Comparative study between the use of image guided pleural biopsy using abram’s needle and medical thoracoscope in diagnosis of exudative pleural effusion

When cytology for pleural fluid is nondiagnostic, thoracoscopy or cutting-needle pleural biopsy or closed percutaneous needle biopsy using Abrams needle (ANPB) can be used to obtain tissue samples. Ultrasound guidance for biopsies performed with an Abrams needle can be used to increase the diagnostic yield of this traditional method.Aim of the study: This study aimed to compare the diagnostic validity of ANPB under ultrasound guidance (US-ANPB) with that of medical thoracoscopy in patients with pleural effusion.Methods: 30 patients with recurrent exudative pleural effusion of undetermined etiology that have undergone cytologic analysis and could not be diagnosed were included in the study and divided into 2 groups, Group I who underwent medical thoracoscopy for diagnosis (n = 15) and Group II who underwent ultrasound-guided Abrams needle biopsy for diagnosis (n = 15). Comparison between the two groups was drawn in terms of diagnostic sensitivity and complications associated with the methods used.Results: The sensitivity and specificity of diagnostic thoracoscopy in group I was 100% & 100% respectively. The sensitivity and specificity of ultrasound-guided Abrams needle in group II was 100% & 100% respectively. No difference was identified between the sensitivities of the two methods. Complications of both groups were of low rate and tolerable.Conclusion: If US guidance can be used for biopsies performed with an Abrams needle, the yield of this traditional method can be increased. The use of US-guided Abram’s needle pleural biopsy is simple, safe and well tolerated