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© 2003 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 22:703-708 • 0278-4297

Color Doppler Sonographically Guided Transthoracic Needle Aspiration of Lung and Mediastinal Masses

Metin Gorguner, MD, Filiz Misirlioglu, MD, Pinar Polat, MD, Hasan Kaynar, MD, Leyla Saglam, MD, Arzu Mirici, MD and Selami Suma, MD

Departments of Chest Diseases (M.G., F.M., H.K., L.S., A.M.) and Radiology (P.P., S.S.), Faculty of Medicine, Atatürk University, Erzurum, Turkey.

Address correspondence and reprint requests to Metin Gorguner, MD, PO Box 121, Erzurum 25020, Turkey; e-mail: gorguner{at}atauni.edu.tr.

Objective. This study investigated the diagnostic value of color Doppler sonographically guided transthoracic needle aspiration in lung and mediastinal masses. Methods. B-mode and color Doppler sonographic images were obtained in 48 patients with mediastinal or peripheral pulmonary tumors. Color Doppler sonography was used to show the vascular structures before the transthoracic needle aspiration procedure. It was also used to locate the needle tip during the procedure by showing the twinkling sign. This maneuver was performed with motion of the inner stylet. Pathologic and microbiological examination of the aspirates was made. Results. Vascular structures were detected in 37 cases on color Doppler images and in 10 cases on B-mode images. Similarly, the needle tip was observed in 39 cases on color Doppler images but in only 9 cases on B-mode images. No complications were observed except partial pneumothorax in 2 cases. The method had sensitivity of 90.0%, specificity of 87.5%, a positive predictive value of 97.2%, a negative predictive value of 63.6%, and diagnostic accuracy of 89.6%. Conclusions. Color Doppler sonographically guided transthoracic needle aspiration is a safe diagnostic method in malignant lung tumors, especially peripheral tumors, because of its ability to differentiate vascular structures within a tumor before the transthoracic needle aspiration procedure. It provides additional information about the location of the needle tip.

Key Words: color Doppler sonography • lung • mediastinal • transthoracic needle aspiration • tumor

Abbreviations: CT, computed tomography • TTNA, transthoracic needle aspiration • VATS, video-assisted thoracic surgery

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Copyright © 2003 by the American Institute of Ultrasound in Medicine.