自制栅栏定位器在CT引导下经皮肺穿刺活检中的应用价值

目的探讨自制栅栏定位器在CT引导下经皮肺穿刺活检中的应用价值。方法随机抽取经皮肺穿刺病例160例,A、B两组,A组为使用传统定位器穿刺,B组为使用自制栅栏定位器穿刺,每组80例,并把两组病例的穿刺组织学符合率及并发症进行比较。结果A组病例组织学符合率高,明显减少了由于穿刺时进针的位置和角度不当及穿刺次数过多而产生的并发症。结论自制栅栏定位器在CT引导下经皮肺穿刺活检中具有定位准确,穿刺成功率高,并发气胸率低等优点,具有推广价值。     

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.     

CT引导下经皮穿刺活检76例护理体会

肺、肝脏及肾脏的结节与肿块发病机率较高，临床上比较常见。CT引导下穿刺活检术，可以为临床定性诊断提供有价值的论断依据，现将我院76例经皮穿刺活检结果及护理要点报道如下。     

CT引导下经皮脏器穿刺活检的配合及护理

目的：通过对50例患者在CT引导下经皮脏器穿刺活检术时给予合理的心理护理与技术配合，使患者能顺利完成穿刺活检术。方法：选择50例不同部位或脏器，且经X线、B超、CT、MR诊断困难的病例。配合医生实施CT引导下穿刺活检术。结果：本组病例全部穿刺成功，无明显并发症。结论：运用完善的心理护理，严格的无菌操作规程，熟练的配合，严密观察病情等保证穿刺顺利进行。以便为临床提供更可靠的诊断依据。     

CT引导下经皮肺穿刺活检经验总结

目的：探讨CT导引下经皮肺穿刺活检的技术方法和影响诊断准确性的因素，防范并发症的心得。方法：回顾性分析36例肺内病变CT引导下经皮肺穿刺活检的技术方法，就如何提高穿刺准确性及影响诊断准确率的因素、防范并发症的心得进行讨论。结果：36例中，穿刺成功率100％，活检诊断准确率为30／36（83％）。3例发生轻度气胸。结论：CT引导下经皮肺穿刺活检术是安全的，可有效提高肺内病变的诊断准确性。但操作医生熟练的技术方法非常重要，并可以减少并发症的发生。     

激光倾角仪在CT引导下经皮纵隔穿刺活检中的应用北大核心CSCD

目的探讨激光倾角仪引导进针角度装置在CT引导下经皮纵隔穿刺活检中的应用价值。方法选择2017年4月至2022年4月湖北省肿瘤医院放射科CT引导下经皮纵隔穿刺活检患者100例,其中采用激光倾角仪引导下穿刺患者50例,采用常规穿刺患者50例。对比两组一次穿刺靶灶成功率、CT扫描次数、进针时间及穿刺并发症、穿刺病理阳性率。结果激光倾角仪组一次穿刺达靶灶率为74%(37/50),常规穿刺组为42%(21/50),差异有统计学意义(χ^(2)=10.509,P=0.01)。激光倾角仪组CT扫描次数为(3.42±2.05)次,常规穿刺组为(5.42±3.37)次,差异有统计学意义(t=8.502,P=0.004)。激光倾角仪组进针时间为(8.67±3.12)s,常规穿刺组为(12.08±4.70)s,差异有统计学意义(t=10.120,P=0.002)。激光倾角仪组出现并发症12例(24%),常规穿刺组出现并发症22例(44%),差异有统计学意义(χ^(2)=4.456,P=0.035)。激光倾角仪组病理阳性率为94%(47/50),常规穿刺组为92%(46/50),差异无统计学意义(χ^(2)=0.154,P=0.695)。结论激光倾角仪引导进针角度装置联合CT引导下经皮纵隔穿刺活检术可使穿刺更加精准和安全,值得临床推广应用。     

Complications of CT-guided percutaneous needle biopsy of the chest: prevention and management

OBJECTIVE: The objective of this article is to describe potential complications of percutaneous needle biopsy of the chest, discuss the risk factors associated with the development of complications, and explain how to prevent complications and manage complications when they occur. CONCLUSION: Pneumothorax and pulmonary hemorrhage are the most common complications of percutaneous needle biopsy of the chest, whereas air embolism and tumor seeding are extremely rare. Attention to biopsy planning and technique and postprocedural care help to prevent or minimize most potential complications.     

CT导向经皮肺穿刺活检术的临床应用

目的：评价CT导引下经皮肺穿刺活检的临床应用价值。方法：回顾性分析经手术或病理证实的CT导向肺穿刺活检38例。活检的要点包括选择最佳层面、进针点及作点扇状快速抽吸。结果：38例中明确诊断33例，其中腺癌11例，鳞癌4例，转移癌1例，未分化癌1例，查到癌细胞但未能分型2例，异形细胞3例，肺脓肿4例，肺结核4例，炎性假瘤3例。未明确诊断5例。发生气胸2例，少量咯血2例。穿刺活检总确诊率为86．8％。结论；CT导引下肺穿刺活检确诊率高，并发症少，是一种简便、实用、安全的检查方法，应广泛推广应用。     

CT导向下腹部肿块细针穿刺抽吸活检

Fine needle aspiration biopsy were made under CT guidance of 50 cases of intra-abdominal masses, including liver in 37 cases, kidney in 6, pancreas and spleen in 1 respectively, and 5 biopsies were made of tumors of the abdominal cavity. The overall diagnostic accuracy was 92%, and the accuracy for malignancies was 84.6%. No complications occurred related to the procedure. The relevant factors for precise biopsy safety and the therapeutic value of this technique were discussed. It was concluded that CT-guided fine needle aspiration biopsy is precise in localization, it is a safe approach yielding satisfactory diagnostic accuracy.     

自制颅脑CT定位装置在颅内病灶体表定位中的应用

目的：探讨自制颅脑 CT 定位装置在颅内病灶体表定位中的应用价值。方法对65例颅内存在病灶的患者,应用自制颅脑 CT 定位装置行64排螺旋 CT 平扫检查,利用 CT 扫描准直线与定位装置金属线构成的二维平面体表定位颅内病灶。结果65例颅内存在病灶的患者,均能一次性准确体表定位颅内病灶,平均费时3 min。而常规颅内定位方法,按照体表标记物与颅内病灶体表最近点(拟手术切开处)的距离进行统计,前后或上下大多都会偏移1~2 cm。结论利用该颅脑 CT 定位装置,能提高颅内病灶体表定位准确性、效率及减少辐射剂量,使用方便,便于推广。     

Asymptomatic systemic air embolism after CT-guided percutaneous transthoracic needle biopsy

PurposeWe presented details and incidence of systemic arterial embolism (SAE) following a CT-guided percutaneous transthoracic needle biopsy (PTNB) and evaluated risk factors for SAEs.MethodsWe retrospectively evaluated 1014 PTNBs performed in our hospital from 2005 to 2017. SAE was identified in the pulmonary vein, left heart, coronary artery, and aorta by reviewing post-biopsy CT images. Limited post-biopsy CT scans only covering the region biopsied were available until the first case of SAE was identified (n = 503). Then, the entire thorax was scanned for further examination of SAE (n = 511). Eighteen-gauge automatic cutting needles were used in all procedures. When SAE was evident on post-biopsy CT, subsequent brain CT was performed in order to confirm the cerebral SAE.ResultsNine patients (0.89%) developed SAEs. In the univariate analyses, the location of the needle tip relative to the lesion (outside or inside of the lesion) as well as accompanying pulmonary hemorrhage were significant risk factors for SAEs (P = 0.021 and 0.036, respectively). Two patients developed neurological symptoms with cerebral SAEs, and one of these had sequelae. In seven asymptomatic SAEs with no cerebral SAE, four patients were retrospectively-diagnosed cases and three patients were detected on post-biopsy CT images. All seven of these patients had no sequelae.ConclusionThe incidence of SAE was higher than expected, due to radiologically detected asymptomatic SAEs. The location of the needle tip relative to the lesion and accompanying pulmonary hemorrhage were significant risk factors for the occurrence of SAEs. We proposed a guideline for treating asymptomatic SAEs.     

CT引导下经皮肺穿刺活检诊断肺空洞病变的临床应用

目的：探讨在CT引导下,经皮肺穿刺诊断肺空洞病变的可行性、操作技巧及诊断价值。方法：回顾分析28例肺空洞病变患者,在CT引导下行穿刺活检术,取出组织经涂片和固定后,分别送细胞学和组织病理学,分析其阳性率及并发症的发生率,并比较两种诊断方法的相关性和一致性。结果：28例患者,均穿刺成功,取得标本多少不一。组织学诊断鳞癌12例,腺癌6例,慢性炎症5例,结核3例,2例不能做出准确诊断,诊断阳性率为92．9％;细胞学17例查到癌细胞,其中16例与组织学诊断一致,1例为组织学不能做出诊断者,其余11例未查到癌细胞。2例出现气胸（7．14％）,4例出现咳血（14．3％）,均为痰中带血。结论：CT引导下经皮肺穿刺活检诊断肺空洞病变准确率高,并发症少,具有较高的临床应用价值。     

IG4电磁导航系统辅助CT引导下肺结节穿刺活检术的临床应用

目的 评价IG4电磁导航系统在CT引导下经皮穿刺肺活检术中的应用价值.方法 选择40例患者20例行IG4电磁导航系统辅助CT引导下肺穿刺活检,20例行常规CT引导下肺穿刺活检,记录2组定位时间、调针次数、扫描次数、辐射剂量、瞄准精度以及并发症情况.结果 IG4电磁导航系统辅助组中20例患者在穿刺过程中成功应用该系统,其肺活检平均定位时间为(10.05±1.75) min(7.5～14.0 min);穿刺针平均调整次数(1.10±0.31)次(1～5次);平均扫描次数为(3.30±0.73)次(3～6次);剂量长度乘积(DLP)均值为(724.25±186.23) mGy·cm (415.50～1 080.50 mGy·cm);20次穿刺定位中,15次瞄准精度＜5 mm,4次为5～ 10 mm,1次为13 mm,穿刺针瞄准精度均值为(4.72±3.33) mm(1～13 mm).常规穿刺组肺活检平均定位时间(15.10±2.40) min(11～19 min);穿刺针平均调整次数(4.05±1.32)次(3～7次);平均扫描次数为(6.05±1.32)次(5～9次),剂量长度乘积(DLP)均值为(1419.10±387.59) mGy·cm (900.50～1 958.90 mGy·cm).40例患者均无严重并发症发生.两组患者平均定位时间、平均穿刺针调整次数、平均扫描次数、剂量长度乘积均值对比差异均有统计学意义.结论 电磁导航系统辅助下CT引导肺穿刺活检术可缩短定位时间,减少调针次数、扫描次数,同时可减少患者接受的辐射剂量,是一种值得推广的影像引导新方法.     

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。