Image-guided minimally invasive treatments play an increasingly important role in clinical works.With the progressing of science and technology,image-guided robot technology are mature gradually.It can accomplish parts of clinical minimally invasive treatments,and make up for the deficiencies in the process of surgery.Present situation and application in minimally invasive treatments of image-guided robot system were reviewed in this article.

Objective To explore the application value of coaxial semi automatic biopsy gun in the biopsy of small pulnonary nodules.Methods A retrospective analysis was performed on 40 patients with small pulmonary nodules who underwent CT guided percutaneous pulmonary nodules biopsy.Taking postoperative pathology diagnosis or imaging follow-up results as gold standard,the accuracy,specificity,sensitivity,intraoperative complications and puncture techniques of biopsy were analyzed.Results All operations were successfully completed.There were 29 malignant lesions and 11 benign lesions confirmed by postoperative pathology diagnosis or imaging follow-up results.The sensitivity,specificity,accuracy rate of puncture biopsy in diagnosis of malignant small pulmonary nodules was 89.65％ (26/29),100％ (11/11),92.50％ (37/40).The main complications were pneumothorax and local hemorrhage.Conclusion Percutaneous biopsy of small pulmonary nodules using coaxial semi-automatic biopsy gun has high accuracy,specificity and sensitivity,is a safe and effective method.

Objective To explore the efficacy of percutaneous nucleus pulposus atherectomy combined with ozone injection in treatment of lumbar disc herniation.Methods A total of 60 patients with lumbar disc herniation were randomly divided into 3 groups:20 patients were treated by ozone injection (group A),20 patients were treated by percutaneous atherectomy (group B),20 patients were treated by percutaneous atherectomy combined with ozone injection (group C).The changes of visual analogue scale (VAS) and clinical effects in three groups pre-and 1 week,1 month and 3 month postoperation were compared.Intraoperative and postoperative complications were analyzed.Results The VAS of postoperation in three groups were significantly lower than those of preoperation (all P＜0.017).The short term and long term VAS of group C were lower than those of group A and group B (all P＜0.017).But there was no statistically significant difference among three groups of recent and long-term excellent rates (all P＞0.017).related complications were mainly waist pain,lower limb soreness and pain.Conclusion Percutaneous nucleus pulposus atherectomy combined with ozone injection is a safe and effective method,which can improve the curative effect of operation.

Objective To explore the methods of the hemorrhage prevention and the measures of hemostasis by CT guided after renal cancer cryoablation.Methods Retrospective analysis of 8 patients of renal cell carcinoma patienthave been done,all the patients were underwent cryoablation.The basic model included 10 min frozen,3 min thawed and 1 cycle were repeated.Before the cryoprobe puncture,a CT scan was taken to observe the blood supply of the tumor and the relationship between the border of the tumor and renal cortex,renal pelvis.Besides,the path of reducing the injury of normal renal cortex and renal pelvis was chosen,and the decreased number of probes was adopted by taking conformal cryoablation to reduce the damage to the renal capsule,in theensurance of the treatment efficacy.Intraoperative CT scan was performed discontinuously,to observe the covering status of the range of ice ball on the lesion and to monitor the perirenal bleeding.Postoperative ECG and blood pressure changes was observed 24 h after operation.Besides,CT scan or blood routine examination is necessary to monitor whether active bleeding happened.Results According enhanced CT image positioning puncture path,the path of probes were selected in the shortest path between the tumor margins and the renal cortical which avoid the renal pelvis.Probes were CT-guided conformal puncture into the lesion successfully for 8 patients,according to freezing basic mode to complete cryoablation.Timely intraoperative CT scan can clearly observe that a low-density ice ball wrapped lesion completely without involving the renal pelvis and normal tissue surrounding the kidney.There was no bleeding in the procedure of cryoablation.After the probe was pulled,CT scan showed:3 of the 8 patients didn't show any sign of henorrhage,in which 1 patient had heavily bleeding,about 150 ml due to the biopsy after cryoablation.The bleeding was stopped by interventional embolization.A little hemorrhage was found in two patients,about 10 ml outside renal capsule.Medium hemorrhage took place in two patients,30 nl in one patient which underwent several cycles of thawing and 60 ml in another.The patients of mild and medium hemorrhage was treated with intravenous injection of Reptilase and strict bed rest.There was a great hemorrhage in one patient,about 200 ml.The bleeding was stopped by interventional embolization.A small and moderate bleeding,it necessary to execute intravenous infusion 2 IU reptilase and strict bed rest.There was no significant active bleeding from the CT scan after 24 h operation and no change in the blood routine examination of blood hemoglobin and red blood cell count.Conclusions Before the puncture,it is necessary to perform an enhanced CT scan to understand the position,which can determine the path of the puncture.It can reduce the damage of renal cortex,renal capsule and surrounding tissue and prevent and reduce the risk of bleeding.For larger amounts of intraoperative and postoperative bleeding subjects,the embolization should be given immediately,as for the small or moderate amount of bleeding,the conservative treatment may be given firstly.

Purpose To investigate the diagnostic value of high-resolution CT reconstruction techniques on the same slice in hypertrophy of transverse process of the fifth lumbar vertebra (HTPL5V), and to provide a basis for clinical diagnosis and treatment. Materials and Methods Twenty-two cases of clinically diagnosed HTPL5V and 20 normal adults were examined with GE LightSpeed 16-slice spiral CT (36 cases) and Philips iCT 256-slice (6 cases). L5 transverse process and the fifth lumber nerve were reconstructed and observed on the workstations. Results In 22 cases of HTPL5V, there were 26 pseudarthrosis formation and 2 sides with L5 transverse process touching the sacral ala. In 28 sides the iffth lumber nerve traveled through false foramina of the HTPL5V including 6 cases of bilateral compression and 16 cases of unilateral compression. In 21 cases, the nerve was compressed by hyperosteogeny on 27 sides (96.4%) and 1 side due to stenosis (3.6%). On 25 sides (89.3%) the compressed nerves were curved in shaper. There was bulging and/or herniated lumbar disc on 9 sides in 7 cases (32.1%). Conclusion High-resolution CT reconstruction techniques can demonstrate the iffth lumbar nerve of HTPL5V and provide evidence for clinical diagnosis and treatment.

Objective To explore the CT and MR features of cystic nephroma. Methods CT and MRI findings of 8 patients with cystic nephroma comfirmed surgically and pathologically were analyzed retrospectively. Results In all 8 patients, cystic nephromas were unilateral and solitary, and diameter of lesions was 2.92-7.81 cm. The CT and MR scans showed multilocular cystic lesion with clear border. These locules did not communicate with each other. The septa were intact and smooth, and showed slight to moderate and gradual enhancement. The interlocular septa were demonstrated clearly on coronal T2WI, and showed hypointensity signals. The intracapsular liquids were heterogenous in 4 patients on MR images. The CT scanning showed a patchy calcification in 1 case. Histopathology proved that the capsule and septa of the lesions were lined by cuboidal or flattened epitheial cells, of which hemosiderin depositions were presented in 4 patients. Conclusion CT and MR are valuable in the diagnosis of cystic nephroma, and MRI can reflect the pathology of cystic nephroma more clearly, and supply the accurate reference information for diagnosis.

BACKGROUND: Differences of thick and thin tissues in imaging areas is great because of postero-anterior images in cervical spine-thoracic spine.Although there are many image processing functions in direct digital radiography(DR)image with big range dynamic exposing,but routine direct DR hardly reveals anatomic structure of cervical spine-thoracic spine to detect diseases.Image quality of cervical spine-thoracic spine requires improvement.OBJECTIVE: To evaluate the difference between direct DR image with tissue equalization(TE)technique and standard DR in cervical spine-thoracic spine,so as to explore the best image quality in cervical spine-thoracic spine.METHODS: A total of 200 cases were randomly selected from DR cervical thoracic image from Department of Radiology,General Hospital of Chinese PLA between April 2005 and August 2009 to evaluate the difference between these images of DR processed by tissue equalization and that of standard DR.RESULTS AND CONCLUSION: The detail images of DR with tissue equalization in different thickness area of body could be revealed clearly in the same image,while the detail images of standard DR in cervical thoracic could be revealed clearly by adjusting window width and location repeatedly.Results show that the image quality of TE technique of direct digital X-ray radiography in cervical spine-thoracic spine could be clearly improved,it could be easily read and avoid the influence of body thickness area.Moreover,it could reveal clearly other part of body in detail.DR image with TE technique in cervical spine-thoracic spine can be applied widely due to simple operation,high diagnosis rate and low cost.

Objective To evaluate the effectiveness of transcatheter arterial chemoembolization(TACE) combined with radiofrequency ablation(RFA) and TACE combined with 125I interstitial brachytherapy in the treatment of primary hepatocellular carcinoma(HCC) and to compare the results of the two therapies.Methods Fifty patients with HCC underwent TACE and RFA during laparotomy and 34 patients received TACE and radioactive 125I particle seeding.Four weeks after the procedure,dynamic enhanced CT or MR scanning was performed for a check.If the lipiodol deposit was poor,TACE was repeated.Follow-up check was made at regular intervals to observe the results.Results One month after the treatment,the local control rate of the tumor for TACE +RFA and TACE + 125I particle seeding combination therapy was 98.0% and 97.1%,respectively.No statistically significant difference existed between the two therapies.Conclusions Both TACE combined with RFA or with 125I particle seeding are effective therapies for HCC,which can be regarded as an ideal alternative therapy for patients who have failed to respond to TACE alone.

Objective To investigate the preparation of a biodegradable intravascular stent (BIS) with poly-l-lactic acid (PLLA), and to evaluate its physical and mechanical properties, as well as its biocompatibility. Methods The study of this BIS was first prepared by PLLA with molecular weight of 100 000 unit as the strut, and then the micro-porous structure was fabricated and the film was coated at the struts. Following the solidified shaping of BIS, the primary physical and mechanical properties of the BIS were tested, and 22 zigzag type BISs were implanted into the aorta and iliac arteries of 11 canines, then they were euthanized according to a fixed timetable for histopathological assessment. Results Two types of BIS (spiral and zigzag) were prepared, and the strut diameter of the BIS was 0.1-0.6 mm, stent diameter of BIS was 6-15 mm, and stent length was 30-80 mm. Of this BIS, the radial strength was 1.6-2.0 kPa (1 kPa=7.5 mm Hg), the dilatable rate was 6.0-6.5, the shortening rate was smaller than 8%-10%, and the proportion of stent surface area to open surface area was 0.16-0.18 (

Objective To define the effect of drug eluting BIS with antiproliferation agent-paclitaxel in preventing vascular restenosis.Methods Bare BIS and drug BIS with 60 ?g paclitaxel were prepared. Both types of the BIS were implanted into the infrarenal restenosis aortas in canine models, and the animals were euthanized 6 weeks after implantation for histopathological, morphometric and immunohistochemical assessment.Results The mean lumen area of bare BIS group was (77 586.5?66.0) ?m2, and lumen of paclitaxel eluting BIS group was (113 435.9?71.0) ?m2. The mean neointima area of bare BIS group was (24 803?56) ?m2, and paclitaxel eluting BIS group was (12 931?63) ?m2. The PCNA-positive ratio was (38?15)% in bare BIS group and (11?0.31)% in paclitaxel eluting BIS group. The statistically significant difference between the two groups were noted ( P