence of chronic obstructive pulmonary disease(COPD),higher frailty proportion,smaller lesions,lesions located further from the chest wall,more frequent bronchial involvement,and a higher rate of puncture depth≥5 cm(all P<0.05).Multivariate logistic regression analysis revealed the following as significant risk factors for minor pneumothorax:COPD(OR=1.256,95%CI:1.014-1.558,P=0.033),lesion size≤2 cm(0R=1.345,95%Cl:1.075-1.659,P=0.022),lesion-to-chest-wall distance≥2 cm(OR=1.372,95%CI:1.105-1.703,P=0.007),presence of pulmonary bullae or emphysema(OR=1.524,95%CI:1.223-1.899,P<0.001),groundglass opacity density(0R=1.313,95%Cl:1.072-1.839,P=0.014),bronchial involvement(OR=1.211,95%CI:1.047-1.694,P=0.038),and needle insertion depth≥5 cm(OR=1.312,95%Cl:1.024-1.749,P=0.038).For major pneumothorax,significant risk factors included age(OR=1.286,95%CI:1.021-1.819,P=0.041),COPD(0R=1.248,95%CI:1.098-1.753,P=0.035),heart failure(0R=1.312,95%CI:1.027-1.956,P=0.042),frailty(0R=1.301,95%CI:1.063-1.981,P=0.036),lesion size≤2 cm(0R=1.345,95%CI:1.040-1.872,P=0.039),lesion-to-chest-wall distance≥2 cm(0R=1.482,95%CI:1.116-1.738,P=0.032),presence of bullae or emphysema(OR=1.705,95%CI:1.316-2.431,P=0.024),and puncture depth≥5 cm(0R=1.343,95%CI:1.058-1.763,P=0.037).Conclusion Elderly patients undergoing CT-guided PLB have a high risk of pneumothorax.Personalized predictive strategies are necessary to reduce the risk of pneumothorax,particularly major pneumothorax.
