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Clinical application of CT-guided percutaneous biopsy for bone lesions

Xiao ZHANG ; Ruirong ZHAO ; Yueyong XIAO ; Bin WU ; Shirong LIU ; Xuyang MA

Chinese Journal of Interventional Imaging and Therapy.2010;7(2):97-100.

Objective To investigate the clinical value of CT-guided percutaneous bone biopsy in skeletal lesions.Methods Totally 857 patients with skeletal lesions who underwent CT-guided percutaneous bone biopsy were analyzed retrospectively.The position and path of puncture were selected according to the adjacent and safety principle after CT localization.Lesions were penetrated with 8-13G bone puncture needles or 16-18G trigger-type biopsy needles for obtaining specimens.Results The whole procedures were generally finished within 20-40 min,and adequate samples were obtained for pathologic examinations in all patients.The pathological findings of biopsy for 766 patients were consistent with that of surgeries (89.38%) .No false positive patient was found.Postoperative complications occurred in 27 patients (3.15%) ,including local hematomas in 22 patients,nerve injury in 1 patient and infection in 4 patients.Conclusion CT-guided percutaneous bone biopsy is safe and with high diagnostic accuracy.It can be used to diagnose metastases,primary bone tumors,tumor-like lesions and inflammatory lesions.The reasonable selection of the path of puncture,puncture needles and biopsy methods can improve the success rate of biopsy.

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Comparison of single-arterial phase enhancement CT and dual-arterial phase of enhancement MR for the detection of hepatocellular carcinoma

Gusheng XING ; Shuang WANG ; Han OUYANG ; Xiaohong MA ; Chunwu ZHOU

Chinese Journal of Interventional Imaging and Therapy.2010;7(1):1-4.

Objective To evaluate the detectability of dual-arterial phase of MRI and single-artery phase of CT scan for hepatocellular carcinoma (HCC). Methods A total of 39 patients with HCC underwent CT and MR scan, and 59 lesions of HCC were confirmed definitely. According to lesion size, the lesions were divided into 3 groups: >3 cm group (n=20), 1-3 cm group (n=27) and <1 cm group (n=12). CT was performed with 25 seconds delaying for artery phase. MR imaging was performed with liver accelerate volume acquisition (LAVA) technique, dual-artery phases included early artery phase of 17 seconds delaying and a mid-artery phase of 24 seconds delaying. The detectability of dual-artery phase of MR was compared with that of single-artery phase of CT. Results In <1 cm group, the sensitivity of CT single-artery phase images and MR dual-artery phase images in detecting HCC lesions was 50.00% (6/12) and 75.00% (9/12), respectively;the later showed a higher sensitivity (P=0.04). In groups of 1-3 cm and ＞3 cm, the sensitivity of the two technique had no statistical difference (66.67% vs 81.48% and 95.00% vs 95.00%). Conclusion For the detection of <1 cm HCC, dual-artery phase MRI has higher detectability than single artery phase enhancement CT.

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Application of spiral CT in therapy observation during and after radiofrequency ablation for lung and liver tumors

Jiansheng LI ; Rijie TANG ; Guohui LING ; Bingui LU ; Peiyu YANG

Chinese Journal of Interventional Imaging and Therapy.2009;6(4):338-340.

Objective To investigate the value of spiral CT in therapy observation during and after radiofrequency ablation (RFA) for lung or liver tumors. Methods Spiral CT-guided RFA were performed in 35 patients (38 lesions) with lung or liver tumors. CT value of lesions during operation and the changes of lesions after operation were observed. Results Thirty-eight lesions were accurately located under spiral CT. The position of the electrode and the expension of claw-like thin needle electrode could be observed directly. CT value of lesions decreased and some gasification foci in some lesions were observed after RAF therapy. One month after RFA, tumor volume decreased, and the tumors present as slightly low-density mass on contrast-enhanced CT. The total effective rate of RFA was 85.71% (30/35). Conclusion Spiral CT is able to accurately guide RFA treatment for lung or liver tumors and evaluate the efficacy of therapy.

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Multi-slice spiral CT diagnosis of complex congenital heart diseases

Yan BAI ; Zhengguang CHEN ; Rongfeng WANG ; Ping LU

Chinese Journal of Interventional Imaging and Therapy.2009;6(6):509-512.

Objective To investigate scanning and reconstruction techniques of multi-slice spiral CT (MSCT) in patients with complex congenital heart diseases (CCHD).Methods One hundred eighty-four patients suffering from CCHD underwent 16-detector MSCT scanning without ECG-gating.Multi-planar reconstruction (MPR),maximum intensity projection (MIP),curved-planar reconstruction (CPR) and volume rendering (VR) were used to reconstruct images.CT findings were compared with those of surgical operation or angiocardiography.Results A total of 616 cardiac deformities were found with MSCT and proved by angiocardiograms or surgical operation.The diagnostic accuracy of extracardiac malformation with MSCT was 100%,of atrial septal defect was 54.65%,and of ventricular septal defect was 78.62%.MSCT failed to display heart valve disease well.Conclusion MSCT can accurately detect extracardiac malformations of CCHD.

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Real time contrast-enhanced ultrasound in diagnosis of liver localized fatty deletion and fatty infiltration

Yuan LIANG ; Jun GUO ; Jianying YAN

Chinese Journal of Interventional Imaging and Therapy.2009;6(4):314-316.

Objective To explore the clinical value of real time contrast-enhanced ultrasound in diagnosis of liver localized fatty deletion and fatty infiltration which couldn't be confirmed by conventional ultrasonography. Methods Contrast-enhanced ultrasound was performed on 94 patients with liver localized diseases confirmed by baseline sonography, among them 34 patients with liver localized fatty deletion and fatty infiltration were enrolled. Results Contrast-enhanced ultrasonography didn't show apparent occupancy nidus in 34 patients. Enhancement mode of lesions was the same as liver parenchyma, which was distinctly different from liver occupancy diseases. Conclusion Real time contrast-enhanced ultrasound can display typical signs of liver localized fatty deletion and fatty infiltration and has significant value in diagnosis and differentiating diagnosis of them.

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Value of vascular enhancement technology in diagnosis of fetal pulmonary sequestration

Xinlin CHEN ; Lei ZHANG ; Xufeng WU ; Yangqing XU

Chinese Journal of Interventional Imaging and Therapy.2009;6(6):545-547.

Objective To assess the clinical value of vascular enhancement technology (VET) in diagnosis of fetal pulmonary sequestration (PS).Methods Color Doppler velocity (CDV),color Doppler energy (CDE) and VET were performed in 11 fetus with PS to display the vessels in region of interest.Results The abnormal vessels in region of interest were displayed in distinct degree with CDV,CDE and VET.The courser and disposition of the great vessels were displayed with CDV and CDE,while lumen of blood vessel was clearly discriminated with VET,while CDV depicted the direction of blood flow.Satisfaction assessment of the VET image was superior than those of CDV and CDE image (P<0.05).No difference was found between the satisfaction assessment of the CDV and CDE images (P>0.05).Conclusion VET can improve the contrast resolution,having superiority in displaying vessels and fine branches,therefore has clinical value in the diagnosis of fetal PS.

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MRI diagnosis of chronic injury of the elbow in athletes:Optimization of imaging sequences

Haibin LIU ; Wei ZHANG

Chinese Journal of Interventional Imaging and Therapy.2011;08(5):428-430.

ObjectiveTo explore the value of MRI in diagnosis of chronic injury of the elbow in young athletes,and to discuss the optimization of imaging sequences.MethodsA total of 34 athletes (40 elbows) aged 6-16 years underwent MR examination on axial,sagittal and coronal planes.The characteristics of MRI were analyzed.ResultsThe anatomy of parenchyma and bones in elbow joint were displayed clearly by using axial TIW,sag T1W,T2W,sag STIR and PDW sequences.The thickening of periosteum and arthroedema were displayed well with sagittal T2W and STIR sequence,while bone marrow,ligament injury and synovitis were displayed well with PDW sequence.ConclusionMRI can display clearly the injury of bones and muscles in young athletes with chronic injury of the elbow.Optimization of imaging sequences is of importance in the depicting and diagnosis of chronic injury of bone and muscles.

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Management of complications in endovascular treatment for arteriosclerotic occlusive disease of lower extremities

Zhonghua WANG ; Lei TIAN ; Xuedong CHEN ; Baixi ZHUANG ; Xiaodong YANG ; Shihua WANG ; Futing JIANG ; Yuhong WANG

Chinese Journal of Interventional Imaging and Therapy.2011;08(5):363-366.

ObjectiveTo discuss the prevention and treatment of the perioperative complications in endovascular treatment for arteriosclerosis obliterans (ASO) of lower extremities.MethodsEndovascular treatment was performed for 210 patients (248 limbs) with ASO of lower extremities,including 28 iliac lesions,76 femoral-popliteal lesions,56 inferior genicular lesions and 88 multiple segment lesions.The clinical data and complications were reviewed and analyzed.Results The technical success was achieved in 92.74％ (230/248).Perioperative complications occurred in 21 patients (21/210,10.00 ％),including hematoma (n= 6),pseudoaneurysm (n= 1),heart failure (n= 2),constrast-induced nephropathy (n = 1),artery perforation (n= 3),artery section (n = 3) and restenosis (n= 5).All the complications were relieved after corresponding treatment.ConclusionEndovascular treatment is a safe and effective method for ASO of lower extremities because of its high success rate and few complications.Effective control of systemic diseases,careful operation and regular treatment after operation are all the effective measures to prevent and reduce the occurrenceof complications.

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Research progress of evaluation on abdominal aortic aneurysm rupture risk with morphological and biomechanical characteristics

Nan ZHANG ; Zhanming FAN

Chinese Journal of Interventional Imaging and Therapy.2011;08(5):443-446.

Abdominal aortic aneurysm (AAA) is a common fatal aortic disease.The rupture of AAA is the procession affected by multiple factors.Besides physiological,pathological and biochemical changes,morphological and biomechanical alteration can also influence this procession.The progress of rupture risk evaluation through morphological and biomechanical characteristics of AAA were reviewed in this article.

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Efficiency analysis of transcatheter arterial chemoembolization combined with CT-guided percutaneous acetic acid injection for huge hepatocellular carcinoma

Cangzheng JIN ; Mingxin ZHU ; Yushu HUANG ; Yinghe ZHANG ; Wenzhao LIANG ; Chunfang LI

Chinese Journal of Interventional Imaging and Therapy.2010;7(1):47-49.

Objective To explore the clinical application value of transcatheter arterial chemoembolization (TACE) combined with CT-guided percutaneous acetic acid injection (PAI) in treatment of huge hepatocellular carcinoma (HCC). Methods Forty-three patients with huge HCC were randomly divided into two group. Twenty-one patients in group A underwent routine one course for TACE (three times), and the interval of TACEs was one month. Twenty-two patients in group B underwent TACE combined with PAI, and CT-guided PAI was performed once a week since 2-3 weeks after first TACE, and one course included 6-9 times of PAI. Postoperative follow-up was conducted (including AFP, the size of tumor, etc.). One course of treatment was repeated in case of tumor recurred. Results At the 1st month after treatment, no statistical difference was found of AFP positive rate between two groups. Statistical difference of total effective rate was found between two groups (38.10% vs 77.27%). The 1-, 2- and 3-year survival rate In group A was 47.62%, 23.81% and 9.52%, respectively, while in group B was 81.82%, 54.55% and 36.36%, respectively, and significant differences were found between the two groups for the same period. Conclusion TACE combined with PAI is safe and more effective than TACE alone in the treatment of huge HCC.

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