Capillary versus aspiration biopsy: Effect of needle size and length on the cytopathological specimen quality

Purpose To test the value of the nonaspiration, or capillary, biopsy technique by experimental comparison with the conventional fine-needle aspiration technique using various needle gauges and lengths. Methods On fresh hepatic and renal tissue from five autopsies, multiple biopsy specimens were taken with 20, 22, and 23-gauge Chiba needles of 5, 10, 15, and 20-cm length, using the aspiration technique and the capillary technique. The resultant specimens were graded on the basis of a grading scheme by a cytopathologist who was blinded to the biopsy technique. Results The capillary technique obtained less background blood or clot which could obscure diagnostic tissue, although not significantly different from the aspiration technique (p=0.2). However, for the amount of cellular material obtained, retention of appropriate architecture, and mean score, the capillary technique performed statistically worse than aspiration biopsy (p<0.01). In addition, with decreasing needle caliber (increasing needle gauge) and increasing length, the capillary biopsy was inferior to the aspiration biopsy. Conclusion The capillary biopsy technique is inferior to the aspiration technique according to our study. When the capillary technique is to be applied, preference should be given to larger caliber, shorter needles.     

Traction osteophytes of the lumbar spine: radiographic-pathologic correlation

Previous reports have emphasized two types of osteophytes on the anterior aspects of the lumbar vertebral bodies: the common claw osteophyte and the less common but more significant traction osteophyte, which is indicative of spinal instability. To delineate the importance of the traction osteophyte, a radiographic-pathologic study was conducted. The results indicate that claw osteophytes are more frequent than traction osteophytes, that both may coexist in a single vertebral body, and that, in most cases, these osteophytes appear to represent different stages of the same pathologic process.     

Effect of suction on specimen size in fine-needle aspiration biopsy

High incidences of unsatisfactory specimens in fine-needle aspiration biopsy for cytology have been reported previously. Inappropriate aspiration techniques may account partly for this. In this study, the effect of suction on specimen size was studied in vitro using an automatic sampler. Bovine liver, testis, and pig's kidney were used as target tissues and biopsies were performed with 18-, 20- and 22-gauge needles. Specimen weight increased rapidly and linearly with suction force (P less than .001), regardless of the target tissue or needle diameter, when standard needle movement was applied. In the absence of needle movement, the suction force, rate of increase of suction, and duration of suction had no effect on the weight of the specimens. Needle movement alone, without suction, also produced meager specimens. Suction alone does not seem to tear fragments off target tissues. Nevertheless, in combination with needle movement, suction force plays an important role in the determination of specimen size.     

Central osteophytes in the knee: prevalence and association with cartilage defects on MR imaging

OBJECTIVE: The objective of this study was to determine the prevalence and location of central osteophytes in patients referred for MR imaging of the knee and the relationship of central osteophytes to articular cartilage defects, marginal osteophytes, meniscal tears, and anterior cruciate ligament tears as seen on MR imaging. MATERIALS AND METHODS: Two hundred consecutive patients referred for MR imaging of the knee were evaluated for central osteophytes, articular cartilage defects, marginal osteophytes, meniscal tears, and anterior cruciate ligament tears. A 1.5-T scanner was used, and assessments were made by consensus of two experienced musculoskeletal radiologists. Seven patients were excluded, leaving 193 patients in the study population. RESULTS: The prevalence of central osteophytes in the knee was 15% (35 central osteophytes in 29 patients). Patients with central osteophytes were older (mean age, 52 years versus 38 years), weighed more (mean weight, 204 lb [92 kg] versus 174 lb [78 kg]), had more articular cartilage defects (mean, 4.3 versus 1.3), and had more marginal osteophytes (mean, 3.9 versus 1.1) than patients without central osteophytes (p < 0.0001, Student's t test). Patients with central osteophytes were more likely to have a meniscal tear (p = 0.004, chi-square test), but they were not more likely to have an anterior cruciate ligament tear. All central osteophytes were associated with articular cartilage defects at the same location, which were full or near-full thickness on MR imaging for 32 of 35 central osteophytes. CONCLUSION: Central osteophytes are common in patients referred for MR imaging of the knee. When central osteophytes are seen in the knee there is a high likelihood of an associated full thickness or near-full thickness articular cartilage defect.     

Effect of sampling technique on specimen size in fine needle aspiration biopsy

The effect of the sampling technique in fine needle aspiration biopsy for cytology (FNAC) on the specimen size obtained was studied in vitro. The specimen size increased rapidly and linearly (P less than .001) with the number of needle passes, if the needle was angled between the passes into different directions in a fan-like fashion. However, if the needle was stroking repeatedly into the same channel, less and less tissue was detached per pass. The effect of the amplitude of needle passes (needle excursion) on the specimen weight was linear (P less than .001) after an initial plateau; when needle excursion was less than 3 to 4 mm, no tissue was detached. The specimen weight was significantly larger when a few passes with long needle excursions were used compared with a large number of passes with small needle excursions. Given an equal number of needle passes, the time interval (frequency) between these passes was less important. The sampling technique is important in determining the size of the specimen. The high incidences of unsatisfactory specimens reported and the wide variation in the accuracy rates of FNAC could be explained partly by differences in sampling techniques.     

Imaging diagnostics of the pharynx and larynx

The pharynx and larynx represent very sophisticated regions and may be involved in a diverse range of pathologic conditions. Evaluation of the head and neck has developed significantly with the establishment of CT and MRI as they provide true insights into the endoscopically blind areas as well as depth of tumor infiltration, its submucosal growth and contralateral involvement, cartilage invasion, bone marrow invasion, and nonpalpable adenopathy. Inflammations in the head and neck region are only exceptionally imaged with CT or MRI; indications are the diagnosis of retrotonsillar and parapharyngeal abscesses and ensuing complications. The different imaging modalities of malignant pharyngeal and laryngeal tumors and their differential diagnosis are presented in this paper.     

Imaging of the pharynx and the esophagus.

In the past year there have been an unusual number of new concepts developed concerning the pharynx and the esophagus. The normal swallowing mechanism has been studied in detail using a variety of techniques that have increased our understanding of the normal and abnormal swallowing mechanism. In the esophagus, simultaneous barium swallows and esophageal manometry have created new insights into esophageal peristalsis. Based on this material, new recommendations have been developed for a standard barium swallow for the evaluation of esophageal motility. Also, findings previously considered to be abnormal, such as mild tertiary contractions, have now been demonstrated to be within normal limits. For the first time, detailed criteria for abnormal esophageal peristalsis have been described. This article reviews the literature, emphasizing those areas in which new concepts will affect the practicing radiologist.     

重视高分辨率MRI新技术对颅内血管壁病变的研究

颅内血管壁MRI成像技术发展迅速,能够实现对多种颅内动脉管壁病变的高分辨率成像,不仅明显提升了影像诊断及鉴别诊断能力,还有助于脑血管病的预防、危险分层及制定治疗方案,高分辨率MR管壁成像技术在颅内动脉病变的诊疗中具有明显的优势和应用前景。