CT导引下经皮胸部穿刺活检的应用价值(附64例分析)

目的：探讨CT导引下经皮胸部穿刺活检的诊断价值。方法：64例病人，男38例，女26例，均采用18G抽吸针(Cook)，在CT导引下经皮穿刺活检，活检组织送病理。结果：除3例穿刺失败外，61例均穿刺成功，有4例并发少量气胸。穿刺成功率为95％，穿刺阳性诊断率为88％，并发症发生率为6％。结论：CT导引下经皮胸部穿刺活检安全、准确、易行，在胸部疾病的诊断和鉴别诊断方面起着重要的作用。     

胸部结节或肿块的 CT 导向穿刺活检的临床应用

目的：探讨CT导向下经皮穿刺活检对胸部结节或肿块病变诊断的临床意义。方法 CT导向下采用18~20 G切吸两用穿刺针对25例胸部占位性病变进行穿刺并活检。结果25例患者穿刺活检病理诊断为恶性肿瘤12例,良性肿瘤4例,结核3例,淋巴结肿大6例;恶性肿瘤中鳞癌6例,腺癌2例,小细胞癌1例,转移瘤3例。总阳性诊断率达100%,其中细胞学诊断阳性率76%,组织学诊断阳性率92%。无一例发生严重并发症及针道转移。结论 CT导向穿刺对胸部结节或肿块的诊断安全有效,值得临床广泛应用。     

CT导引下经皮穿刺活检的意义及体会：——附124例报告

本文报告了124例身体各部位病变 CT 导引下针吸活检,包括腹部51例、胸部50例、盆腔7例,其它部位16例;病变包括肿瘤67例、脓肿27例、腹及胸腔积液30例。同时还对其中胸部及肝脏脓肿进行了治疗,即行脓肿抽吸引流。本文着重讨论了 CT 导引下穿刺活检的诊断意义及治疗意义。本组穿刺总准确率为85.1%,其中腹部87.5%,胸部79.2%,其它部位90%,假阴性13.4%。除胸部穿刺出现胸痛、气胸及咯血痰各1例外,发生严重并发症。认为 CT 导引下穿刺活检较 B 超及普通 X 线导引准确性高、安全性大、并发症少,是对疑难及不典型病例的补充诊断手段之一。     

CT导引下穿刺活检对胰腺占位性病变的诊断价值

目的 探讨CT导引穿刺活检胰腺占位性病变的诊断价值.方法 回顾性分析CT导引细针穿刺胰腺占位性病变68例,其中胰头区病变49例、胰体12例和胰尾7例.病灶直径2～7 cm,<3cm 10例,3～7 cm 58例.术前均作CT平扫和增强扫描,均采用前路进针,使用20 G细针穿刺.活检标本送病理科作组织病理检查.结果 68例患者均安全地穿刺到病变内,活检成功率为100%.穿刺活检诊断率为恶件病变46例,良性17例,5例未见病变.5例中2例经临床和CT随访均无异常,另3例最终证实胰腺囊腺癌2例和胃癌转移1例.穿刺活检总正确率、灵敏度和特异度分别为96%、95%和100%.CT导引活检对恶性、良性病变的正确率为94%和100%(P>0.05).较大肿块病灶(≥3.0 cm 97%,<3 cm90%)和病变位于胰尾(胰尾100%,胰头96%,胰体92%)的正确率稍高,但经统计学检验正确率差异并无统计学意义(P>0.05),未发现严重的并发症.结论 CT导引经皮细针穿刺活检胰腺占位性病变是一种安全的有效的诊断和鉴别诊断的方法.     

CT导引下自动活检枪经皮肺穿刺活检的临床应用

目的:探讨CT导向下18G自动活检枪肺活检对肺部结节及肿块病变的临床诊断价值。方法:在CT导向下使用18G自动活检枪对125例患者进行活检取材并送病理检查。结果:穿刺成功率100%,取材成功率98.4%。取材后120例取得病检结果,其中原发性肺癌79例(鳞癌39例,腺癌28例,大细胞癌4例,小细胞癌6例,腺鳞癌2例),肺滑膜肉瘤1例,肺错构瘤2例,肺硬化性血管瘤1例,炎性肿块28例,结核9例。穿刺后4例出现少量气胸,8例针道周围出血,4例痰中带血。结论:CT导引下18G同轴自动活检枪肺活检具有定位精准、穿刺成功率高、获取组织标本可满足病理诊断要求、并发症较少等优点,对肺部结节及肿块病变的定性诊断具有较高的应用价值。     

CT及电视导引经皮胸部穿刺活检

目的：总结４２例ＣＴ及电视透视导引下经皮胸部穿刺活检经验。方法：其中肺部病变３１例;胸膜病变６例;纵隔肿块５例。采用改进后的１８ 号Ｃｏｏｋ 切割针在ＣＴ或电视透视导引下经皮穿刺活检。结果：一次穿刺成功率为９４％ ;确诊率为９６％ ;并发症发生率为１２％ 。结论：该方法获取组织较大,既可涂片作细胞学检查,又可切片作病理检查。     

CT导引下经皮胸部肿块穿刺活检

CT导引下经皮胸部肿块穿刺活检是临床诊断和鉴别诊断的手段之一,由于其准确率高、并发症少,临床应用广泛。现将我院CT导引下经皮活检,并经临床随访或经手术病理证实的28例经验介绍如下。1材料与方法本组28例中,其中男19例,女9例,年龄42~78岁,平均年龄63岁。肺内病灶20例,胸膜病变5例,纵隔3例。病变直径2~8cm不等。所用CT机为GE公司ProSpeed AI,穿刺器械为COOK公司20G自动弹射活检枪,长度10~15cm,前端活检槽为10~30mm.。18G带芯腰穿针,长度10~15cm。方法:①穿刺前检查血凝四项;②患者进行CT扫描,层厚10mm,观察病变的部位与周围器官的…     

两种活检针在经皮胸肺穿刺活检中的应用

目的：观察两种不同活检针在CT导向下经皮胸肺穿刺活检的准确率和并发症的发生率。方法：对17例肺内直径≤2cm的病灶用22G抽吸活检针行经皮胸肺穿刺活检；对22例直径〉2cm的病灶用18Gmedi—tech同轴切割针行经皮胸肺穿刺活检。结果：22G抽吸活检针活检确诊率为76．5％，并发症发生率为11．7％；18G同轴切割针活检确诊率为91%，并发症发生率为13．6%。结论：1、根据病灶的大小、位置，选择不同的穿刺针获取不同大小的组织．提高了穿刺活检确诊率和减少了并发症的发生率；2、除不能合作者外，CT导向经皮胸肺穿刺技术可用于几乎所有胸部病灶的活检。     

弹簧活检枪在胸部肿块活检中的应用

目的 :探讨应用弹簧活检枪行胸部肿块CT引导下穿刺活检的临床价值。材料和方法 :使用 15～ 18G弹簧活检枪在CT引导下对 42例胸部肿块 (肺 3 4例、纵隔 8例 )行穿刺活检术 ,标本行组织学、细胞学检查 ,活检结果与手术及随访结果对照。结果 :活检枪活检总准确性为 90 .5 %。肺部肿块中恶性肿瘤 3 0例、良性病变 4例 ,肺癌假阴性 3例 ,无假阳性 ;纵隔肿块中恶性 8例 ,1例淋巴瘤穿刺物难以定性。并发症发生率 2 1.4% ,其中气胸 6例、针道区少量出血 3例 ,除 1例气胸行闭式引流外均无需处理。结论 :使用弹簧活检枪行CT引导下胸部肿块穿刺活检准确、安全 ,临床价值高。     

CT引导经皮肺穿刺切割活检对肺内疑难病变诊断的研究

目的:探讨CT导引下经皮肺穿刺切割活检技术及临床应用价值。方法:在CT定位导引下使用槽式切割活检针进行病理组织学检查。结果:110例病变中,12例肺内弥漫性病变,98例肺内局灶性病变。在局灶性病变中,邻近胸膜的病灶36例,邻近肺门的病灶6例,距穿刺点胸膜最远8. 5cm。病灶靶区刺中率98. 18% (10. 8/110 ) ,切割取材成功率92 . 72 % (10 2 /110 ) ,病理确诊率96 . 36 % (10. 6 /110 ) ,并发症19.0 9(2 1/110 )。结论:①让患者保持相对固定的呼吸屏气相位,精确控制进针深度、角度及穿刺路径是刺中病灶靶区、减少并发症的关键;②CT导引下经皮肺穿刺切割活检技术是肺内疑难病变定性诊断的理想方法,具有重要的临床意义     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.