Laser projection system for radiotherapy and CT-guided biopsy

We devised a laser projection system combined with a CT scanner and radiotherapy treatment planning computer (CT stimulator). The irradiation field can be projected over a range of 180 degrees on the skin of a patient lying on the CT couch. For CT-guided biopsy, the system can project the skin entry point and needle direction.     

CT引导下经皮穿刺活检诊断颈部病变

目的 评价CT引导下的颈部病灶经皮穿刺活检的临床应用价值.方法 在CT引导下对15例颈部病灶经皮穿刺活检.结果 CT证实15例穿刺活检针均在病灶内,穿刺成功,全部取得病理结果,其中13例与临床诊断相一致.结论 CT引导下经皮穿刺活检颈部病变是安全、准确、微创的介入诊断技术.     

胸骨病变CT引导下经皮穿刺活检

目的 评价CT引导下经皮穿刺活检在胸骨病变中的诊断价值.方法 CT引导下经皮穿刺活检胸骨病变36例,局麻下操作,经病变前方进针.结果 36例穿刺活检成功,35例(97.2%)获得病理诊断;1例穿刺获取组织不足病理检查所需.36例中30例有手术病理结果,29例手术结果和穿刺结果相符,1例不相符,另6例转移瘤找到原发病灶而未手术.CT引导下经皮穿刺活检胸骨病变其组织学定性的符合率为97.2%,均未见严重并发症.结论 CT引导下经皮穿刺活检在胸骨病变的应用中安全可靠,并发症少,可得到明确的病理诊断,为临床制订治疗方案提供依据.     

CT导引下移植肝脏穿刺活检方法及病理改变

目的探讨CT导引下移植肝脏穿刺活检技术及其临床意义。方法25例次移植肝脏在CT导引下行穿刺活检,用HE染色法显示其病理形态学改变。结果25例次肝脏穿刺成功率为100%,其中诊断为急性排斥9例次,保存性灌注再损伤6例次,胆道并发症4例次,药物性肝脏损伤4例次,慢性排斥1例,急性肝坏死1例。结论CT导引下肝脏穿刺组织学检查是临床削断移植肝再损伤的重要方法,对鉴别引起肝脏损害的原因有很大的应用价值。     

改良的CT引导下同轴法经皮肺穿刺活检术应用

目的：探讨CT引导下同轴法经皮肺穿刺活检术的临床应用价值。方法：选择因肺内病变需活检的116例患者,所有患者均采用CT引导下自动活检枪同轴法经皮肺穿刺活检术。结果：116例患者均成功获取病理标本,穿刺成功率100％,病变阳性率94．8％,并发症6例（5．2％）,经对症处理后2～7天后患者身体逐渐恢复。结论：改良CT引导下经皮肺穿刺活检术器材简单易得,费用低廉操作简便,穿刺成功率高、并发症发生率低。     

CT-guided transthoracic needle biopsy

CT-guided biopsy of pulmonary and mediastinal lesions is safe and effective. It is most valuable in those cases in which fluoroscopic guidance is not possible due to resolution or anatomic consideration. CT guidance permits puncture of lesions as small as 0.5 cm, typically not seen fluoroscopically. Sensitivity of biopsy in malignant lung lesions in our series of 83 cases was 92%. Pneumothorax is the most frequent complication (10–60%) and requires chest tube insertion in 5–15% of patients.     

CT导引下的纵隔病变穿刺活检

目的探讨CT导引纵隔病变穿刺活检技术及其临床意义。方法35例纵隔病变在CT导引下行穿刺活检。结果35例纵隔病变穿刺活检病灶成功率100%。诊断准确率94.2%(33/35),其中恶性病变诊断准确率100%(21/21),良性病变为85.7%(11/14)。并发气胸3例(8.6%),纵隔出血1例(2.9%)。结论CT导引下穿刺活检术对于纵隔病变诊断的正确率高,对纵隔病变的诊治具有很大的帮助。     

CT-guided suprasternal approach for mediastinal biopsy.

A case involving the use of the suprasternal approach for CT-guided biopsy of small retrosternal lesions is discussed, with the mention of some technical details.     

CT-guided biopsy of pelvic masses

CT-guided fine-needle puncture (FNP) was carried out in 74 patients with pelvic masses and resulted in a correct diagnosis in 36/45 patients (80%) with malignant disease. FNP was true-positive in 66.7% and false-negative in 20%. In benign and inflammatory pelvic space-occupying lesions, FNP confirmed the suspected CT diagnosis in all cases by cytology and bacteriology. CT-guided puncture should always be used complementary to CT when a mass of unclear etiology is present.     

CT引导淋巴瘤穿刺活检的临床应用

目的探讨CT引导下穿刺活检深部病灶确诊淋巴瘤的临床应用价值。方法58例患者在CT引导下用16~20G活检枪穿刺取材,穿刺部位包括纵隔、肺部、后腹膜、胃肠道、脾、肾、肾上腺及骨骼肌肉深部肿块。病理行常规HE染色及免疫组化染色检查。结果CT引导下穿刺活检确诊恶性淋巴瘤47例,诊断阳性率81%,假阴性11例;其中4例重复穿刺活检明确诊断。穿刺确诊病例中,89.4%(42/47)获得淋巴瘤的组织学分型,另5例因组织少,仅诊断为恶性淋巴瘤,未做出具体分型。本组病例无一例发生严重并发症。结论CT引导深部病灶穿刺活检术对淋巴瘤诊断有确诊率高,并发症少,快速、安全的优点;对恶性淋巴瘤的确诊及组织学分型有重要的作用。     

CT-guided brachial plexus biopsy.

We describe a technique for conducting a CT-guided biopsy of the brachial plexus region, report two illustrative cases, discuss potential complications, and conclude that, in selected cases, biopsy of lesions in the region of the brachial plexus can be performed safely with CT guidance.     

CT 引导下腰椎病变穿刺活检

探讨ＣＴ引导下腰椎及椎间盘突变穿刺活检的价值和方法。方法在ＣＴ引导下用Ａｃｋｅｒｍａｎｎ氏对３２例腰椎及腰椎间盘病变进行了穿刺活检。结果：３２例均经追踪或／和手术证实,穿刺准确率为９０．６％。无１例引起严重并并发症及后遗症。结论ＣＴ引导下行腰椎活检是一种安全可靠的方法。．     

Pancreatic transplants: CT-guided biopsy

With use of computed tomographic (CT) guidance, 10 biopsies of pancreatic allografts were performed in four patients to determine the cause of pancreatic dysfunction. All biopsies were performed with an 18-gauge biopsy needle and with use of a biopsy gun. On four occasions, simultaneous biopsies of the pancreatic head and tail were performed. In nine of the 10 biopsies, specimens obtained were adequate for diagnosis. In two of the four simultaneous procedures, important histologic differences were noted between specimens from the head and those from the tail of the allograft. No complications occurred. These findings demonstrate the ease, accuracy, and safety of CT-guided biopsies of pancreatic transplants with a biopsy gun. Simultaneous sampling of the pancreatic head and tail may provide important clinical information that may not be available when the usual cystoscopically guided biopsy of the pancreatic head is used.     

Gantry tilt technique for CT-guided biopsy and drainage

An angled approach to percutaneous biopsy or drainage using CT guidance is often required to avoid transgressing vital intervening structures. We describe a simple technique for CT-guided angled biopsy. By tilting the CT gantry off the axial plane, CT scans can be obtained that directly demonstrate the appropriate angle of approach while avoiding intervening structures. The gantry tilt technique provides direct visualization of the pathway of the needle tract; direct visualization is not possible with previously described techniques such as stereotactic biopsy or the triangulation technique. The gantry tilt technique is a practical, simple means for performing angled CT biopsy or aspiration in many cases.     

Accuracy of CT-guided chest biopsy for benign lesions

Purpose

To demonstrate that CT-guided chest biopsy can effectively prevent surgery for patients with benign tumors.

Patients and methods

We present a cohort of patients who underwent CT-guided biopsy for a chest lesion where diagnosis could not be achieved through other means. The gold standard was defined, based on availability, by surgery or imaging and clinical follow-up over a 2-year period.

Results

From a total of 114 biopsied lesions, 101 were malignant and 13 were benign. Sensitivity and specificity values for benign lesions were 92.1 and 92.3% respectively with PPV and NPV of 60 and 98.9%. Sensitivity and specificity values for malignant lesions were 86.1 and 100% respectively with PPV and NPV of 100 and 48%. No statistically significant correlation could be established between the groups with concordant and discordant results.

Conclusion

The diagnosis of specific benign lesion on CT-guided biopsy, all sizes and sites included, may effectively prevent unnecessary surgery.