Objective: the aim of this study is to assess the severity and risk factors associated with pulmonary hemorrhage complicating percutaneous transthoracic CT-guided core needle biopsy.
Patient and Methods: this retrospective study was approved by our scientific and ethical committee. A total of 312 CT-guided lung biopsies done from December 2016, to September 2019 were included in this study. Pulmonary hemorrhage was assessed for each procedure. The severity of pulmonary hemorrhage was categorized into Grade 0 defined as no pulmonary hemorrhage, grade 1 as needle tract hemorrhage 2 cm or less, grade 2 as hemorrhage more than 2 cm, grade 3 as lobar hemorrhage or greater, and grade 4 as hemothorax. Grade 2 or higher was considered as high grade hemorrhage.
Results: Pulmonary hemorrhage occurred 97(31%) out of the 312 after lung core biopsies. Grade I hemorrhage occur after 57 (18.3%) procedures, grade II after 37 (11.8%) procedures, grade III after 2 (0.6%) procedures and grade IV occur only after one procedure (0.3%). Grade II and more hemorrhage occur after 40 (13%) procedures and were considered as high grade hemorrhage. High grade hemorrhage was statistically significant to occur more with female sex, lesions less than 3 cm, non-subpleural location and co-axial technique (P ˂0.05). Emphysema and age were not a significant risk factor for high grade hemorrhage (P >0.05).
Conclusion: pulmonary hemorrhage complicating CT-guided core needle lung biopsy is common. Significant risk factors associated high grade hemorrhage includes female sex, lesions less than 3 cm, non-subpleural location and co-axial technique.