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[Ultrasound-guided transthoracic puncture].

G Mathis1, R Bitschnau, O Gehmacher

  • 1Interne Abteilung Krankenhaus Hohenems.

Ultraschall in Der Medizin (Stuttgart, Germany : 1980)
|February 12, 2000
PubMed
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Ultrasound-guided lung puncture is a safe and effective method for diagnosing peripheral lung lesions, offering high accuracy for malignant and benign conditions. This minimally invasive technique provides a low complication rate, making it a valuable diagnostic tool.

Area of Science:

  • Pulmonology
  • Radiology
  • Interventional Ultrasound

Background:

  • Diagnosing peripheral lung foci can be challenging using conventional methods.
  • Ultrasound-guided puncture offers a potential alternative for pleural-accessible lesions.

Purpose of the Study:

  • To evaluate the efficacy and safety of ultrasound-guided lung puncture for diagnosing peripheral lung lesions.
  • To review the accuracy, complication rates, and cost-effectiveness of this minimally invasive procedure.

Main Methods:

  • Systematic review of 97 original papers, focusing on 26 studies involving 1876 patients undergoing lung punctures.
  • Analysis of diagnostic accuracy for malignant (carcinomas, metastases) and benign lesions.
  • Assessment of complication rates, including pneumothorax and hemoptysis, and factors influencing them.

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Main Results:

  • High diagnostic accuracy for carcinomas and metastases (average >90%, range 70-97%).
  • Moderate accuracy for benign lesions (approximately 70%).
  • Low complication rates: 2.6% pneumothorax, ~1% requiring drainage, 1-2% hemoptysis. Complication rates correlate with needle thickness.

Conclusions:

  • Ultrasound-guided lung puncture is an accurate, safe, and cost-effective method for diagnosing accessible intrathoracic lesions.
  • The procedure is minimally stressful for patients and recommended for lesions within ultrasound imaging range.
  • Color-coded Duplex sonography is advised for highly vascularized lesions, such as in chronic pneumonia, to minimize hemoptysis risk.