Systemic air embolism depicted on systematic whole thoracic CT acquisition after percutaneous lung biopsy: Incidence and risk factors

Autor: Marie Christine Picot, Hélène Vernhet-Kovacsik, Sébastien Bommart, Juliette Vanoverschelde, Hamid Zarqane, Valérie Monnin-Bares, Guillaume Chassagnon
Přispěvatelé: MORNET, Dominique, Service central de radiologie et d'imagerie médicale, CHU Grenoble-Hôpital Michallon, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre de vision numérique (CVN), Institut National de Recherche en Informatique et en Automatique (Inria)-CentraleSupélec, Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Université de Montpellier (UM), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Target lesion
Male
medicine.medical_specialty
Percutaneous
air
Embolism
Lung biopsy
Air embolism
Image-guided biopsy
[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Biopsy
medicine
Embolism
Air
Humans
Radiology
Nuclear Medicine and imaging
Tomography
Aged
Retrospective Studies
Lung
medicine.diagnostic_test
Interventional
business.industry
Incidence
Biopsy
Needle
General Medicine
Middle Aged
medicine.disease
Prone position
medicine.anatomical_structure
Risk factors
[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie
030220 oncology & carcinogenesis
X-Ray computed
[SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
Female
Radiography
Thoracic
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Radiology
business
Tomography
X-Ray Computed
Zdroj: European Journal of Radiology
European Journal of Radiology, 2019, 117, pp.26-32. ⟨10.1016/j.ejrad.2019.05.016⟩
European Journal of Radiology, Elsevier, 2019, 117, pp.26-32. ⟨10.1016/j.ejrad.2019.05.016⟩
ISSN: 0720-048X
Popis: International audience; Objectives: To evaluate the incidence and risk factors of systemic air embolism (SAE) depicted on systematic whole thoracic CT performed after percutaneous lung biopsy.Methods: A total of 559 CT-guided lung biopsies performed between April 2014 and May 2016 were retrospectively evaluated. SAE was defined by the presence of air in the aorta or left cardiac cavities seen on whole thorax CT images acquired after needle withdrawal. Analyzed data focused on patient (age, sex, spirometry data, emphysema on CT, therapeutics received), target lesion (location, depth, size and feature) and procedure (patient position, length of intrapulmonary needle path, number of pleural passes and of biopsy samples, operator’s experience). A regression logistic model was used to identify risk factors of SAE.Results: SAE was observed after 27 of the 559 lung biopsies, corresponding to a radiological incidence of 4.8% (95%CI: 3.3–7.0). Clinical incidence was 0.17% (n = 1). For 21/27 patients (78%), a targeted acquisition in the nodule area would not have included the cardiac cavities meaning SAE would have been missed. On multivariate analysis, the independent risk factors were needle path length through ventilated lung (OR: 1.13, 95%CI: 1.02–1.25, p = 0.024), number of samples (OR: 1.48, 95%CI: 1.01–2.17, p = 0.046) and prone position (OR: 3.12, 95%CI: 1.11–8.31, p = 0.031) or right-sided lateral decubitus (OR: 6.15, 95%CI: 1.66–22.85, p = 0.005).Conclusions: Asymptomatic systemic air embolism can be depicted in almost 5% of post biopsy CT examinations, when they are not limited to the targeted nodule area but include the entire thorax.
Databáze: OpenAIRE
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