Background Computed tomography （CT）-guided transthoracic lung biopsy is a well-established technique for the diagnosis of pulmonary lesions. The objective of this study was to evaluate the diagnostic efficiency and ...Background Computed tomography （CT）-guided transthoracic lung biopsy is a well-established technique for the diagnosis of pulmonary lesions. The objective of this study was to evaluate the diagnostic efficiency and complication rate of CT-guided lung biopsy in a Chinese population. Methods CT-guided cutting needle lung biopsies were performed in our institution on 1014 patients between January 2000 and October 2010. A chest radiograph was taken after the biopsy. Data about basic patient information, final diagnosis, and complications secondary to biopsy procedure （pneumothorax and bleeding） were extracted. Results The diagnostic efficiency of CT-guided lung biopsy was 94.8%; only 53 patients did not get a final diagnosis from lung biopsy. Final diagnoses found 639 malignant lesions （63.0%） and 322 benign lesions （31.8%）. Pneumothorax occurred in 131 patients and 15 required insertion of an intercostal drain. Small hemoptysis occurred in 41 patients and mild parenchymal hemorrhage occurred in 16 patients. The overall complication rate was 18.5%. Conclusions CT-guided cutting needle biopsy of pulmonary lesions is a relatively safe technique with a high diagnostic accuracy. It can be safely performed in clinical trials.展开更多
AIM： To determine the feasibility of performing computed tomography （CT）-guided transpulmonary radiofrequency ablation （RFA） for hepatocellular carcinoma （HCC） located in the hepatic dome. METHODS： A total of ...AIM： To determine the feasibility of performing computed tomography （CT）-guided transpulmonary radiofrequency ablation （RFA） for hepatocellular carcinoma （HCC） located in the hepatic dome. METHODS： A total of seven patients with HCC comprising seven nodules located in the hepatic dome were treated from April 2004 to December 2004. CTguided transpulmonary RFA was performed using a cool-tip type electrode （Radionics Company） based on a standardized energy protocol. All tumors located in the hepatic dome were not detectable by the usual ultrasound （US） methods. The lesion diameters ranged from 15 to 27 mm. RESULTS： RFA was technically feasible in all the patients. The puncture procedure was performed twice or less and the total average performance time was 40.6 min. Local tumor control was achieved in all the patients. The necrosis diameter ranged from 25 to 35 mm. The mean follow-up period was 9.6 （7-14 mo） mo. There was no local recurrenceat the follow-up points. Pneumothorax requiring pleural drainage was the main complication, which was observed in two of the seven patients （28.6%）. However, it improved with chest drainage tube, and the tube could be removed within 2-3 d. No other major complications were observed.CONCLUSION： CT-guided puncture is useful for the treatment of tumors located in the hepatic dome which are hardly detectable by US, even though pneumothorax sometimes may occur as a complication. In the cases with adhesion in the pleura for which artificial pleural effusion methods are not appropriate, CT-guided RFA is thus considered to be an alternative treatment for HCC located in the hepatic dome.展开更多
文摘Background Computed tomography （CT）-guided transthoracic lung biopsy is a well-established technique for the diagnosis of pulmonary lesions. The objective of this study was to evaluate the diagnostic efficiency and complication rate of CT-guided lung biopsy in a Chinese population. Methods CT-guided cutting needle lung biopsies were performed in our institution on 1014 patients between January 2000 and October 2010. A chest radiograph was taken after the biopsy. Data about basic patient information, final diagnosis, and complications secondary to biopsy procedure （pneumothorax and bleeding） were extracted. Results The diagnostic efficiency of CT-guided lung biopsy was 94.8%; only 53 patients did not get a final diagnosis from lung biopsy. Final diagnoses found 639 malignant lesions （63.0%） and 322 benign lesions （31.8%）. Pneumothorax occurred in 131 patients and 15 required insertion of an intercostal drain. Small hemoptysis occurred in 41 patients and mild parenchymal hemorrhage occurred in 16 patients. The overall complication rate was 18.5%. Conclusions CT-guided cutting needle biopsy of pulmonary lesions is a relatively safe technique with a high diagnostic accuracy. It can be safely performed in clinical trials.
基金Supported by the grant of Center of E-xcellence,Biomedical Research Using Accelerator Technology
文摘AIM： To determine the feasibility of performing computed tomography （CT）-guided transpulmonary radiofrequency ablation （RFA） for hepatocellular carcinoma （HCC） located in the hepatic dome. METHODS： A total of seven patients with HCC comprising seven nodules located in the hepatic dome were treated from April 2004 to December 2004. CTguided transpulmonary RFA was performed using a cool-tip type electrode （Radionics Company） based on a standardized energy protocol. All tumors located in the hepatic dome were not detectable by the usual ultrasound （US） methods. The lesion diameters ranged from 15 to 27 mm. RESULTS： RFA was technically feasible in all the patients. The puncture procedure was performed twice or less and the total average performance time was 40.6 min. Local tumor control was achieved in all the patients. The necrosis diameter ranged from 25 to 35 mm. The mean follow-up period was 9.6 （7-14 mo） mo. There was no local recurrenceat the follow-up points. Pneumothorax requiring pleural drainage was the main complication, which was observed in two of the seven patients （28.6%）. However, it improved with chest drainage tube, and the tube could be removed within 2-3 d. No other major complications were observed.CONCLUSION： CT-guided puncture is useful for the treatment of tumors located in the hepatic dome which are hardly detectable by US, even though pneumothorax sometimes may occur as a complication. In the cases with adhesion in the pleura for which artificial pleural effusion methods are not appropriate, CT-guided RFA is thus considered to be an alternative treatment for HCC located in the hepatic dome.
