Percutaneous biopsy of thoracic lesions: value of sonography for needle guidance.

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Abstract
Fluoroscopy and CT are widely used to guide percutaneous needle biopsy of thoracic lesions. However, some lesions are not sufficiently visible on fluoroscopy and others are dangerous to access on CT without real-time monitoring. When these are the circumstances, sonographic guidance may be helpful. Real-time sonography was used to guide percutaneous needle biopsy in 124 patients with thoracic lesions. The indications for sonographic guidance included pulmonary, pleural, or mediastinal lesions in contact with the chest wall, including lesions near the heart or great vessels (n = 12); lesions in the apical region (n = 5); lesions in a juxtadiaphragmatic location (n = 6); small lung nodules adjacent to the chest wall (n = 16); and peripheral tumors with adjacent pleural effusion (n = 4). A diagnosis was made in 74 (90%) of 82 malignant lesions and in 24 (67%) of 36 benign lesions. Complications included pneumothorax (n = 5), hemoptysis (n = 1), and hemothorax (n = 1). The advantages of sonographic guidance a...