CT-guided percutaneous biopsies of mediastinal and paramediastinal masses in the lateral decubitus position

Eur Radiol. 2020 Jun;30(6):3146-3151. doi: 10.1007/s00330-020-06659-2. Epub 2020 Feb 17.

Abstract

Background: Percutaneous parasternal puncture is a common procedure that allows sampling of mediastinal lesions. The trans-pulmonary route is sometimes mandatory in the dorsal position and is associated with complications such as pneumothorax.

Methods: Our study explored the efficacy of the lateral decubitus position in avoiding the trans-pulmonary route. Sixteen patients were included between 2005 and 2019. In three patients, the procedure was intended to place fiducial markers.

Results: No pneumothorax or hematoma occurred. Access to the lesion was not possible in 1 patient. A histological diagnosis was made for all patients undergoing sampling. This technique seems to be safe and efficient.

Key points: • Parasternal access to mediastinal and paramediastinal lesions whenever a trans-pulmonary crossing is mandatory in the dorsal position is safe, simple, and efficient in the lateral decubitus position.

Keywords: Image-guided biopsy; Lung neoplasms; Thoracic neoplasms.

MeSH terms

  • Adult
  • Aged
  • Female
  • Hematoma / etiology
  • Humans
  • Image-Guided Biopsy / adverse effects
  • Image-Guided Biopsy / methods*
  • Lung Neoplasms / diagnostic imaging
  • Male
  • Mediastinal Neoplasms / diagnostic imaging*
  • Mediastinum / diagnostic imaging*
  • Middle Aged
  • Patient Positioning*
  • Pneumothorax / etiology
  • Tomography, X-Ray Computed / methods*