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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
Summary
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.
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.