| Characteristics of TBLB According to the Type of Pulmonary Lesion and Diagnostic Validity of Biplane-Fluoroscopy in TBLB |
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Hee Soon Chung, Woo Sung Kim, Man Pyo Jeong, Sung Koo Han, Young Soo Shim, Keun Youl Kim, Yong Chol Han, In Gyu Hyun |
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Department of Internal Medicine & Tuberculosis Research Institute, College of Medicine, Seoul National University, Seoul, Korea |
| 경기관지폐생검의 병소유형에 따른 특징 및 양면방사선투시의 효용도 |
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정희순, 김우성, 정만표, 한성구, 심영수, 김건열, 한용철, 현인규 |
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| Abstract |
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TBLB (transbronchial lung biopsy) is wel1 .known as a valuable and relatively safe diagnostic tool in both diffuse and localized lesion which is invisible on routine bronchoscopy. To investigate the diagnostic validity of biplane-fluoroscopy in TBLB of diffuse lesion and the diagnostic rate of TBLB according to the size of localized lesion, we analyzed 105 cases (54 cases of diffuse lesion and 51 cases of localized lesion) of TBLB In diffuse pulmonary lesion, diagnostic rate of TBLB under the fluoroscopic guide was 85.7% and that of blind biopsy was 78.9%. The incidence of pneumothorax as complication of TBLB was 5.7% with fluoroscopy, and 5.3% without it. Between the presence and the absence of fluoroscopy, there was no significant difference (p>0.05) in the rates of diagnosis and complication of TBLB. When TBLB was performed at anterobasal segment of lower lobe, the diagnostic rate was significantly high (p<0.01). In localized pulmonary lesion, the diagnostic rate of TBLB was 70.6% and the diagnostic yield significantly increased (p < 0.01) when the size of lesion was 3 cm or more. Pneumothorax was found in only 2.0%. It can be concluded that biplane-fluoroscopy isn’t an absolute prerequisite for TBLB and the diagnostic rate might be maximized when TBLB is done at anterobasal segment of lower lobe in diffus pulmonary lesion. And it is anticipated that the diagnostic yield of TBLB is better when the diameter of lesion is 3 cm or more in localized disease |
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