Turkiye Klinikleri Archives of Lung

.: ORIGINAL RESEARCH
Üçüncü Basamak Bir Göğüs Hastalıkları Kliniğinde Tanısal İşlemlerde Torasik Ultrasonografi: Retrospektif Gözlemsel Çalışma
Thoracic Ultrasonography in Diagnostic Procedures in a Tertiary Pulmonology Clinic: Retrospective Observational Study
Coşkun DOĞANa , Samet SAMANCIa , Deniz BİLİCİa , Ömer ZENGİNa , Serap DİKTAŞ TAHTASAKALb , Sacit İÇTENa , Esra ERTAN YAZARa
aİstanbul Medeniyet Üniversitesi Göztepe Prof. Dr. Süleyman Yalçın Şehir Hastanesi, Göğüs Hastalıkları ABD, İstanbul, Türkiye
bİstanbul Fatih Sultan Mehmet Eğitim ve Araştırma Hastanesi, Göğüs Hastalıkları Kliniği, İstanbul, Türkiye
Turkiye Klinikleri Arch Lung. 2023;22(2):19-26
doi: 10.5336/archlung.2023-98572
Article Language: TR
Full Text
ÖZET
 Amaç: Torasik ultrasonografi (USG) rehberliğinde yapılan girişimsel işlemlerin özelliklerini incelemek. Gereç ve Yöntemler: Ocak 2021-Aralık 2022 tarihleri arasında torasik USG rehberliğinde işlem yapılan olguların dosyaları geriye dönük olarak incelendi. Olguların klinik-demografik, radyolojik bulguları kayıt edildi. Torasik USG rehberliğinde yapılan tüm tanısal işlemler, var ise işlem sonrası komplikasyonlar kayıt edildi. Bulgular: Çalışmaya yaş ortalaması 69,3±12,1 olan, 45'i (%36,3) kadın, 79'u (%63,7) erkek olmak üzere toplam 124 olgu dâhil edildi. Seksen bir (%65,3) olguya torasentez amaçlı, 33 (%26,6) olguya biyopsi amaçlı, 10 (%8,1) olguya plevral kateter takılması amacı ile torasik USG yapıldı. Torasentez işlemleri incelendiğinde; 61 (%49,1) olguya tanısal torasentez, 20 (%16,1) olguya terapötik amaçlı torasentez yapıldığı görüldü. Biyopsi işlemleri incelendiğinde, akciğerde primer kitle lezyonu olan 20 (%16,1) olguya USG rehberliğinde transtorasik ince iğne aspirasyon biyopsisi (TTİAB) yapıldığı, akciğerde primer kitle lezyonu olup göğüs duvarı metastazı olan 5 (%4) olguya göğüs duvarı lezyonuna TTİAB, yine primer akciğer malignitesi şüphesi olup supraklavikular lenfadenopatisi (LAP) tespit edilen 3 (%2,4) olguya supraklavikular LAP'a İAB yapıldığı, ayrıca plevral sıvı nedeni ile tetkik edilip plevral biyopsi endikasyonu koyulan 5 (%4) olguya da USG rehberliğinde plevral tru-cut biyopsi yapıldığı görüldü. Sonuç: Seçilmiş olgularda ve girişimsel işlemlerde torasik USG'nin tanı başarısı yüksektir ve USG rehberliğinde yapılan girişimsel işlemlerde komplikasyon oranı düşüktür.

Anahtar Kelimeler: Biyopsi; torasentez; torasik ultrasonografi
ABSTRACT
 Objective: To examine the characteristics of interventional procedures performed under the guidance of thoracic ultrasonography (USG). Material and Methods: The files of the cases who underwent procedures under thoracic USG guidance between January 2021 and December 2022 were examined retrospectively. Clinical-demographic and radiological findings of the cases were recorded. All diagnostic procedures performed under the guidance of thoracic USG and post-procedural complications, if any, were recorded. Results: A total of 124 cases, 45 (36.3%) women and 79 (63.7%) men, with a mean age of 69.3±12.1 years, were included in the study. Thoracic USG was performed for thoracentesis in 81 (65.3%) cases, for biopsy in 33 (26.6%) cases, and for pleural catheter insertion in 10 (8.1%) cases. When thoracentesis procedures were examined, it was seen that diagnostic thoracentesis was performed in 61 (49.1%) cases and therapeutic thoracentesis was performed in 20 (16.1%) cases. When the biopsy procedures were examined, USG-guided transthoracic fine needle aspiration biopsy (TTNAB) was performed in 20 (16.1%) cases with a primary mass lesion in the lung, and TTNAB was performed on the chest wall lesion in 5 (4%) cases with a primary mass lesion in the lung and chest wall metastasis. Again, NAB was performed on supraclavicular LAP in 3 (2.4%) cases with supraclavicular lymphadenopathy (LAP) and suspicion of primary lung malignancy. In addition, pleural tru-cut biopsy was performed under USG guidance in 5 (4%) cases who were examined for pleural fluid and indicated for pleural biopsy. Conclusion: The diagnostic success rate of thoracic USG is high in selected cases and interventional procedures, and the complication rate is low in USG-guided interventional procedures.

Keywords: Biopsy; thoracentesis; thoracic ultrasonography
REFERENCES:
  1. Demi L, Wolfram F, Klersy C, De Silvestri A, Ferretti VV, Muller M, et al. New international guidelines and consensus on the use of lung ultrasound. J Ultrasound Med. 2023;42(2):309-44. [Crossref]  [PubMed]  [PMC] 
  2. Bourgouin PP, Rodriguez KJ, Fintelmann FJ. Image-guided percutaneous lung needle biopsy: how we do it. Tech Vasc Interv Radiol. 2021;24(3):100770. [Crossref]  [PubMed] 
  3. Stanton AE, Edey A, Evison M, Forrest I, Hippolyte S, Kastelik J, et al. British thoracic society training standards for thoracic Ultrasound (TUS). BMJ Open Respir Res. 2020;7(1):e000552. [Crossref]  [PubMed]  [PMC] 
  4. Annessi V, Paci M, De Franco S, Cavazza A, Ferrari G, Ricchetti T, et al. Diagnosis of anterior mediastinal masses with ultrasonically guided core needle biopsy. Chir Ital. 2003;55(3):379-84. [PubMed] 
  5. Doğan C, Kıral N, Parmaksız ET, Çağlayan B, Sağmen SB, Salepçi B, et al. Ultrasonographic evaluation of lung parenchyma involvement in sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2019;36(2):130-40. [PubMed]  [PMC] 
  6. Evison M, Blyth KG, Bhatnagar R, Corcoran J, Saba T, Duncan T, et al. Providing safe and effective pleural medicine services in the UK: an aspirational statement from UK pleural physicians. BMJ Open Respir Res. 2018;5(1):e000307. [Crossref]  [PubMed]  [PMC] 
  7. Jones PW, Moyers JP, Rogers JT, Rodriguez RM, Lee YC, Light RW. Ultrasound-guided thoracentesis: is it a safer method? Chest. 2003;123(2):418-23. [Crossref]  [PubMed] 
  8. Doran J, Hanna R, Nyagura-Mangori T, Mahotra N, Das SK, Borok M, et al. Stakeholder perspectives on current determinants of ultrasound-guided thoracentesis in resource limited settings: a qualitative study. BMJ Open. 2022;12(12):e064638. [Crossref]  [PubMed]  [PMC] 
  9. Diacon AH, Theron J, Schubert P, Brundyn K, Louw M, Wright CA, et al. Ultrasound-assisted transthoracic biopsy: fine-needle aspiration or cutting-needle biopsy? Eur Respir J. 2007;29(2):357-62. [Crossref]  [PubMed] 
  10. Laursen CB, Naur TM, Bodtger U, Colella S, Naqibullah M, Minddal V, et al. Ultrasound-guided lung biopsy in the hands of respiratory physicians: diagnostic yield and complications in 215 consecutive patients in 3 centers. J Bronchology Interv Pulmonol. 2016;23(3):220-8. [Crossref]  [PubMed] 
  11. Doğan C, Cömert SŞ, Salepçi B, Kıral N, Parmaksız ET, Çağlayan B. Efficient and safe method in diagnosis of thoracic lesions: Ultrasound-guided needle aspiration biopsy. Eurasian Journal of Pulmonology. 2019;21(3):148-55. [Crossref] 
  12. Choe J, Kim MY, Baek JH, Choi CM, Kim HJ. Ultrasonography-guided core biopsy of supraclavicular lymph nodes for diagnosis of metastasis and identification of epidermal growth factor receptor (EGFR) mutation in advanced lung cancer. Medicine (Baltimore). 2015;94(29):e1209. Erratum in: Medicine (Baltimore). 2015;94(33):1. [Crossref]  [PubMed]  [PMC] 
  13. Jany B, Welte T. Pleural effusion in adults-etiology, diagnosis, and treatment. Dtsch Arztebl Int. 2019;116(21):377-86. [PubMed]  [PMC] 
  14. Light RW, Macgregor MI, Luchsinger PC, Ball WC Jr. Pleural effusions: the diagnostic separation of transudates and exudates. Ann Intern Med. 1972;77(4):507-13. [Crossref]  [PubMed] 
  15. Benamore RE, Scott K, Richards CJ, Entwisle JJ. Image-guided pleural biopsy: diagnostic yield and complications. Clin Radiol. 2006;61(8):700-5. [Crossref]  [PubMed] 
  16. Metintas M, Ak G, Dundar E, Yildirim H, Ozkan R, Kurt E, et al. Medical thoracoscopy vs CT scan-guided Abrams pleural needle biopsy for diagnosis of patients with pleural effusions: a randomized, controlled trial. Chest. 2010;137(6):1362-8. [Crossref]  [PubMed] 
  17. Hooper C, Lee YC, Maskell N; BTS Pleural Guideline Group. Investigation of a unilateral pleural effusion in adults: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010;65 Suppl 2:ii4-17. [Crossref]  [PubMed] 
  18. Metintas M, Yildirim H, Kaya T, Ak G, Dundar E, Ozkan R, et al. CT scan-guided abrams' needle pleural biopsy versus ultrasound-assisted cutting needle pleural biopsy for diagnosis in patients with pleural effusion: a randomized, controlled trial. Respiration. 2016;91(2):156-63. [Crossref]  [PubMed] 
  19. Chang DB, Yang PC, Luh KT, Kuo SH, Yu CJ. Ultrasound-guided pleural biopsy with Tru-Cut needle. Chest. 1991;100(5):1328-33. [Crossref]  [PubMed] 
  20. Zhang Y, Tang J, Zhou X, Zhou D, Wang J, Tang Q. Ultrasound-guided pleural cutting needle biopsy: accuracy and factors influencing diagnostic yield. J Thorac Dis. 2018;10(6):3244-52. [Crossref]  [PubMed]  [PMC] 
  21. TUKMOS. Tıpta Uzmanlık Kurulu Müfredat Oluşturma ve Standart Belirleme Sistemi. 2016. Erişim tarihi: 8 Haziran 2023. Erişim linki: [Link] 

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