Objective  Computed tomography (CT)-guided percutaneous lung biopsy is difficult for small nodules and lesions that are adjacent to large blood vessels. This study investigated the validity of CT-guided percutaneous lung biopsy in the diagnosis of pulmonary nodules with a digital angle instrument.

  Methods  This study was a retrospective analysis of 35 patients with lung mass ≤60 mm, who underwent CT- guided percutaneous lung biopsy from January 2018 to September 2018. Patients were assigned in to three groups. Group A and B were patients with pulmonary nodules ≤30 mm. Biopsy of group A was performed with the help of a digital angle instrument, and group B didn' t use digital angle instrument. Group C had lung mass of > 30 mm, and the biopsy was performed without using the instrument. The size of the mass, frequency of punctures, distance of the puncture, and complication of pneumothorax after puncture were compared among the three groups.

  Results  The maximum diameter of pulmonary nodules in group A (18.4 ± 2.1) mm was significantly lower than that in groups B (28.3 ± 2.0) mm and C (43.2 ± 3.6) mm, and their P value were 0.0034 and 0.0028, respectively. Some patients in group A were at risk because of severe chronic obstructive pulmonary disease and proximity of lesions to large blood vessels. The puncture distance in group A was also significantly more than groups B (P < 0.039). However, the probability of puncture success in group A was 100%, which was significantly higher than groups B and C. The postoperative complications in group A were also significantly fewer than in other two groups.

  Conclusions  CT-guided percutaneous lung biopsy with a digital angle instrument is a safe, simple, and accurate diagnostic method, especially in patients with pulmonary nodular lesions.