A new method of thoracocentesis using CT guidance in patients with a small amount of pleural fluid

A new technique of CT-guided diagnostic thoracocentesis (CT-TC) for patients with a small amount of pleural fluid was performed in 52 patients. More than 10 ml of pleural fluid was obtained successfully without any complications in all cases; 14 patients were found to have malignant cells in the pleural fluid. The main points of the CT-TC procedure are as follows: (1) The patient is placed supine with two radiolucent blocks underneath the shoulders and hips in order to make space for inserting the needle from the back (below). (2) Serial CT images are obtained to determine the insertion route and to measure the depth of the fluid level below the skin. (3) The needle is bent at the appropriate angle and length and is advanced upward slowly from the skin entry point on the back. CT-TC can also be used therapeutically in debilitated patients who can not maintain a sitting position or when the pleural fluid needs to be drained completely.