Biopsy of thoracic lesions - From CT-controlled to ultrasound guidance

Purpose: Having practised CT-controlled biopsies only, we introduced sonographically guided punctures since 1993 for pulmonary diagnoses. The effects are studied. Method: In a retrospective study 166 CT-guided biopsies from 1/89 to 12/95 and 50 sonographically guided biopsies from 7/93 to 12/95 were analysed. Results: By CT, 67% intrapulmonary, 22% peripheral pulmonary and 11% pleuropulmonary, pleural and chest wall lesions were punctured. In 66% a diagnosis could be made. 13% of the patients experienced complications, most of them pneumothorax. Half of the patients subjected to sonographic biopsy showed peripheral pulmonary lesions, the other half tumours of the pleura, pleura and lung, mediastinum and chest wall. In 92% a positive result was obtained, whereas pneumothorax occurred in 2%. Leaving aside the intrapulmonary lesions, which would not have been visible by ultrasound, diagnosis with CT could be achieved in only 56% of the cases. Conclusion: In diagnosis of pleural, peripheral pulmonary and chest wall lesions, ultrasound guided biopsy is a safe, cost-effective, convenient and accurate method without exposure to x-rays.