To assess biopsy technique, technical success rate, and diagnostic yield of image-guided percutaneous biopsy of omental and mesenteric lesions.
Materials and Methods
This retrospective study included 186 patients (89 men, 97 women; mean [SD] age, 63 [13.8] y) who underwent percutaneous image-guided biopsy of omentum and mesentery between March 2007 and August 2015. Biopsies were performed with computed tomography (CT) (n = 172) or ultrasound (US) (n = 14) guidance using coaxial technique yielding core and fine-needle aspiration (FNA) specimens. Biopsy results were classified as diagnostic (neoplastic or nonneoplastic) or nondiagnostic based on histopathology and cytology. Technical success rate and diagnostic yield of omental and mesenteric lesions were calculated.
Results
There were 186 image-guided percutaneous biopsies of omental (n = 95) and mesenteric (n = 91) lesions performed. Technical success rate was 99.5% for all biopsies, 100% for omental biopsies, and 98.9% for mesenteric biopsies. Overall sensitivity was 95.5%, specificity was 100%, negative predictive value was 78.3%, and positive predictive value was 100%, which was comparable for omental and mesenteric biopsies. Core biopsies had higher diagnostic yields compared with FNA: 98.4% versus 84% overall, 99% versus 88% for omental biopsies, and 97.7% versus 80% for mesenteric biopsies. Spearman rank correlation showed no correlation between lesion size and diagnostic yield (P = .14) and lesion depth and diagnostic yield (P = .29) for both groups. There were 5 complications.
Conclusions
Image-guided percutaneous omental and mesenteric biopsies have high technical success rates and diagnostic yield regardless of lesion size or depth from the skin for both omental and mesenteric specimens. 相似文献
PurposeMillions of patients undergo CT imaging examinations every year. These encounters may represent opportunities to improve colorectal cancer (CRC) screening rates among patients who have not received recommended CRC screening. Using a nationally representative cross-sectional survey, our purpose was to estimate the proportion of patients who have undergone CT examinations who have not received recommended CRC screening.MethodsSurvey respondents aged 45-75 years in the 2015 National Health Interview Survey without history of CRC were included. Proportion of patients who have undergone CT examinations among those who have not received recommended CRC screening was estimated. Multiple variable logistic regression analyses were performed to evaluate the association between sociodemographic characteristics and CRC screening adherence. Analyses were conducted accounting for complex survey design features.ResultsSixteen thousand two hundred and six survey respondents met inclusion criteria. About 44.3% (43.1, 45.5) reported having ever received a CT scan and 50.8% (49.6, 51.9) underwent CRC screening. Among those who previously had CT scans, Asian race participants and participants without health insurance coverage had lower odds of adherence, while increasing household income and education were associated with higher odds of adherence (P < 0.01). Among participants who did not receive CRC screening, 33.7% (32.1%, 35.3%) reported having a CT scan, representing an estimated 15,278,667 people across the United States.ConclusionAmong patients who have not received recommended CRC screening, nearly 1 out of 3 report having undergone a CT examination. CT encounters may represent opportunities to improve overall CRC screening rates. 相似文献
The celiac plexus is the largest visceral plexus and is located deep in the retroperitoneum, over the anterolateral surface of the aorta and around the origin of the celiac trunk. It serves as a relay center for nociceptive impulses that originate from the upper abdominal viscera, from the stomach to the proximal transverse colon. Celiac plexus neurolysis, with agents such as ethanol, is an effective means of diminishing pain that arises from these structures. Percutaneous imaging-guided celiac plexus neurolysis has been established as an invaluable therapeutic option in the management of intractable abdominal pain in patients with upper abdominal malignancy. The use of multidetector computed tomography (CT) for imaging guidance has superseded other modalities and allows direct visualization of the spread of the neurolytic agent in the antecrural space. Accurate depiction of the retroperitoneal anatomy and the position of the needle tip helps avoid crucial anatomic structures such as the pancreas, aorta, celiac artery, and superior mesenteric artery. Proper patient education, meticulous preprocedure planning, use of optimal multidetector CT techniques, adjunctive CT maneuvers, and postprocedure care are integral to successful celiac plexus neurolysis. Celiac plexus neurolysis does not completely abolish pain; rather, it diminishes pain, helping to reduce opioid requirements and their related side effects and improving survival in patients with upper abdominal malignancy. 相似文献
OBJECTIVE: Computed radiography (CR) has provided a ready cost-effective transition from screen film to digital radiography and a convenient entrance to PACS. This article revisits artifacts encountered in CR systems. These artifacts may obscure abnormalities, mimic a clinical entity, or hamper image quality. CONCLUSION: With the new-generation CR systems, software- and hardware-related artifacts have decreased, making operator errors more evident. The purpose of this study is to establish the current trend of CR artifacts and the new facets in identifying and resolving problems quickly that will help prevent future occurrences. This article also brings to light the importance of constant review required of this extensively studied topic to avoid diagnostic misadventures. 相似文献
Abdominal Radiology - To determine the feasibility of performing dual-energy CT with a single-source spectral detector system in obese patients. Retrospective, IRB-approved review of 28 patients... 相似文献
To determine the diagnostic potential of Material Density (MD) iodine images in dual-energy CT (DECT) for visualization and quantification of arterial phase hyperenhancement and washout in hepatocellular carcinomas compared to magnetic resonance imaging (MRI).
Materials and Methods
The study complied with HIPAA guidelines and was approved by the ethics committee of the institutional review board. Thirty-one patients (23 men, 8 women; age range, 36–87 years) with known or suspected Hepatocellular Carcinoma (HCC) were included. All of them underwent both single-source DECT and MRI within less than 3 months. Late arterial phase and portal venous phase CT imaging was performed with dual energies of 140 and 80 kVp, and virtual monoenergetic images (at 65 keV) and MD-iodine images were generated. We determined the contrast-to-noise ratio (CNR) for HCC in arterial phase and portal venous phase images. In addition, we introduced a new parameter which combines information of CNR in arterial and portal venous phase images into a single ratio (combined CNR). All parameters were assessed on monoenergetic 65 keV images, MD-iodine images, and MRI. Paired t test was used to compare CNR values in Mono-65 keV, MD-iodine, and MR images.
Results
CNR was significantly higher in the MD-iodine images in both the arterial (81.87 ± 40.42) and the portal venous phases (33.31 ± 27.86), compared to the Mono-65 keV (6.34 ± 4.23 and 1.89 ± 1.87) and MRI (30.48 ± 25.52 and 8.27 ± 8.36), respectively. Combined CNR assessment from arterial and portal venous phase showed higher contrast ratios for all imaging modalities (Mono-65 keV, 8.73 ± 4.03; MD-iodine, 119.87 ± 52.94; MRI, 34.87 ± 27.34). In addition, highest contrast ratio was achieved in MD-iodine images with combined CNR evaluation (119.87 ± 52.94, P < 0.001).
Conclusion
MD-iodine images in DECT allow for a quantitative assessment of contrast enhancement and washout, with improved CNR in hepatocellular carcinoma in comparison to MRI.
