WorldWideScience

Sample records for ct-guided percutaneous catheter

  1. Therapeutic impact of CT-guided percutaneous catheter drainage in treatment of deep tissue abscesses

    International Nuclear Information System (INIS)

    Asai, Nobuhiro; Ohkuni, Yoshihiro; Kaneko, Norihiro; Aoshima, Masahiro; Yamazaki, Ikuo; Kawamura, Yasutaka

    2013-01-01

    Combination therapy of CT-guided percutaneous drainage and antibiotics is the first-line treatment for abscesses. Its effectiveness has been demonstrated. However, the therapeutic impact of this procedure for infection treatment has never been reported. We retrospectively analyzed all 47 patients who received CT-guided percutaneous drainage for infection treatment. Patients' characteristics, pathogens isolated, antibiotics administered, technical and clinical outcomes, complications related to this procedure and therapeutic impacts were investigated. Patients were 26 males and 21 females. The mean age was 63.5 years (±18.7). The diseases targeted were 19 retroperitoneal abscesses, 18 intraabdominal abscesses, three pelvic abscesses, and seven others. As for technical outcomes, all of the 54 procedures (100%) were successful. As for clinical outcomes, 44 (93.6%) were cured and three patients (6.4%) died. No complications related to this procedure were found in this study. A total of 42 patients (88%) had a change in the management of their infection as a result of CT-guided percutaneous drainage, such as selection and discontinuation of antibiotics. In conclusion, CT-guided percutaneous drainage is a safe and favorable procedure in the treatment of deep tissue abscesses. Therapeutic impact of these procedures helped physicians make a rational decision for antibiotics selection. (author)

  2. Therapeutic impact of CT-guided percutaneous catheter drainage in treatment of deep tissue abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Asai, Nobuhiro; Ohkuni, Yoshihiro; Kaneko, Norihiro; Aoshima, Masahiro; Yamazaki, Ikuo; Kawamura, Yasutaka, E-mail: nobuhiro0204@hotmail.com [Kameda Medical Center, Chiba (Japan)

    2013-03-15

    Combination therapy of CT-guided percutaneous drainage and antibiotics is the first-line treatment for abscesses. Its effectiveness has been demonstrated. However, the therapeutic impact of this procedure for infection treatment has never been reported. We retrospectively analyzed all 47 patients who received CT-guided percutaneous drainage for infection treatment. Patients' characteristics, pathogens isolated, antibiotics administered, technical and clinical outcomes, complications related to this procedure and therapeutic impacts were investigated. Patients were 26 males and 21 females. The mean age was 63.5 years ({+-}18.7). The diseases targeted were 19 retroperitoneal abscesses, 18 intraabdominal abscesses, three pelvic abscesses, and seven others. As for technical outcomes, all of the 54 procedures (100%) were successful. As for clinical outcomes, 44 (93.6%) were cured and three patients (6.4%) died. No complications related to this procedure were found in this study. A total of 42 patients (88%) had a change in the management of their infection as a result of CT-guided percutaneous drainage, such as selection and discontinuation of antibiotics. In conclusion, CT-guided percutaneous drainage is a safe and favorable procedure in the treatment of deep tissue abscesses. Therapeutic impact of these procedures helped physicians make a rational decision for antibiotics selection. (author)

  3. CT-guided percutaneous treatment of solitary pyogenic splenic abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Pombo, F. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Suarez, I. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Marini, M. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Arrojo, L. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Echaniz, A. [Dept. of Internal Medicine, Hospital Juan Canalejo, La Coruna (Spain)

    1991-08-01

    Six patients with solitary pyogenic splenic abscesses treated by CT-guided percutaneous drainage (by catheter or needle), are presented. There were 3 unilocular, purely intrasplenic abscesses and 3 complex lesions with loculations and perisplenic involvement. Percutaneous drainage and intravenous antibiotics were curative in 4 patients. In the other 2, who had multiloculated abscesses, despite initially successful drainage, splenectomy was performed because of intractable left upper quadrant pain in one case and persistent fever and drainage of pus after 30 days in the other. These patients also developed large, sterile left pleural effusions. Solitary pyogenic splenic abscesses - particularly if uniloculated - can be effectively treated by CT-guided percutaneous drainage. (orig.)

  4. CT guided transthoracic catheter drainage of intrapulmonary abscess.

    Science.gov (United States)

    Yunus, Mahira

    2009-10-01

    To determine the efficacy of CT- guided transthoracic catheter drainage of intrapulmonary abscess considering success rate versus complications. This prospective study was carried out at radiology department of Al-Noor Specialist Hospital, Makkah, Saudi Arabia, from 1.1.2003 to 31.12.2005. Nineteen patients were selected for CT guided percutaneous drainage. Under CT guidance catheter placement was carried out using Seldinger technique. Nineteen patients with lung abscess were selected for the percutaneous CT guided drainage. Eight (42.105%) patients encountered no complications and lung abscess completely resolved with no residual cavity. Five (26.31%) patients developed pneumothorax, which was the most common complication of this study. These patients were kept under observation and followed-up by chest X-rays. Three (15.78%) had mild pneumothorax, which resolved and needed no further management, while two (10.52%) patients developed moderate pneumothorax and chest tube was inserted. Two (10.52%) patients developed mild haemoptysis which resolved within two hours, hence, no further management was required. Two (10.52%) patients had residual cavity and surgery was performed. Congenital cystic adenomatoid malformation (CCAM) was found in both cases. Two patients out of nineteen patients (10.52%) developed bronchopleural fistula and were operated. No mortality occurred during or after the procedure. CT allows optimal placement of catheter and hence enables safe and effective percutaneous evacuation of lung abscess. The morbidity and mortality of patients with percutaneous catheter drainage is lower than with surgical resection. Hence, CT guided drainage should be considered the first therapeutic choice in most patients of lung abscess who do not respond to medical therapy.

  5. CT guided percutaneous needle biopsy of the chest: initial experience

    African Journals Online (AJOL)

    The objective of this article is to report our first experience of CT guided percutaneous thoracic biopsy and to demonstrate the accuracy and safety of this procedure. This was a retrospective study of 28 CT-Guided Percutaneous Needle Biopsies of the Chest performed on 24 patients between November 2014 and April 2015.

  6. CT guided percutaneous renal cysts puncture with ethanol therapy

    International Nuclear Information System (INIS)

    Zhang Xuezhe; Lu Yan; Wang Wu; Huang Zhengguo; Ren An

    2002-01-01

    Objective: To analyse our clinical experience with CT guided percutaneous renal cysts puncture and ethanol therapy. Methods: Five hundred and ten renal cysts in 445 patients were undergone CT guided percutaneous renal cysts puncture and ethanol therapy. Among the 445 cases, 385 cases had solitary renal cyst, 53 multiple renal cysts, and 7 polycystic kidneys. The renal cysts varied in size from 1.9 to 13.5 cm in diameter. The amount of aspirated fluid varied from 3 to 780 ml. A 18-21 gauge aspiration needles were used for all patients. A 25.0% cyst volume replacement with 99.7% ethanol was approved to be appropriate. Results: 427 renal cysts in 396 patients were followed up by computed tomographic (CT) or ultrasound for less than 3 months to more than one year duration. The curative effective rate and disappearance rate of the renal cystic cavity in solitary renal cysts were 97% and 82%, respectively. In multiple renal cysts, the corresponding values were 95% and 79%. In polycystic kidneys, the curative rate was 67%. The complications such as local abdominal pain (28 cases) and hematuria (four cases) were observed in this series. There were no fatal complications. Conclusions: CT guided percutaneous renal cyst puncture and ethanol therapy is an useful procedure for the treatment of solitary renal cysts and multiple renal cysts

  7. Bilateral CT-guided percutaneous cordotomy for cancer pain relief

    International Nuclear Information System (INIS)

    Yegul, I.; Erhan, E.

    2003-01-01

    AIM: CT-guided percutaneous cordotomy is a useful procedure for treating unilateral cancer pain, however, bilateral cordotomy can be required on some occasions. We evaluated the effectiveness and complications of bilateral cordotomy. MATERIALS AND METHODS: Two hundred and thirty-four patients who suffered from unilateral cancer pain underwent CT-guided percutaneous cordotomy. The procedure was repeated in 22 patients, and nine patients had bilateral cordotomy. Effectiveness and complications were recorded after each procedure. RESULTS: Of nine patents (three women and six men) having bilateral percutaneous cordotomy in our study, four patients had mirror pain after the first procedure. In the remaining five patients the contralateral pain was due to new pain sites. The pain scores before and after the first procedure were 9.3 (range 7-10) and 1.2 (range 0-3), respectively. After the first procedure complete or satisfactory pain relief was achieved in all patients. The duration between the two procedures ranged from 7-243 days (mean 59.8 days). The pain scores before and after the second procedure were 8.4 (range 5-10) and 1.6 (range 0-4), respectively. After the second procedure complete or satisfactory pain relief was reported in all patients. There were no complications in four patients. One patient developed transient motor deficit after the first procedure. Other complications (nausea/vomiting, headache, ipsilateral neck pain, postcordotomy dysesthesia) were mild and transient. CONCLUSION: CT-guided percutaneous cordotomy is a useful procedure for the treatment of severe unilateral cancer pain syndromes. The procedure can be repeated on the other side at least 1 week later. These results show that the success on the second side appears to be similar to the first side with low complication rate for both procedures

  8. Bilateral CT-guided percutaneous cordotomy for cancer pain relief

    Energy Technology Data Exchange (ETDEWEB)

    Yegul, I. E-mail: iyegul@med.ege.edu.tr; Erhan, E. E-mail: elvanerhan@yahoo.com

    2003-11-01

    AIM: CT-guided percutaneous cordotomy is a useful procedure for treating unilateral cancer pain, however, bilateral cordotomy can be required on some occasions. We evaluated the effectiveness and complications of bilateral cordotomy. MATERIALS AND METHODS: Two hundred and thirty-four patients who suffered from unilateral cancer pain underwent CT-guided percutaneous cordotomy. The procedure was repeated in 22 patients, and nine patients had bilateral cordotomy. Effectiveness and complications were recorded after each procedure. RESULTS: Of nine patents (three women and six men) having bilateral percutaneous cordotomy in our study, four patients had mirror pain after the first procedure. In the remaining five patients the contralateral pain was due to new pain sites. The pain scores before and after the first procedure were 9.3 (range 7-10) and 1.2 (range 0-3), respectively. After the first procedure complete or satisfactory pain relief was achieved in all patients. The duration between the two procedures ranged from 7-243 days (mean 59.8 days). The pain scores before and after the second procedure were 8.4 (range 5-10) and 1.6 (range 0-4), respectively. After the second procedure complete or satisfactory pain relief was reported in all patients. There were no complications in four patients. One patient developed transient motor deficit after the first procedure. Other complications (nausea/vomiting, headache, ipsilateral neck pain, postcordotomy dysesthesia) were mild and transient. CONCLUSION: CT-guided percutaneous cordotomy is a useful procedure for the treatment of severe unilateral cancer pain syndromes. The procedure can be repeated on the other side at least 1 week later. These results show that the success on the second side appears to be similar to the first side with low complication rate for both procedures.

  9. CT-guided percutaneous radiofrequency denervation of the sacroiliac joint

    Energy Technology Data Exchange (ETDEWEB)

    Gevargez, A.; Schirp, S.; Braun, M. [Department of Radiology and Microtherapy, University of Witten/Herdecke, Bochum (Germany); Groenemeyer, D. [Department of Radiology and Microtherapy, University of Witten/Herdecke, Bochum (Germany); EFMT Development and Research Center for Microtherapy, Bochum (Germany)

    2002-06-01

    Defining the origin of low back pain is a challenging task. Among a variety of factors the sacroiliac joint (SIJ) is a possible pain generator, although precise diagnosis is difficult. Joint blocks may reduce pain, but are, in cases, of only temporary effect. This study was conducted to evaluate CT-guided percutaneous radiofrequency denervation of the sacroiliac joint in patients with low back pain. The procedure was performed on 38 patients who only temporarily responded to CT-guided SIJ blocks. The denervation was carried out in the posterior interosseous sacroiliac ligaments and on the dorsal rami of the fifth spinal nerve. All interventions were carried out under CT guidance as out-patient therapies. Three months after the therapy, 13 patients (34.2%) were completely free of pain. Twelve patients (31.6%) reported on a substantial pain reduction, 7 patients (18.4%) had obtained a slight and 3 patients (7.9%) no pain reduction. The data of 3 patients (7.9%) was missing. There were no intra- or postoperative complications. Computed tomography-guided percutaneous radiofrequency denervation of the sacroiliac joint appears safe and effective. The procedure may be a useful therapeutic modality, especially in patients with chronic low back pain, who only temporarily respond to therapeutic blocks. (orig.)

  10. CT-guided percutaneous radiofrequency denervation of the sacroiliac joint

    International Nuclear Information System (INIS)

    Gevargez, A.; Schirp, S.; Braun, M.; Groenemeyer, D.

    2002-01-01

    Defining the origin of low back pain is a challenging task. Among a variety of factors the sacroiliac joint (SIJ) is a possible pain generator, although precise diagnosis is difficult. Joint blocks may reduce pain, but are, in cases, of only temporary effect. This study was conducted to evaluate CT-guided percutaneous radiofrequency denervation of the sacroiliac joint in patients with low back pain. The procedure was performed on 38 patients who only temporarily responded to CT-guided SIJ blocks. The denervation was carried out in the posterior interosseous sacroiliac ligaments and on the dorsal rami of the fifth spinal nerve. All interventions were carried out under CT guidance as out-patient therapies. Three months after the therapy, 13 patients (34.2%) were completely free of pain. Twelve patients (31.6%) reported on a substantial pain reduction, 7 patients (18.4%) had obtained a slight and 3 patients (7.9%) no pain reduction. The data of 3 patients (7.9%) was missing. There were no intra- or postoperative complications. Computed tomography-guided percutaneous radiofrequency denervation of the sacroiliac joint appears safe and effective. The procedure may be a useful therapeutic modality, especially in patients with chronic low back pain, who only temporarily respond to therapeutic blocks. (orig.)

  11. CT-guided percutaneous aspiration and drainage of postoperative abdominal fluid collections

    International Nuclear Information System (INIS)

    Marano, I.; Mainenti, P.P.; Selva, G.; Cannavale, M.; Sodano, A.

    1999-01-01

    The authors report the personal techniques and the results of CT-guided percutaneous drainage of postoperative abdominal fluid collections. CT-guided percutaneous drainage offers many advantages over surgery: it is less invasive, can be repeated and requires no anesthesia, there are not surgery-related risks and lower morbidity and mortality rates. Moreover, subsequent hospitalization is shorter and costs are consequently reduced. The authors conclude that CT-guided percutaneous drainage is the method of choice in the treatment of postoperative abdominal fluid collections [it

  12. CT-guided percutaneous conformal cryoablation for lung carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yueyong, Xiao; Bin, Wu; Xiao, Zhang; Hongjun, Li; Da, Yu; Jie, Li; Jun, Li [Department of Radiology, PLA General Hospital, Beijing (China)

    2010-02-15

    Objective: To investigate the safety, efficacy and feasibility of CT-guided percutaneous conformal cryoablation for lung cancer. Methods: The inclusion criteria were: (1) Poor respiratory function and aged patients who can not bear the thoracic surgical operation. (2) Peripheral lung cancer involving the pleura and chest wall which can not be resected. (3) Residual tumor after other comprehensive treatment. (4) Focal lung cancer but the patient refused surgical resection. The exclusion criteria were: (1) Multifocal lesions. (2) Lesion close to mediastinum with possible risk of vessel injury. (3) Severe impairment of pulmonary functions, the maximum voluntary ventilation is less than 39%. (4) Repeated cough or dyspnea, can not cooperate with the procedure. (5) Poor systemic conditions, cachexia or bleeding. Totally, 76 lung carcinoma lesions on 66 patients were treated by CT-guided percutaneous conformal cryoablation using 17 G cryoprobes. The maximum diameters of the tumors ranged from 1.5 cm to 1.6 cm. For the tumors with the maximum diameter less than 3.0 cm, they were treated by double-needle clamping cryoablation. For those with the maximum diameter between 3.0 and 5.0 cm, they were treated by multiple-needle conformal cryoablation. For those with the maximum diameter larger than 5.0 cm, they were treated with multiple-needle conformal cyroablation, with the needle distance less than 1.5 cm. All the patients were followed-up 6 to 24 months after the procedure using contrast-enhanced CT to evaluate the tumor size and enhancement. Results: For 18 cases with the maximum diameters less than 3.0 cm, CT scan during the procedure showed that the frozen areas extended beyond the edge of the lesions more than 1.0 cm, the lesion attenuated, narrow-band-like encircled translucency around the lesions and 'target sign' with ground-glass density of the peripheral lung tissue. There was no enhancement during the first 1 st, 3 rd month follow-up, only fibrosis scar in 6 th

  13. CT-guided percutaneous conformal cryoablation for lung carcinoma

    International Nuclear Information System (INIS)

    Xiao Yueyong; Wu Bin; Zhang Xiao; Li Hongjun; Yu Da; Li Jie; Li Jun

    2010-01-01

    Objective: To investigate the safety, efficacy and feasibility of CT-guided percutaneous conformal cryoablation for lung cancer. Methods: The inclusion criteria were: (1) Poor respiratory function and aged patients who can not bear the thoracic surgical operation. (2) Peripheral lung cancer involving the pleura and chest wall which can not be resected. (3) Residual tumor after other comprehensive treatment. (4) Focal lung cancer but the patient refused surgical resection. The exclusion criteria were: (1) Multifocal lesions. (2) Lesion close to mediastinum with possible risk of vessel injury. (3) Severe impairment of pulmonary functions, the maximum voluntary ventilation is less than 39%. (4) Repeated cough or dyspnea, can not cooperate with the procedure. (5) Poor systemic conditions, cachexia or bleeding. Totally, 76 lung carcinoma lesions on 66 patients were treated by CT-guided percutaneous conformal cryoablation using 17 G cryoprobes. The maximum diameters of the tumors ranged from 1.5 cm to 1.6 cm. For the tumors with the maximum diameter less than 3.0 cm, they were treated by double-needle clamping cryoablation. For those with the maximum diameter between 3.0 and 5.0 cm, they were treated by multiple-needle conformal cryoablation. For those with the maximum diameter larger than 5.0 cm, they were treated with multiple-needle conformal cyroablation, with the needle distance less than 1.5 cm. All the patients were followed-up 6 to 24 months after the procedure using contrast-enhanced CT to evaluate the tumor size and enhancement. Results: For 18 cases with the maximum diameters less than 3.0 cm, CT scan during the procedure showed that the frozen areas extended beyond the edge of the lesions more than 1.0 cm, the lesion attenuated, narrow-band-like encircled translucency around the lesions and 'target sign' with ground-glass density of the peripheral lung tissue. There was no enhancement during the first 1 st, 3 rd month follow-up, only fibrosis scar in 6 th

  14. Accuracy of CT-guided percutaneous core needle biopsy for assessment of pediatric musculoskeletal lesions

    International Nuclear Information System (INIS)

    Hryhorczuk, Anastasia L.; Strouse, Peter J.; Biermann, J.S.

    2011-01-01

    CT-guided percutaneous core needle biopsy has been shown in adults to be an effective diagnostic tool for a large number of musculoskeletal malignancies. To characterize our experience with CT-guided percutaneous core needle biopsy of pediatric bone lesions and determine its utility in diagnosing pediatric osseous lesions, in a population where such lesions are commonly benign. From 2000 to 2009, 61 children underwent 63 CT-guided percutaneous biopsies. Radiological, pathological and clinical records were reviewed. Fourteen biopsies (22%) were performed on malignant lesions, while 49 biopsies (78%) were performed on benign lesions. Forty-nine of the 63 biopsies (78%) were adequate; these children underwent no further tissue sampling. Fourteen of the 63 biopsies (22%) were inadequate or non-conclusive. Of these patients, 12 underwent open biopsy. Retrospective analysis of percutaneous biopsies in these patients demonstrates that 9/12 provided clinically relevant information, and 4/12 patients received final diagnoses that confirmed initial core biopsy findings. No malignancies were diagnosed as benign on percutaneous biopsy. Overall, percutaneous core needle biopsy provided accurate diagnostic information in 84% (53/63) of biopsies. Our results demonstrate that CT-guided percutaneous biopsy is safe and beneficial in children. This study supports the use of CT-guided percutaneous core needle biopsy for primary diagnosis of pediatric bone lesions. (orig.)

  15. Percutaneous Catheter Drainage of Periappendiceal abscess due to Appendicolith : A case report

    International Nuclear Information System (INIS)

    Ryu, Dae Sik; Kim, Heung Chueol; Han, Tae Kyun; Hur, Hun; Yum, Kung Tae; Namkung, Sook; Park, Man Soo; Hwang, Woo Chueol

    1996-01-01

    Percutaneous catheter drainage of periappendiceal abscess is an effective and safe method of treatment. It is known that CT guided approach is the first choice of method. We experienced a successful percutaneous catheter drainage under ultrasound guidance for periappendiceal abscess with appendicolith

  16. Percutaneous CT-guided interventional procedures in musculoskeletal system (our experience)

    Energy Technology Data Exchange (ETDEWEB)

    Thanos, Loukas E-mail: loutharad@yahoo.com; Mylona, Sophia; Kalioras, Vasilios; Pomoni, Maria; Batakis, Nikolaos

    2004-06-01

    Percutaneous interventional procedures include a broad spectrum of minimal invasive techniques, which are a useful diagnostic and therapeutic tool. In this study we present our experience in CT-guided percutaneous musculoskeletal biopsies, drainages of musculoskeletal abscesses, facet and sacroiliac joint injection and radiofrequency thermal ablation of painful metastases or osteoid osteomas.

  17. CT-Guided Percutaneous Drainage of Infected Collections Due to Gastric Leak After Sleeve Gastrectomy for Morbid Obesity: Initial Experience

    International Nuclear Information System (INIS)

    Kelogrigoris, M.; Sotiropoulou, E.; Stathopoulos, K.; Georgiadou, V.; Philippousis, P.; Thanos, L.

    2011-01-01

    This study was designed to evaluate the efficacy and safety of computed tomography (CT)-guided drainage in treating infected collections due to gastric leak after laparoscopic sleeve gastrectomy for morbid obesity. From January 2007 to June 2009, 21 patients (9 men and 12 women; mean age, 39.2 (range, 26–52) years) with infected collections due to gastric leak after laparoscopic sleeve gastrectomy for morbid obesity underwent image-guided percutaneous drainage. All procedures were performed using CT guidance and 8- to 12-Fr pigtail drainage catheters. Immediate technical success was achieved in all 21 infected collections. In 18 of 21 collections, we obtained progressive shrinkage of the collection with consequent clinical success (success rate 86%). In three cases, the abdominal fluid collection was not resolved, and the patients were reoperated. Among the 18 patients who avoided surgery, 2 needed replacement of the catheter due to obstruction. No major complications occurred during the procedure. The results of our study support that CT-guided percutaneous drainage is an effective and safe method to treat infected abdominal fluid collections due to gastric leak in patients who had previously underwent laparoscopic sleeve gastrectomy for morbid obesity. It may be considered both as a preparatory step for surgery and a valuable alternative to open surgery. Failure of the procedure does not, however, preclude a subsequent surgical operation.

  18. Percutaneous catheter drainage of tuberculous psoas abscesses

    International Nuclear Information System (INIS)

    Pombo, F.; Martin-Egana, R.; Cela, A.; Diaz, J.L.; Linares-Mondejar, P.; Freire, M.

    1993-01-01

    Six patients with 7 tuberculous psoas or ilio-psoas abscesses were treated by CT-guided catheter drainage and chemotherapy. The abscesses (5 unilateral and 1 bilateral) were completely drained using a posterior or lateral approach. The abscess volume was 70 to 700 ml (mean 300 ml) and the duration of drainage 5 to 11 days (mean 7 days). Immediate local symptomatic improvement was achieved in all patients, and there were no procedural complications. CT follow-up at 3 to 9 months showed normalization in 5 patients, 2 of whom are still in medical therapy. One patient, who did not take the medication regularly, had a recurrent abscess requiring new catheter drainage after which the fluid collection disappeared. Percutaneous drainage represents an efficient and attractive alternative to surgical drainage as a supplement to medical therapy in the management of patients with large tuberculous psoas abscesses. (orig.)

  19. Analysis of diagnositc accuracy with CT-guided percutaneous transthoracic lung biopsy for pulmonary lesions

    International Nuclear Information System (INIS)

    Wang Haiyan; Zhuang Yiping; Zhang Jin; Feng Yong; Zhang Xiao; Xu Lin

    2007-01-01

    Objective: To evaluate the factors which may affect the diagnostic accmracy of CT-guided percutaneous transthoracic lung biopsy for pulmonary lesions. Methods: CT-guided percutaneous transthoracic lung biopsy was performed in 264 patients, all of which were proved by surgical pathology or clinical follow-up. A logistic regression analysis was used to investigate the relationship between the location and the size of the lesions and insertion depth of biopsy needles and the diagnostic accuracy of CT-guided percutaneous transthomcic lung biopsy. The complication rate including pneumatothorax and bleeding rate were record. Results: The diagnostic accuracy was 87.5%. Both the pneumothorax and the bleeding of lesion were 1.9%. The size of lesion was suggested by Logistic regression analysis had a significant influence on the diagnostic accuracy (Wald=12.891, P=0.00034, OR=0.96). Conclusion: CT-guided pereumneous transthoracic lung biopsy has a high diagnostic accuracy for pulmonary lesions. The size of the lesions had significant effect on the diagnostic accuracy. (authors)

  20. Factors influencing diagnostic yield of CT-guided percutaneous core needle biopsy for bone lesions

    International Nuclear Information System (INIS)

    Li, Y.; Du, Y.; Luo, T.Y.; Yang, H.F.; Yu, J.H.; Xu, X.X.; Zheng, H.J.; Li, B.

    2014-01-01

    Aim: To evaluate the factors influencing diagnostic yield of computed tomography (CT)-guided percutaneous core needle biopsy (CNB) for bone lesions. Materials and methods: Between September 2005 and July 2011, 162 consecutive CT-guided CNB procedures were performed in 155 patients. The variables analysed were age, sex, lesion location, lesion type, lesion size, specimen size, biopsy needle gauge, and individual radiologist. The factors influencing diagnostic yield of CT-guided percutaneous CNB for bone lesions were determined by multivariate analysis of variables. Results: The diagnostic yield was 81.5%. Diagnostic yield was 89.9% for lytic bone lesions and 48.5% for sclerotic bone lesions (p < 0.001), and 89.2% for lesions ≥3 cm and 73.4% for lesions <3 cm (p = 0.010). The significant factors influencing diagnostic yield of CT-guided percutaneous CNB for bone lesions were lesion type [p < 0.001; odds ratio (OR) for a lytic lesion was approximately 12 times higher than that for a sclerotic lesion; 95% confidence interval (CI): 4.22–34.01], and lesion size (p = 0.012; OR for a lesion size ≥3 cm was about five-times higher than that for a lesion size <3 cm; 95% CI: 1.42–16.71). Conclusion: Lesion type and lesion size are determining factors in diagnostic yield. The higher diagnostic yield is correlated with lytic lesion and lesion size ≥3 cm

  1. CT-guided percutaneous treatment of osteoid osteoma

    International Nuclear Information System (INIS)

    Mazoyer, J.F.; Kohler, R.; Bossard, D.

    1990-01-01

    The authors of this paper report seven cases of percutaneous destruction of osteoid osteoma. All patients complained of typical pain lasting for several months. In each case, finding of plain radiography, bone scintigraphy, and CT were strongly suggestive of an osteoid osteoma. All the lesions were located on the lower limb (five femoral and two tibial). Under general anesthesia, the nidus was drilled through a trocar inserted percutaneously with CT guidance. Patients were discharged 1-3 days after the procedure with no residual pain, and they are still asymptomatic 18-33 months later, with normal scintigraphic and CT studies. Histologic confirmation was allowed by technical improvement of the method in the last four cases

  2. Diagnostic Yield of CT-Guided Percutaneous Transthoracic Needle Biopsy for Diagnosis of Anterior Mediastinal Masses.

    Science.gov (United States)

    Petranovic, Milena; Gilman, Matthew D; Muniappan, Ashok; Hasserjian, Robert P; Digumarthy, Subba R; Muse, Victorine V; Sharma, Amita; Shepard, Jo-Anne O; Wu, Carol C

    2015-10-01

    The purpose of this study was to evaluate the diagnostic yield and accuracy of CT-guided percutaneous biopsy of anterior mediastinal masses and assess prebiopsy characteristics that may help to select patients with the highest diagnostic yield. Retrospective review of all CT-guided percutaneous biopsies of the anterior mediastinum conducted at our institution from January 2003 through December 2012 was performed to collect data regarding patient demographics, imaging characteristics of biopsied masses, presence of complications, and subsequent surgical intervention or medical treatment (or both). Cytology, core biopsy pathology, and surgical pathology results were recorded. A per-patient analysis was performed using two-tailed t test, Fisher's exact test, and Pearson chi-square test. The study cohort included 52 patients (32 men, 20 women; mean age, 49 years) with mean diameter of mediastinal mass of 6.9 cm. Diagnostic yield of CT-guided percutaneous biopsy was 77% (40/52), highest for thymic neoplasms (100% [11/11]). Non-diagnostic results were seen in 12 of 52 patients (23%), primarily in patients with lymphoma (75% [9/12]). Fine-needle aspiration yielded the correct diagnosis in 31 of 52 patients (60%), and core biopsy had a diagnostic rate of 77% (36/47). None of the core biopsies were discordant with surgical pathology. There was no statistically significant difference between the diagnostic and the nondiagnostic groups in patient age, lesion size, and presence of necrosis. The complication rate was 3.8% (2/52), all small self-resolving pneumothoraces. CT-guided percutaneous biopsy is a safe diagnostic procedure with high diagnostic yield (77%) for anterior mediastinal lesions, highest for thymic neoplasms (100%), and can potentially obviate more invasive procedures.

  3. CT-guided percutaneous radiofrequency ablation of hepatic malignancies located in unusual regions under general anesthesia

    International Nuclear Information System (INIS)

    Pan Jie; Chen Shaohui; Lu Xin; Mao Yilei; Sang Xinting; Chen Fang; Li Yumei; Huang Yuguang; Jin Zhengyu

    2010-01-01

    Objective: To discuss the feasibility of CT-guided percutaneous radiofrequency ablation (RFA) of liver malignancies located in unusual regions under general anesthesia, and to assess its clinical value. Methods: Eighteen patients with a total of 26 malignant hepatic lesions were enrolled in this study. The lesions were located at diaphragmatic surface, hepatic hilum, hepatic subcapsular site,side of inferior vena cava, side of gallbladder or near by colon. Transcatheter arterial chemoembolization was performed in all patients, which was followed by CT-guided percutaneous RFA under general anesthesia. The time used for puncturing and the time used for putting the needles to the scheduled sites were recorded. A follow-up for 115 months was conducted. The complications and the therapeutic results were observed. Results: For all patients,the procedure of puncture and needle placement was completed in 1-3 minutes. A total of 35 RFA procedures were conducted for 26 lesions. No severe complications occurred. Complete necrosis was observed in 20 tumors and partial necrosis in 6 tumors. Conclusion: The result of this study indicates that CT-guided percutaneous RFA under general anesthesia is a feasible technique for the treatment of liver malignancies located at unusual regions. This technique is very helpful for reducing the manipulating difficulty and lowing the complication risk of RFA procedures. (authors)

  4. Percutaneous CT-guided cryoablation for the treatment of refractory pudendal neuralgia

    Energy Technology Data Exchange (ETDEWEB)

    Prologo, J.D.; Williams, Roger [Emory University Hospital, Department of Radiology and Imaging Sciences Division of Interventional Radiology and Image-Guided Medicine, Atlanta, GA (United States); Lin, Roger C. [University Hospitals Case Medical Center, Department of Radiology, Cleveland, OH (United States); Corn, David [Case Western Reserve University, Department of Biomedical Engineering, Cleveland, OH (United States)

    2015-05-01

    To evaluate the safety and efficacy of percutaneous CT-guided cryoablation of the pudendal nerve for the treatment of refractory pudendal neuralgia. Eleven patients were selected to undergo percutaneous CT-guided cryoablation of the pudendal nerve based on established diagnostic criteria. Brief Pain Inventory questionnaires were administered prior to the procedure, during the immediate 24 h post procedure, and 45 days and 6 months following the procedure. Prior to treatment, the average level of pain on a scale from 0 (no pain) to 10 (worst pain imaginable) was 7.6, with pain described as ''burning'' (80%), ''pulling'' (37.5%), ''crushing'' (50%), ''pressure'' (84.5%), ''throbbing'' (50%), ''knife-life'' (52%), and ''other'' (60%). At 24 h, 45 days, and 6 months post-treatment, pain intensity dropped to 2.6, 3.5, and 3.1, respectively (p < 0.005). There were no procedure-related complications. CT-guided percutaneous cryoablation may represent a safe and efficacious option for selected patients with refractory pudendal neuralgia. (orig.)

  5. Study of CT-guided percutaneous biopsy for the spine lesions

    International Nuclear Information System (INIS)

    Zhang Ji; Wu Chungen; Cheng Yongde; Zhu Xuee; Gu Yifeng; Zhang Huijian

    2008-01-01

    Objective: To determine the successful rate, diagnostic accuracy and clinical usefulness of CT-guided percutaneous biopsy for the spine lesions. Methods: Eight-five patients (61 outpatients, 24 ward patients)underwent CT-guided percutaneous biopsy for the spine lesion. The imaging appearance of spinal lesions were lytic in 57 cases, osteosclerotic in 19 cases, and mixed in 9 cases. Biopsy specimens were sent for cytologic and histologic analysis in order to correct diagnosis. Bacterial studies were performed when ever infection was suspected. Results: The localization of puncture biopsy needle inside the spinal lesions, was conformed by computed tomography including 3 cervical, 26 thoracic, 37 lumbar, and 19 sacral lesions. Biopsy specimens included bone (29 cases), soft tissue (5 cases), mixed tissue (47 cases )and no specimen be obtained(4 cases). An adequate specimen for pathologic examination was obtained in 81 biopsies (95%). The pathologic examinations revealed 44 metastases, 17 primary bone neoplasms, 18 infections (included tuberculosis)and 2 normal tissues of vertebral body. The diagnostic accuracy reached 97.5% (79 of 81 patients). Conclusions: CT-guided percutaneous biopsy is an important tool in the evaluation of spinal lesions, providing accurate localization, less trauma and reliable pathologic diagnosis and worthwhile to be the routine before vertebroplasy. (authors)

  6. CT-guided percutaneous spine biopsy in suspected infection or malignancy. A study of 214 patients

    International Nuclear Information System (INIS)

    Rehm, J.; Veith, S.; Kauczor, H.U.; Weber, M.A.; Akbar, M.

    2016-01-01

    To retrospectively determine the effectiveness and accuracy of CT-guided percutaneous biopsy of malignant and inflammatory bone lesions of the spine and to assess the reliability of pre-biopsy CT and MRI. 214 patients with lesions of the spine, which were suspicious either for being malignant or inflammatory, underwent CT-guided biopsy for pathological and/or microbiological detection. Biopsy samples were sent for histological examination in 128/214 patients, for microbiological analysis in 17/214 patients and for both analyses in 69/214 patients. Retrospectively, the diagnostic accuracy and sensitivity/specificity of the pre-interventional imaging (CT and MRI) were determined. In addition, the influence of the biopsy on subsequent patient management was assessed. The accuracy was 94.4% for histopathological analysis and 97.7% for microbiological analysis. In 25% of cases the microbiological analysis revealed an underlying pathogen that was not significantly affected by pre-biopsy antibiotic therapy. The sensitivity/specificity of the pre-biopsy cross-sectional imaging concerning suspected malignancy was 69%/78%. For suspected infection, the sensitivity/specificity of pre-biopsy imaging was 81%/44%. In 52% of all cases, the biopsy result changed subsequent patient management. Percutaneous CT-guided spine biopsy is a useful and reliable diagnostic procedure to establish a definitive diagnosis but with a relatively low yield of microorganisms in the case of infection.

  7. CT-guided percutaneous spine biopsy in suspected infection or malignancy. A study of 214 patients

    Energy Technology Data Exchange (ETDEWEB)

    Rehm, J.; Veith, S.; Kauczor, H.U.; Weber, M.A. [Heidelberg Univ. (Germany). Inst. of Diagnostic and Interventional Radiology; Akbar, M. [Heidelberg Univ. (Germany). Dept. of Orthopaedic Surgery and Rehabilitation Medicine

    2016-12-15

    To retrospectively determine the effectiveness and accuracy of CT-guided percutaneous biopsy of malignant and inflammatory bone lesions of the spine and to assess the reliability of pre-biopsy CT and MRI. 214 patients with lesions of the spine, which were suspicious either for being malignant or inflammatory, underwent CT-guided biopsy for pathological and/or microbiological detection. Biopsy samples were sent for histological examination in 128/214 patients, for microbiological analysis in 17/214 patients and for both analyses in 69/214 patients. Retrospectively, the diagnostic accuracy and sensitivity/specificity of the pre-interventional imaging (CT and MRI) were determined. In addition, the influence of the biopsy on subsequent patient management was assessed. The accuracy was 94.4% for histopathological analysis and 97.7% for microbiological analysis. In 25% of cases the microbiological analysis revealed an underlying pathogen that was not significantly affected by pre-biopsy antibiotic therapy. The sensitivity/specificity of the pre-biopsy cross-sectional imaging concerning suspected malignancy was 69%/78%. For suspected infection, the sensitivity/specificity of pre-biopsy imaging was 81%/44%. In 52% of all cases, the biopsy result changed subsequent patient management. Percutaneous CT-guided spine biopsy is a useful and reliable diagnostic procedure to establish a definitive diagnosis but with a relatively low yield of microorganisms in the case of infection.

  8. The diagnostic significance of CT-guided percutaneous transthoracic cutting needle biopsy for pulmonary lesions

    International Nuclear Information System (INIS)

    Wang Hui; Zhang Fuchen; Ji Hongjian; Chen Liping

    2009-01-01

    Objective: To evaluate the diagnostic significance of CT-guided percutaneous transthoracic cutting needle biopsy for pulmonary lesions. Methods: The clinical data of CT-guided transthoracic cutting needle biopsy in 436 patients performed in past 10 years were retrospectively analyzed. Of 436 cases with pulmonary lesions, primary lung cancer was confirmed in 341, pulmonary metastasis in 62, non-malignant lesions in 33. The diagnostic accuracy and sensitivity were statistically analyzed. The occurrence of complications was discussed. Results: The diagnostic accuracy rate and sensitivity rate in primary lung cancer group were 94.7% and 94.1% respectively, in pulmonary metastasis group were 58.2% and 51.6% respectively and in non-malignant lesions group were 57.6% and 57.6% respectively. The successful rate of biopsy was 97.9%. The occurrence of complications was 15.6%. Conclusion: CT-guided percutaneous transthoracic cutting needle biopsy is a safe and valuable diagnostic technique with high diagnostic accuracy and less complications. It is very helpful in confirming the diagnosis in the patients with suspected primary pulmonary cancer, although the technical procedures need to be further improved for metastatic and non-malignant lung lesions. (authors)

  9. CT-guided percutaneous transthoracic aspiration biopsy of lung lesions: factors influencing the diagnostic accuracy

    International Nuclear Information System (INIS)

    Huang Zhenguo; Zhang Xuezhe; Wang Wu

    2006-01-01

    Objective: To investigate the factors influencing the diagnostic accuracy in CT-guided percutaneous transthoracic aspiration biopsy of lung lesions. Methods: CT-guided percutaneous transthoracic biopsy was performed in 435 patients with surgical pathologic confirmation or clinical follow-up. Univariant statistical analysis and multivariant stepwise Logistic regression analysis were used to study the influence of lesion-related factors (benignancy or malignancy, size, location, depth, presence of cavity), procedure factors (laser-guidance, position of patient) and patient-related factors (sex, age, presence of emphysema); with the accuracy of the diagnosis. Results: 1)289 lesions were diagnosed as malignant ones and 146 as benign ones. The accuracy of CT-guided biopsy was 83.4%(363/435). Univariant analysis showed that the diagnostic accuracies for malignant and benign lesions were 88.9%(257/289) and 72.6%(106/146), respectively (χ 2 =18.71, P=0.00002). Laser-group was superior to non-laser group (88.4% versus 80.9%, respectively, χ 2 =4.00, P=0.0456). Mean diameters of lesions in correct diagnostic group and non-correct diagnostic group were 3.78±1.64 cm and 3.02±1.26 cm, respectively (F=13.79, P=0.0002). 2)Multivariant stepwise Logistic regression analysis showed that among the various factors influencing the final benign or malignant diagnoses (Wald χ 2 =14.01, P=0.0002) and using laser-guidance(Wald χ 2 =3.92, P=0.0477) were significantly associated with the diagnostic accuracy. Conclusions: Final correct diagnoses (benign, malignant) are closely related to the application of laser-guidance for determining the diagnostic accuracy in CT-guided transcutaneous thoracic needle aspiration biopsy. (authors)

  10. The comparative study of CT guided and ultrasound guided percutaneous ethanol injection in the treatment of intra-abdominal cyst

    International Nuclear Information System (INIS)

    Li Heping; Yang Jianyong; Chen Wei; Zhuang Wenquan; Huang Yulian; Chen Jianye

    2005-01-01

    Objective: An comparative study of the interventional approach of CT guided and ultiasound guided percutaneous ethanol injection(PEI) in the treatment of intra-abdominal cyst. Methods: CT guided PEI was performed in the treatment of intra-abdominal cyst in 38 patients while ultrasound guided PEI was performed in 45 cases. Results: The puncture procedure of CT guided PEI was totally performed 83 times in treating 56 intra-abdominal cysts in 38 patients and CT guided PEI was unsuccessful in 6 patients. The puncture procedure of ultrasound guided PEI were performed 87 times in treating 71 intra-abdominal cysts in 55 patients and ultrasound guided PEI only failed only in 1 patient. Conclusion: Ultrasound guided PEI is superior to CT guided PEI in the treatment of intra-abdominal cyst. (authors)

  11. Clinical application of multi-detector CT-guided percutaneous coaxial biopsy for pulmonary lesions

    International Nuclear Information System (INIS)

    Jia Ningyang; Liu Shiyuan; Zhang Dianbo; Xiao Xiangsheng; Li Wentao; Li Chenzhou

    2008-01-01

    Objective: To evaluate the clinical application of multi-slice CT-guided percutaneous transthoracic lung coaxial-biopsy for pulmonary lesions. Methods: 152 times of 143 patients were performed with percutaneous transthoracic coaxial biopsy under multiple-slice CT-guidance. Analysis was carried out to investigate the diagnostic accuracy and the relationship between the size of the lesions for coaxial biopsy, together with the complications. Results: The diagnostic accuracy was 94.9% with specificity of 100%, including malignant tumors 116 cases (squamous cell cancer 48 cases, adenocarcinoma 34, small cell undifferentiated carcinoma 6, large cell carcinoma 4, bronchial alveolar carcinoma 8, metastatic carcinoma 16) and 19 cases of benign ones(TB 7 cases, inflammatory pseudotumor 9, hematoma 1, lung abscess 1). The size of lesion had a significant influence on the diagnostic accuracy. Conclusions: Percutaneous transthoracic coaxial lung biopsy is a safety method, possessing a high diagnostic accuracy. (authors)

  12. Clinical application of CT-guided percutaneous puncturing biopsy of subcarinal lymph node

    International Nuclear Information System (INIS)

    Yuan Xiaodong; Wang Jianhua; Zuo Changjing; Tian Jianming

    2011-01-01

    Objective: To discuss the safety and clinical significance of CT-guided percutaneous puncturing biopsy of subcarinal lymph node. Methods: During the period of July 2006-July 2010, CT-guided percutaneous puncturing biopsy of subcarinal lymph node was carried out in 17 patients (11 males and 6 females, with an average age of 54 years) with enlarged subcarinal lymph nodes. The clinical data were retrospectively analyzed. Immediately after the puncturing procedure was completed, CT scanning was performed to observe if there any complications and to evaluate the safety of puncturing biopsy. Biopsy specimens were sent for pathological examination to assess the puncturing accuracy and to make the pathologic diagnosis. The clinical usefulness of this technique was evaluated. Results: Of the total 17 cases, successful puncturing into the enlarged subcarinal lymph nodes with single procedure was achieved in 14 and sufficient tissue sample was obtained. The biopsy failed in three cases at initial puncturing procedure as the needle could not be placed into the enlarged subcarinal lymph nodes, the puncturing biopsy had to given up in two patients because of hemoptysis and in another patient the second puncturing biopsy performed one week later was successful. The total technical successful rate was 88.2% (15/17). Of the fifteen cases with successful puncturing, definitive pathological diagnosis was obtained in 13 and the diagnosis was uncertain in the remaining two, with a diagnosis positive rate of 86.7% (13/15). Pathologically, the diagnoses included metastatic lymphadenopathy from lung cancer (n=10), proliferative inflammatory lymphadenopathy (n=2) and tuberculous enlargement of lymph nodes (n=1). Complications occurred in 4 patients (23.5%, 4/17), which mainly were pneumothorax and pulmonary hemorrhage. Conclusion: With high successful rate and diagnostic accuracy, CT-guided percutaneous puncturing biopsy of subcarinal lymph node is a safe and effective technique if the

  13. Percutaneous CT-guided biopsy of the musculoskeletal system: Results of 2027 cases

    International Nuclear Information System (INIS)

    Rimondi, Eugenio; Rossi, Giuseppe; Bartalena, Tommaso; Ciminari, Rosanna; Alberghini, Marco; Ruggieri, Pietro; Errani, Costantino; Angelini, Andrea; Calabro, Teresa; Abati, Caterina Novella; Balladelli, Alba; Tranfaglia, Cristina; Mavrogenis, Andreas F.; Vanel, Daniel; Mercuri, Mario

    2011-01-01

    Introduction: Biopsy of the musculoskeletal system is useful in the management of bone lesions particularly in oncology but they are often challenging procedures with a significant risk of complications. Computed tomography (CT)-guided needle biopsies may decrease these risks but doubts still exist about their diagnostic accuracy. This retrospective analysis of the experience of a single institution with percutaneous CT-guided biopsy of musculoskeletal lesions evaluates the results of these biopsies for bone lesions either in the appendicular skeleton or in the spine, and defines indications. Materials and methods: We reviewed the results of 2027 core needle biopsies performed over the past 18 years at the authors' institution. The results obtained are subject of this paper. Results: In 1567 cases the correct diagnosis was made with the first CT-guided needle biopsy (77.3% accuracy rate), in 408 cases the sample was not diagnostic and in 52 inadequate. Within 30 days these 408 patients underwent another biopsy, which was diagnostic in 340 cases with a final diagnostic accuracy of 94%. Highest accuracy rates were obtained in primary and secondary malignant lesions. Most false negative results were found in cervical lesions and in benign, pseudotumoral, flogistic, and systemic pathologies. There were 22 complications (18 transient paresis, 3 haematomas, 1 retroperitoneal haematoma) which had no influence on the treatment strategy, nor on patient outcome. Conclusion: This technique is reliable and safe and should be considered nowadays the gold standard for biopsies of the musculoskeletal system.

  14. Automatic path proposal computation for CT-guided percutaneous liver biopsy.

    Science.gov (United States)

    Helck, A; Schumann, C; Aumann, J; Thierfelder, K; Strobl, F F; Braunagel, M; Niethammer, M; Clevert, D A; Hoffmann, R T; Reiser, M; Sandner, T; Trumm, C

    2016-12-01

    To evaluate feasibility of automatic software-based path proposals for CT-guided percutaneous biopsies. Thirty-three patients (60 [Formula: see text] 12 years) referred for CT-guided biopsy of focal liver lesions were consecutively included. Pre-interventional CT and dedicated software (FraunhoferMeVis Pathfinder) were used for (semi)automatic segmentation of relevant structures. The software subsequently generated three path proposals in downward quality for CT-guided biopsy. Proposed needle paths were compared with consensus proposal of two experts (comparable, less suitable, not feasible). In case of comparable results, equivalent approach to software-based path proposal was used. Quality of segmentation process was evaluated (Likert scale, 1 [Formula: see text] best, 6 [Formula: see text] worst), and time for processing was registered. All biopsies were performed successfully without complications. In 91 % one of the three automatic path proposals was rated comparable to experts' proposal. None of the first proposals was rated not feasible, and 76 % were rated comparable to the experts' proposal. 7 % automatic path proposals were rated not feasible, all being second choice ([Formula: see text]) or third choice ([Formula: see text]). In 79 %, segmentation at least was good. Average total time for establishing automatic path proposal was 42 [Formula: see text] 9 s. Automatic software-based path proposal for CT-guided liver biopsies in the majority provides path proposals that are easy to establish and comparable to experts' insertion trajectories.

  15. Simple localization of peripheral pulmonary nodules - CT-guided percutaneous hook-wire localization

    International Nuclear Information System (INIS)

    Poretti, F.P.; Vorwerk, D.; Brunner, E.

    2002-01-01

    Background: Video-assisted thoracoscopic surgery (VATS) is an alternative approach to small intrapulmonary nodules, if transbronchial or percutaneous biopsy have failed. We investigated the feasibility and effectiveness of the percutaneous CT-guided placement of hook-wires to localize such nodules before video-assisted thoracoscopy. Subjects and Methods: 19 patients with new by diagnosed intrapulmonary nodules underwent CT-guided hook-wire localization by application of a X-Reidy-Set (Cook, Inc., Bjaeverskov, Denmark). The average age of the patient was 63 years (range: 19-80 years), the mean distance between the nodule and the pleura visceral was 7.58 mm (range: 0-25 mm) and the mean diameter was 11.58 mm (range: 5-25 mm). After localization, the patients underwent a VATS resection of the lesion within a mean time of 30 min (range 10-48 min). Results: In all cases, resection of the nodules was successful. In 4 older patients the marking was complicated by poor cooperability. At the end of manipulation the end of the hook was distanced from the nodule. But also in these cases, resection was successfully performed. 8 patients developed an asymptomatic pneumothorax: 5 of them in a minor (max. 1.5 cm rim), three of them in a moderate (max. 3 cm rim) dimension. In 4 patients, in whom the tumor was hit directly by the needle, local bleeding occurred. In one case, haemoptoe was present. In no patient did a dislocation of the hookwire-system occur. Conclusion: CT-guided placement of a hook-wire system is a simple and reasonable procedure which facilitates safe VATS resection of small pulmonary nodules. (orig.) [de

  16. CT-Guided Percutaneous Radiologic Gastrostomy for Patients with Head and Neck Cancer: A Retrospective Evaluation in 177 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Tamura, Akio, E-mail: a.akahane@gmail.com; Kato, Kenichi, E-mail: kkato@iwate-med.ac.jp; Suzuki, Michiko, E-mail: mamimichiko@me.com [Iwate Medical University School of Medicine, Department of Radiology (Japan); Sone, Miyuki, E-mail: msone@me.com [National Cancer Center Hospital, Department of Diagnostic Radiology (Japan); Tanaka, Ryoichi, E-mail: rtanaka@iwate-med.ac.jp; Nakasato, Tatsuhiko, E-mail: nakasato@iwate-med.ac.jp; Ehara, Shigeru, E-mail: ehara@iwate-med.ac.jp [Iwate Medical University School of Medicine, Department of Radiology (Japan)

    2016-02-15

    PurposeThe purpose of this study was to assess the technical success rate and adverse events (AEs) associated with computed tomography (CT)-guided percutaneous gastrostomy for patients with head and neck cancer (HNC).Materials and MethodsThis retrospective study included patients with HNC who had undergone CT-guided percutaneous gastrostomy between February 2007 and December 2013. Information regarding the patients’ backgrounds, CT-guided percutaneous gastrostomy techniques, technical success rate, and AEs were obtained from the medical records. In all patients, the stomach was punctured under CT fluoroscopy with a Funada gastropexy device.ResultsDuring the study period, 177 patients underwent CT-guided percutaneous gastrostomy. The most common tumor location was the oral cavity, followed by the pharynx and maxilla. The indication for CT-guided percutaneous gastrostomy were tumor obstruction in 78 patients, postoperative dysphagia in 55 patients, radiation edema in 43 patients, and cerebral infarction in 1 patient. The technical success rate was 97.7 %. The overall mean procedure time was 25.3 min. Major AEs occurred in seven patients (4.0 %), including bleeding (n = 4), colonic injury (n = 1), gastric tear (n = 1), and aspiration pneumonia (n = 1). Minor AEs occurred in 15 patients (8.5 %), which included peristomal leakage (n = 6), irritation (n = 4), inadvertent removal (n = 2), peristomal hemorrhage (n = 1), peristomal infection (n = 1), and wound granulation (n = 1). The mean follow-up period was 111 days (range 1–1106 days).ConclusionOur study suggests that CT-guided gastrostomy may be suitable in patients with HNC.

  17. CT-Guided Percutaneous Radiologic Gastrostomy for Patients with Head and Neck Cancer: A Retrospective Evaluation in 177 Patients

    International Nuclear Information System (INIS)

    Tamura, Akio; Kato, Kenichi; Suzuki, Michiko; Sone, Miyuki; Tanaka, Ryoichi; Nakasato, Tatsuhiko; Ehara, Shigeru

    2016-01-01

    PurposeThe purpose of this study was to assess the technical success rate and adverse events (AEs) associated with computed tomography (CT)-guided percutaneous gastrostomy for patients with head and neck cancer (HNC).Materials and MethodsThis retrospective study included patients with HNC who had undergone CT-guided percutaneous gastrostomy between February 2007 and December 2013. Information regarding the patients’ backgrounds, CT-guided percutaneous gastrostomy techniques, technical success rate, and AEs were obtained from the medical records. In all patients, the stomach was punctured under CT fluoroscopy with a Funada gastropexy device.ResultsDuring the study period, 177 patients underwent CT-guided percutaneous gastrostomy. The most common tumor location was the oral cavity, followed by the pharynx and maxilla. The indication for CT-guided percutaneous gastrostomy were tumor obstruction in 78 patients, postoperative dysphagia in 55 patients, radiation edema in 43 patients, and cerebral infarction in 1 patient. The technical success rate was 97.7 %. The overall mean procedure time was 25.3 min. Major AEs occurred in seven patients (4.0 %), including bleeding (n = 4), colonic injury (n = 1), gastric tear (n = 1), and aspiration pneumonia (n = 1). Minor AEs occurred in 15 patients (8.5 %), which included peristomal leakage (n = 6), irritation (n = 4), inadvertent removal (n = 2), peristomal hemorrhage (n = 1), peristomal infection (n = 1), and wound granulation (n = 1). The mean follow-up period was 111 days (range 1–1106 days).ConclusionOur study suggests that CT-guided gastrostomy may be suitable in patients with HNC

  18. CT-guided percutaneous cryoablation of osteoid osteoma in children: an initial study

    International Nuclear Information System (INIS)

    Wu, Bin; Xiao, Yue-Yong; Zhang, Xiao; Zhao, Lei; Carrino, John A.

    2011-01-01

    The purpose of this study was to evaluate the safety and efficacy of CT-guided percutaneous cryoablation for osteoid osteoma in children. This study was approved by the institutional ethics committee. From January 2007 to July 2008, six children (four boys, two girls, mean age 12.6 years old) with osteoid osteoma were treated with CT-guided percutaneous cryoablation. The procedures were carried out under conscious sedation and local anesthesia. CT guidance was used for procedural planning, instrument guidance, and monitoring. An argon-based cryoablation system was used. Each cryoablation included two freezing-thawing cycles. Follow-up was performed to assess technical and clinical outcome for a minimum of 12 months. A visual analog scale (VAS) was used to assess severity of pain pre- and post-procedure, and mean VAS for the group was compared pre- and post-procedure with a t-test. The mean clinical follow-up period was 28.7 months (ranging from 18 to 36 months). Cryoablation was technically and clinically successful for all patients. No major immediate or delayed complications were observed. Significant pain relief (P <0.05) was observed in all patients after operation. Mean VAS were 6.57 ± 0.55 pre-procedure and 0.57 ± 0.10 1 month post-procedure. Patients were allowed to fully bear their weight and function without limitation within 3 days after the procedure. Pain recurrence was not observed in any patient. Percutaneous cryoablation is safe and effective for the treatment of osteoid osteomas in children. Notably, this procedure can be accomplished without general anesthesia. (orig.)

  19. Treatment of aneurysmal bone cysts by percutaneous CT-guided injection of calcitonin and steroid

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Connie Y.; Kattapuram, Susan V.; Huang, Ambrose J.; Simeone, F.J.; Torriani, Martin; Bredella, Miriam A. [Massachusetts General Hospital, Department of Radiology Division of Musculoskeletal Imaging and Intervention, Boston, MA (United States)

    2017-01-15

    To determine the efficacy and safety of percutaneous calcitonin and steroid injection in the treatment of aneurysmal bone cysts (ABCs). Our study was IRB-approved and HIPAA-compliant. We reviewed pre- and post-procedural imaging studies and medical records of all CT-guided percutaneous injections of ABCs with calcitonin and steroid performed at our institution between 2003 and 2015. Treatment success based on imaging was categorized as substantial (51-100 %), partial (1-50 %), or none (0 %) by comparing radiographs of the lesion before and after treatment. Our study group comprised 9 patients (7 female, 2 male; mean age 19 ± 5 (range 12-25) years). ABCs were located in the pubis (n = 3), femur (n = 2), and humerus/scapula/ilium/sacrum (n = 1 for each). One patient did not have any clinical or imaging follow-up. For the other 8 patients, clinical and imaging follow-up ranged from 1 to 93 months (mean 16 ± 29 months). One patient had two injections, and 1 patient had three injections. Six out of eight patients (75 %) had complete symptomatic relief and 2 patients (25 %) had partial symptomatic relief after initial injection. Imaging follow-up revealed substantial imaging response in 4 out of 8 patients (50 %). There was a partial imaging response in 2 patients (25 %) and no imaging response in 2 out of 8 patients (25 %), and all 4 of these patients had local recurrence. There were no complications. Percutaneous CT-guided injection of ABCs with calcitonin and steroid is a safe and effective treatment. Lack of imaging response may necessitate more aggressive treatment to minimize local recurrence. (orig.)

  20. Lung abscess; Percutaneous catheter therapy

    Energy Technology Data Exchange (ETDEWEB)

    Ha, H.K. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Kang, M.W. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Park, J.M. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Yang, W.J. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Shinn, K.S. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Bahk, Y.W. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of))

    1993-07-01

    Lung abscess was successfully treated with percutaneous drainage in 5 of 6 patients. Complete abscess resolution occurred in 4 patients, partial resolution in one, and no response in one. The duration of drainage ranged from 7 to 18 days (mean 15.5 days) in successful cases. The failure of drainage in one neurologicall impaired patient was attributed to persistent aspiration. In 2 patients, concurrent pleural empyema was also cured. CT provided the anatomic details necessary for choosing the puncture site and avoiding puncture of the lung parenchyma. Percutaneous catheter drainage is a safe and effective method for treating lung abscess. (orig.).

  1. CT-guided percutaneous core needle biopsy for small (≤20 mm) pulmonary lesions

    International Nuclear Information System (INIS)

    Li, Y.; Du, Y.; Yang, H.F.; Yu, J.H.; Xu, X.X.

    2013-01-01

    Aim: To assess the accuracy and risk factors for complications of computed tomography (CT)-guided percutaneous core needle biopsy (CNB) for small (≤20 mm) pulmonary lesions. Materials and methods: A retrospective study was undertaken comprising 169 patients who underwent CT-guided CNB for small (≤20 mm) pulmonary lesions. To assess the accuracy of the procedure, the diagnosis at biopsy was compared with the diagnosis after definitive surgery or clinical follow-up. The risk factors for pneumothorax and bleeding were determined by multivariate analysis of variables. Results: The overall diagnostic accuracy was 93.5%. The sensitivity for malignancy and specificity for benign lesions were 90.4% and 100%, respectively. Positive and negative predictive values were 100% and 83.3%, respectively. Twenty-five patients (14.8%) had pneumothorax after CT percutaneous CNB of the lung. The significant risk factors affecting the incidence of pneumothorax were lesion–pleural distance (p = 0.008) and needle–pleural angle (p = 0.012). The highest rate of pneumothorax correlated with a lesion–pleural distance ≥21 mm (OR = 18.46; 95%CI: 2.27–149.95) and a needle–pleural angle ≥51° (OR = 8.22; 95%CI: 2.14–31.49). Bleeding occurred in 30 patients (17.8%). The only significant risk factor affecting the incidence of bleeding was lesion–pleural distance (p = 0.011). The highest bleeding rate correlated with a lesion–pleural distance ≥21 mm (OR = 7.93; 95%CI: 1.73–36.43). Conclusion: CT-guided percutaneous CNB of small (≤20 mm) pulmonary lesions provides high diagnostic accuracy with acceptable complications. A lesion–pleural distance of ≥21 mm and needle–pleural angle of ≥51° are identified as the risk factors for highest pneumothorax rate. In addition, the needle–pleural angle is a novel predictor of pneumothorax. A lesion–pleural distance of ≥21 mm is also identified as a risk factor for the highest bleeding rate.

  2. CT-guided percutaneous vertebroplasty for the treatment of metastases in the cervical spine

    International Nuclear Information System (INIS)

    Wang Jianhua; Wang Zhentang; Zuo Changjing; Shao Chenwei; Chen Wei; Lv Taozhen; Dong Aisheng

    2009-01-01

    Objective: To assess the clinical efficacy and complications of CT-guided percutaneous vertebroplasty in the treatment of metastases of the cervical spine, and to discuss the proper needle path for different cervical vertebra. Methods: CT-guided percutaneous vertebroplasty was performed in 17 patients with cervical vertebral metastatic neoplasm, and the results of the treatment were retrospectively analyzed. Close observation was carded out after the procedure and a follow-up of 3-17 months was conducted. A comparison of the visual analogue pain scale (VAS) and Frankel's classification between pre-and post- operation was made. The occurrence of complications was recorded. The optimal needle path was summarized. Results: (1) The successful puncture was achieved in all 17 cases. The needle pathway included: the front of carotid sheath (n=4), between carotid sheath and vertebral artery (n=11) and behind the vertebral artery and carotid sheath (n=2). (2) Before the procedure the VAS was 7.24 ± 1.01, and at the time of one hour, one week and three months after the procedure it was decreased to 3.24 ± 1.09, 2.40 ± 0.80 and 1.82 ± 0.53 respectively. Wilcoxon signed-rank test showed that the difference in VAS between pre-and post- operation was statistically significant (T=76.5, P 2 =4.52, P=0.033 and P<0.05 when Kruskal-Wallis test was adopted. (3) CT scanning immediately after the procedure showed that slight leakage of cement to the adjacent disc, epidural fat, parosteal tissue or to the needle path occurred in 35.3% with no serious complications. In a follow-up period of 3-17 months, the metastatic lesions remained stable in 14 cases (82.4%). Conclusion: (1) The optimal needle path for upper cervical vertebrae is posterolateral transpedicular approach while for the lower cervical vertebrae it is more reasonable to puncture via the front carotid sheath or between carotid sheath and vertebral artery. Nevertheless, the puncture pathway should be devised individually

  3. CT-guided percutaneous laser disk decompression for cervical and lumbar disk hernia

    International Nuclear Information System (INIS)

    Shimizu, Kanichiro; Koyama, Tutomu; Harada, Junta; Abe, Toshiaki

    2008-01-01

    Percutaneous laser disk decompression under X-ray fluoroscopy was first reported in 1987 for minimally invasive therapy of lumbar disk hernia. In patients with disk hernia, laser vaporizes a small portion of the intervertebral disk thereby reducing the volume and pressure of the affected disk. We present the efficacy and safety of this procedure, and analysis of fair or poor response cases. In our study, 226 cases of lumbar disk hernia and 7 cases of cervical disk hernia were treated under CT guided PLDD. Japan Orthopedic Association (JOA) score and Mac-Nab criteria were investigated to evaluate the response to treatment. Improvement ratio based on the JOA score was calculated as follows. Overall success rate was 91.6% in cases lumber disk hernia, and 100% in cases of cervical disk hernia. We experienced two cases with two cases with postoperative complication. Both cases were treated conservatively. The majority of acute cases and post operative cases were reported to be 'good' on Mac-Nab criteria. Cases of fair or poor response on Mac-Nab criteria were lateral type, foraminal stenosis or large disk hernia. CT-guided PLDD is a safe and accurate procedure. The overall success rate can be increased by carefully selecting patients. (author)

  4. CT-guided percutaneous acetic acid injection therapy for liver metastasis

    International Nuclear Information System (INIS)

    Yu Tongfu; Wang Dehang; Zhuang Zhenwu; Li Linxun; Shi Haibin

    2002-01-01

    Objective: To evaluate the efficacy of CT-guided percutaneous acetic acid injection (PAI) for liver metastasis. Methods: Thirty-five cases (40 lesions) with liver metastasis were treated with PAI. 4-10 ml of 30% acetic acid with 1 ml contrast media was injected into every lesion. PAI was performed twice a week, and repeated for 2 to 3 weeks. Results: The tumors shrunk in 23 lesions, and remained unchanged in 12 lesions. The efficiency was 87.5%. All cases were followed up for 3 months to 3 years. One year survival rates was 62.9% (22 cases), 2 years 40.0% (14 cases), and 3 years 22.9% (8 cases). Conclusion: PAI was an effective therapy for liver metastasis

  5. The role of CT-guided percutaneous drainage of loculated air collections: an institutional experience.

    Science.gov (United States)

    Patel, Bhavik N; Morgan, Madeline; Tyler, Douglas; Paulson, Erik; Jaffe, Tracy A

    2015-10-01

    The purpose of this study is to describe our experience with the role of CT-guided percutaneous drainage of loculated intra-abdominal collections consisting entirely of gas. An IRB-approved retrospective study analyzing patients with air-only intra-abdominal collections over an 8-year period was undertaken. Seven patients referred for percutaneous drainage were included. Size of collections, subsequent development of fluid, and microbiological yield were determined. Clinical outcome was also analyzed. Out of 2835 patients referred for percutaneous drainage between 2004 and 2012, seven patients (5M, 2F; average age 63, range 54-85) met criteria for inclusion with CT showing air-only collections. Percutaneous drain placement (five 8 Fr, one 10 Fr, and one 12 Fr) using Seldinger technique was performed. Four patients (57%) had recently undergone surgery (2 Whipple, 1 colectomy, 1 hepatic resection) while two (29%) had a remote surgery (1 abdominoperineal resection, 1 sigmoidectomy). Despite the lack of detectable fluid on the original CT, 6 patients (86%) had air and fluid aspirated at drainage, 5 (83%) of the aspirates developed positive microbacterial cultures. Four patients (57%) presented with fever at the time of the initial scan, all of whom had positive cultures from aspirated fluid. Four patients (57%) had leukocytosis, all of whom had positive cultures from aspirated fluid. Although relatively rare in occurrence, patients with air-only intra-abdominal collections with signs of infection should be considered for percutaneous management similar to that of conventional infected fluid collections. Although fluid is not visible on CT, these collections can produce fluid that contains organisms.

  6. Percutaneous CT-guided cryoablation of the dorsal penile nerve for treatment of symptomatic premature ejaculation.

    Science.gov (United States)

    David Prologo, J; Snyder, Laura L; Cherullo, Edward; Passalacqua, Matthew; Pirasteh, Ali; Corn, David

    2013-02-01

    To evaluate expansion of image-guided interventional cryoablation techniques usually employed for pain management to address the feasibility, safety, and efficacy of treatment for a urologic condition with otherwise limited treatment options, premature ejaculation (PE). Prospective institutional review board approval was obtained, and 24 subjects with PE were enrolled. All patients underwent unilateral percutaneous computed tomography-guided cryoablation of the dorsal penile nerve (DPN). Postprocedural intravaginal ejaculatory latency times (IELTs) and PE Profile (PEP) results served as outcome variables. In addition, subjects were asked whether they would have the procedure done again based on their experience at the 180- and 360-day marks. The technical success rate was 100%. Baseline average IELT was 54.7 seconds ± 7.8 (n = 24), which increased to a maximum of 256 seconds ± 104 (n = 11; P = .241) by day 7 and decreased to 182.5 seconds ± 87.8 (n = 6; P = .0342) by day 90. The mean IELT remained at 182.5 seconds ± 27.6 at day 180 (n = 23; PIELTs significantly improved at 180 and 360 days, and 83% of subjects reported that they would undergo the procedure again if given the same opportunity. There were no procedure-related complications. CT-guided percutaneous unilateral cryoablation of the DPN is a feasible, safe, single-day outpatient procedure for the treatment of symptomatic PE. Copyright © 2013 SIR. Published by Elsevier Inc. All rights reserved.

  7. CT-guided percutaneous neurolysis methods. State of the art and first results

    International Nuclear Information System (INIS)

    Schneider, B.; Richter, G.M.; Roeren, T.; Kauffmann, G.W.

    1996-01-01

    We used 21G or 22G fine needles. All CT-guided percutaneous neurolysis methods require a proper blood coagulation. Most common CT scanners are suitable for neurolysis if there is enough room for maintaining sterile conditions. All neurolysis methods involve sterile puncture of the ganglia under local anesthesia, a test block with anesthetic and contrast agent to assess the clinical effect and the definitive block with a mixture of 96% ethanol and local anesthetic. This allows us to correct the position of the needle if we see improper distribution of the test block or unwanted side effects. Though inflammatory complications of the peritoneum due to puncture are rarely seen, we prefer the dorsal approach whenever possible. Results: Seven of 20 legs showed at least transient clinical improvement after CT-guided lumbar sympathectomies; 13 legs had to be amputated. Results of the methods in the literature differ. For lumbar sympathectomy, improved perfusion is reported in 39-89%, depending on the pre-selection of the patient group. Discussion: It was recently proved that sympathectomy not only improves perfusion of the skin but also of the muscle. The hypothesis of a steal effect after sympathectomy towards skin perfusion was disproved. Modern aggressive surgical and interventional treatment often leaves patients to sympathectomy whose reservers of collateralization are nearly exhausted. We presume this is the reason for the different results we found in our patient group. For thoracic sympathectomy the clinical treatment depends very much on the indications. Whereas palmar hyperhidrosis offers nearly 100% success, only 60-70% of patients with disturbance of perfusion have benefited. Results in celiac ganglia block also differ. Patients with carcinoma of the pancreas and other organs of the upper abdomen benefit in 80-100% of all cases, patients with chronic pancreatitis in 60-80%. (orig./VHE) [de

  8. Electromagnetic Navigational Bronchoscopy versus CT-guided Percutaneous Sampling of Peripheral Indeterminate Pulmonary Nodules: A Cohort Study.

    Science.gov (United States)

    Bhatt, Kavita M; Tandon, Yasmeen K; Graham, Ruffin; Lau, Charles T; Lempel, Jason K; Azok, Joseph T; Mazzone, Peter J; Schneider, Erika; Obuchowski, Nancy A; Bolen, Michael A

    2018-03-01

    Purpose To compare the diagnostic yield and complication rates of electromagnetic navigational bronchoscopic (ENB)-guided and computed tomography (CT)-guided percutaneous tissue sampling of lung nodules. Materials and Methods Retrospectively identified were 149 patients sampled percutaneously with CT guidance and 146 patients who underwent ENB with transbronchial biopsy of a lung lesion between 2013 and 2015. Clinical data, incidence of complications, and nodule pathologic analyses were assessed through electronic medical record review. Lung nodule characteristics were reviewed through direct image analysis. Molecular marker studies and pathologic analyses from surgical excision were reviewed when available. Multiple-variable logistic regression models were built to compare the diagnostic yield and complication rates for each method and for different patient and disease characteristics. Results CT-guided sampling was more likely to be diagnostic than ENB-guided biopsy (86.0% [129 of 150] vs 66.0% [99 of 150], respectively), and this difference remained significant even after adjustments were made for patient and nodule characteristics (P guided sampling (P guided sampling, 88.9% [32 of 36]; CT-guided sampling, 82.0% [41 of 50]). The two groups had similar rates of major complications (symptomatic hemorrhage, P > .999; pneumothorax requiring chest tube and/or admission, P = .417). Conclusion CT-guided transthoracic biopsy provided higher diagnostic yield in the assessment of peripheral pulmonary nodules than navigational bronchoscopy with a similar rate of clinically relevant complications. © RSNA, 2017 Online supplemental material is available for this article.

  9. Percutaneous CT-guided biopsy for lung lesions 1 cm or smaller: the technique, results and complication

    International Nuclear Information System (INIS)

    Song, Chi Sung

    2006-01-01

    The author wanted to assess the diagnostic accuracy and safety of percutaneous biopsy for lung lesions 1 cm or smaller; the biopsies were performed on the basis of the modified coaxial technique under CT guidance. Thirty-five patients (22 men and 13 women) 23-76 years old (average age: 56.8 years) with lung lesions 1 cm or smaller underwent CT-guided percutaneous biopsy. Fifteen patients had underlying primary malignancies. After an 18 G guiding cannula was introduced to the border of the small lung lesion via the modified coaxial technique, fine-needle aspiration biopsy with 21 G needle and core tissue biopsies with 19.5 G or 20 G biopsy guns were performed through the lumen of the guiding cannula. The core tissue biopsies were finished after 6 macroscopic core tissue specimens were obtained. When the needle hit the eccentric portion of the small lung lesion, a 'fanning-out' technique with using the guiding cannula was applied to get multiple core tissue specimens from the small lung lesion. The diagnostic accuracy of this method was evaluated and the complications were reviewed. Both the cytopathologic and histopathologic specimens were obtained in all 35 cases. The fanning-out technique was necessary in 15 cases (43%) for obtaining six core tissue specimens from small lesions. The final diagnoses were 17 malignant lesions and 18 benign lesions. Sixteen lesions were true-positive, eighteen were true-negative, none was false-positive and one was false-negative. The overall diagnostic accuracy was 97%. The sensitivity for detecting malignancy and the specificity for benign lesion were 94% and 100%, respectively. The positive and negative predictive values were 100% and 95%, respectively. The diagnostic ability to characterize the specific cell type of the malignant lesion was 94% (16 of 17), that for the benign lesions was 83% (15 of 18), and overall diagnostic ability was 89% (31 of 35). Five patients (14%) developed a pneumopthorax, and one of them (3%) received

  10. Posterior pelvic ring fractures: Closed reduction and percutaneous CT-guided sacroiliac screw fixation

    International Nuclear Information System (INIS)

    Jacob, Augustinus Ludwig; Messmer, Peter; Stock, Klaus-Wilhelm; Suhm, Norbert; Baumann, Bernard; Regazzoni, Pietro; Steinbrich, Wolfgang

    1997-01-01

    Purpose. To assess the midterm results of closed reduction and percutaneous fixation (CRPF) with computed tomography (CT)-guided sacroiliac screw fixation in longitudinal posterior pelvic ring fractures. Methods. Thirteen patients with 15 fractures were treated. Eleven patients received a unilateral, two a bilateral, screw fixation. Twenty-seven screws were implanted. Continuous on-table traction was used in six cases. Mean radiological follow-up was 13 months. Results. Twenty-five (93%) screws were placed correctly. There was no impingement of screws on neurovascular structures. Union occurred in 12 (80%), delayed union in 2 (13%), and nonunion in 1 of 15 (7%) fractures. There was one screw breakage and two axial dislocations. Conclusion. Sacroiliac CRPF of longitudinal fractures of the posterior pelvic ring is technically simple, minimally invasive, well localized, and stable. It should be done by an interventional/surgical team. CT is an excellent guiding modality. Closed reduction may be a problem and succeeds best when performed as early as possible

  11. CT-guided percutaneous ethanol injection in the treatment of thyroid adenoma

    International Nuclear Information System (INIS)

    Zheng Jiasheng; Zhao Xia; Cui Xiongwei; Li Hua

    2001-01-01

    Objective: To evaluate the safety and efficacy of CT-guided percutaneous ethanol injection (CT-PEI) in the treatment of thyroid adenoma. Methods: Fifty-four patients with 73 nodules were included in the study. Thyroid adenoma was confirmed by pathology. The serum level T3, T4 and TSH were normal in all cases. CT-PEI (0.3-2.5 ml ethanol/cm 3 nodular tissue) was given for 115 times (mean 1.58 +- 0.78 times/nodule). Results: Complete cure was observed in 37 nodules (50.7%). In 28 nodules (38.3%) volume reduction was greater than 80%. A significant nodule reduction (50%-80%) was observed in 7 nodules. Only 1 (1.4%) nodule volume reduction was 28.9%. Apart from 1 case of transient dysphonia and 2 cases of mild pain and burning sensation, no side effect was observed. Conclusion: CT-PEI is a safe and effective therapeutic procedure with few side effects for thyroid adenoma

  12. Application of CT-guided percutaneous thyroid biopsy in basic study of interventional therapy for Graves disease

    International Nuclear Information System (INIS)

    Yi Genfa; Zhao Wei; Hu Jihong; Jin Cangzheng; Yang Huiying

    2007-01-01

    Objective: To evaluate the value of application of CT-guided percutaneous thyroid biopsy in basic study of interventional treatment for Graves disease. Methods: Fifteen patients of hyperthyroidism caused by Graves' disease had been undertaken transcathter arterial embolizsation with PVA micropheres including 52 core needle biopsy(CNB)of pre-or post-interventional procedure. All procedures were divided into 2 groups according to the size of the thyroid enlargement: (1) II degree enlargement (n=19)under palpation puncture. (2) No enlargement or under II degree enlargement (n=33)with palpation and CT-guided puncture. Results: In group (1), 17 of the 19 procedures with palpation puncture were succeeded, reaching a successful rate of 89.5%. For group (2), the successful rate of CT-guided puncture was 91.7%. The difference between the successful rate of two groups showed statistical significance (P<0.05). No complication occurred during procedures in all cases. Conclusions: CT-guided thyroid core needle biopsy is an accurate, safe and high successful procedure providing the basic study for post-interventional treatment of Graves disease. (authors)

  13. Percutaneous CT-guided radiofrequency ablation of solitary small renal masses. A single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Pieper, C.C.; Fischer, S.; Strunk, H.; Meyer, C.; Thomas, D.; Willinek, W.A.; Schild, H. [Univ. Bonn (Germany). Dept. of Radiology; Hauser, S. [Univ. Bonn (Germany). Dept. of Urology; Nadal, J. [Univ. Bonn (Germany). Inst. for Medical Biometry; Wilhelm, K. [Johanniter Hospital Bonn (Germany). Dept. of Radiology

    2015-07-15

    To analyze the outcome of patients undergoing percutaneous CT-guided radiofrequency ablation (RFA) of small renal masses (SRM) at a single center during a ten-year time period. Patient records of renal RFAs (07/2003 - 11/2013) were reviewed. Indications were SRM suspicious of malignancy on imaging and one of the following: severe comorbidity; old age; solitary kidney; impaired renal function; patient wish. Biopsy was performed at the time of RFA. Patients were excluded if no follow-up was available. Patient and procedural characteristics were recorded. Survival rates were calculated using the Kaplan-Meier's method and compared with log-rank or cox tests. 38 patients (16 females, mean age 70.0 years [range 52 - 87]) presenting with a solitary SRM were included in the study. Biopsy showed malignancy in 29 patients; 9 had benign tumors. 26 patients suffered from cardiovascular, respiratory or hepatic comorbidities. Technical success (complete ablation on first follow-up) was achieved in 95 % of cases. Two major complications (bowel perforation; hematothorax) occurred. The 3- and 7-year overall survival (OS) [any cause] rates were 73.4 ± 0.8 % and 50.3 ± 1.0 %, respectively (mean follow-up 54.6 months, range 1 - 127). 4 recurrences and 2 metastases were observed. The presence of comorbidities was the only independent predictor of OS. There was no difference in survival between patients with benign and malignant tumors. RFA of SRM is successful in a large percentage of cases with a low complication rate and durable local control. As RFA is typically performed in multimorbid patients, overall survival seems to depend primarily on comorbidities rather than cancer progression.

  14. Percutaneous catheter drainage of intrapulmonary fluid collection

    International Nuclear Information System (INIS)

    Park, E. D.; Kim, H. J.; Choi, P. Y.; Jung, S. H.

    1994-01-01

    With the success of percutaneous abdominal abscess drainage, attention is now being focused on the use of similar techniques in the thorax. We studied to evaluate the effect of percutaneous drainage in parenchymal fluid collections in the lungs. We performed percutaneous drainage of abscesses and other parenchymal fluid collections of the lungs in 15 patients. All of the procedures were performed under the fluoroscopic guidance with an 18-gauge Seldinger needle and coaxial technique with a 8-10F drainage catheter. Among 10 patients with lung abscess, 8 patients improved by percutaneous catheter drainage. In one patient, drainage was failed by the accidental withdrawal of the catheter before complete drainage. One patient died of sepsis 5 hours after the procedure. Among three patients with complicated bulla, successful drainage was done in two patients, but in the remaining patient, the procedure was failed. In one patient with intrapulmonary bronchogenic cyst, the drainage was not successful due to the thick internal contents. In one patient with traumatic hematoma, after the drainage of old blood clots, the signs of infection disappeared. Overally, of 14 patients excluding one who died, 11 patients improved with percutaneous catheter drainage and three patients did not. There were no major complications during and after the procedure. We conclude that percutaneous catheter drainage is effective and safe procedure for the treatment of parenchymal fluid collections of the lung in patients unresponsive to the medical treatment

  15. Percutaneous catheter drainage of intrapulmonary fluid collection

    Energy Technology Data Exchange (ETDEWEB)

    Park, E. D.; Kim, H. J.; Choi, P. Y.; Jung, S. H. [Gyeongsang National University Hospital, Chinju (Korea, Republic of)

    1994-01-15

    With the success of percutaneous abdominal abscess drainage, attention is now being focused on the use of similar techniques in the thorax. We studied to evaluate the effect of percutaneous drainage in parenchymal fluid collections in the lungs. We performed percutaneous drainage of abscesses and other parenchymal fluid collections of the lungs in 15 patients. All of the procedures were performed under the fluoroscopic guidance with an 18-gauge Seldinger needle and coaxial technique with a 8-10F drainage catheter. Among 10 patients with lung abscess, 8 patients improved by percutaneous catheter drainage. In one patient, drainage was failed by the accidental withdrawal of the catheter before complete drainage. One patient died of sepsis 5 hours after the procedure. Among three patients with complicated bulla, successful drainage was done in two patients, but in the remaining patient, the procedure was failed. In one patient with intrapulmonary bronchogenic cyst, the drainage was not successful due to the thick internal contents. In one patient with traumatic hematoma, after the drainage of old blood clots, the signs of infection disappeared. Overally, of 14 patients excluding one who died, 11 patients improved with percutaneous catheter drainage and three patients did not. There were no major complications during and after the procedure. We conclude that percutaneous catheter drainage is effective and safe procedure for the treatment of parenchymal fluid collections of the lung in patients unresponsive to the medical treatment.

  16. CT-Guided Percutaneous Transthoracic Localization of Pulmonary Nodules Prior to Video-Assisted Thoracoscopic Surgery Using Barium Suspension

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Nyoung Keun; Park, Chang Min; Kang, Chang Hyun; Jeon, Yoon Kyung; Choo, Ji Yung; Lee, Hyun Ju; Goo, Jin Mo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2012-11-15

    To describe our initial experience with CT-guided percutaneous barium marking for the localization of small pulmonary nodules prior to video-assisted thoracoscopic surgery (VATS). From October 2010 to April 2011, 10 consecutive patients (4 men and 6 women; mean age, 60 years) underwent CT-guided percutaneous barium marking for the localization of 10 small pulmonary nodules (mean size, 7.6 mm; range, 3-14 mm): 6 pure ground-glass nodules, 3 part-solid nodules, and 1 solid nodule. A 140% barium sulfate suspension (mean amount, 0.2 mL; range, 0.15-0.25 mL) was injected around the nodules with a 21-gauge needle. The technical details, surgical findings and pathologic features associated with barium localizations were evaluated. All nodules were marked within 3 mm (mean distance, 1.1 mm; range, 0-3 mm) from the barium ball (mean diameter, 9.6 mm; range, 8-16 mm) formed by the injected barium suspension. Pneumothorax occurred in two cases, for which one needed aspiration. However, there were no other complications. All barium balls were palpable during VATS and visible on intraoperative fluoroscopy, and were completely resected. Both the whitish barium balls and target nodules were identifiable in the frozen specimens. Pathology revealed one invasive adenocarcinoma, five adenocarcinoma-in-situ, two atypical adenomatous hyperplasias, and two benign lesions. In all cases, there were acute inflammations around the barium balls which did not hamper the histological diagnosis of the nodules. CT-guided percutaneous barium marking can be an effective, convenient and safe pre-operative localization procedure prior to VATS, enabling accurate resection and diagnosis of small or faint pulmonary nodules.

  17. CT-Guided Percutaneous Transthoracic Localization of Pulmonary Nodules Prior to Video-Assisted Thoracoscopic Surgery Using Barium Suspension

    International Nuclear Information System (INIS)

    Lee, Nyoung Keun; Park, Chang Min; Kang, Chang Hyun; Jeon, Yoon Kyung; Choo, Ji Yung; Lee, Hyun Ju; Goo, Jin Mo

    2012-01-01

    To describe our initial experience with CT-guided percutaneous barium marking for the localization of small pulmonary nodules prior to video-assisted thoracoscopic surgery (VATS). From October 2010 to April 2011, 10 consecutive patients (4 men and 6 women; mean age, 60 years) underwent CT-guided percutaneous barium marking for the localization of 10 small pulmonary nodules (mean size, 7.6 mm; range, 3-14 mm): 6 pure ground-glass nodules, 3 part-solid nodules, and 1 solid nodule. A 140% barium sulfate suspension (mean amount, 0.2 mL; range, 0.15-0.25 mL) was injected around the nodules with a 21-gauge needle. The technical details, surgical findings and pathologic features associated with barium localizations were evaluated. All nodules were marked within 3 mm (mean distance, 1.1 mm; range, 0-3 mm) from the barium ball (mean diameter, 9.6 mm; range, 8-16 mm) formed by the injected barium suspension. Pneumothorax occurred in two cases, for which one needed aspiration. However, there were no other complications. All barium balls were palpable during VATS and visible on intraoperative fluoroscopy, and were completely resected. Both the whitish barium balls and target nodules were identifiable in the frozen specimens. Pathology revealed one invasive adenocarcinoma, five adenocarcinoma-in-situ, two atypical adenomatous hyperplasias, and two benign lesions. In all cases, there were acute inflammations around the barium balls which did not hamper the histological diagnosis of the nodules. CT-guided percutaneous barium marking can be an effective, convenient and safe pre-operative localization procedure prior to VATS, enabling accurate resection and diagnosis of small or faint pulmonary nodules.

  18. Single-Session CT-Guided Percutaneous Microwave Ablation of Bilateral Adrenal Gland Hyperplasia Due to Ectopic ACTH Syndrome

    International Nuclear Information System (INIS)

    Sarma, Asha; Shyn, Paul B.; Vivian, Mark A.; Ng, Ju-Mei; Tuncali, Kemal; Lorch, Jorchen H.; Zaheer, Sarah N.; Gordon, Michael S.; Silverman, Stuart G.

    2015-01-01

    Bilateral adrenalectomy is currently the only available treatment for adrenocorticotropic hormone (ACTH)-dependent Cushing’s syndrome (ectopic ACTH syndrome) that is refractory to pharmacologic therapy. We describe two patients with refractory ectopic ACTH syndrome who were treated with CT-guided percutaneous microwave ablation of both hyperplastic adrenal glands in a single session: One was not a surgical candidate, and the other had undergone unsuccessful surgery. Following the procedure, both patients achieved substantial decreases in serum cortisol, symptomatic improvement, and decreased anti-hypertensive medication requirements

  19. Percutaneous CT-Guided Cryoablation as an Alternative Treatment for an Extensive Pelvic Bone Giant Cell Tumor.

    Science.gov (United States)

    Panizza, Pedro Sergio Brito; de Albuquerque Cavalcanti, Conrado Furtado; Yamaguchi, Nise Hitomi; Leite, Claudia Costa; Cerri, Giovanni Guido; de Menezes, Marcos Roberto

    2016-02-01

    A giant cell tumor (GCT) is an intermediate grade, locally aggressive neoplasia. Despite advances in surgical and clinical treatments, cases located on the spine and pelvic bones remain a significant challenge. Failure of clinical treatment with denosumab and patient refusal of surgical procedures (hemipelvectomy) led to the use of cryoablation. We report the use of percutaneous CT-guided cryoablation as an alternative treatment, shown to be a minimally invasive, safe, and effective option for a GCT with extensive involvement of the pelvic bones and allowed structural and functional preservation of the involved bones.

  20. Percutaneous CT-Guided Cryoablation as an Alternative Treatment for an Extensive Pelvic Bone Giant Cell Tumor

    International Nuclear Information System (INIS)

    Panizza, Pedro Sergio Brito; Albuquerque Cavalcanti, Conrado Furtado de; Yamaguchi, Nise Hitomi; Leite, Claudia Costa; Cerri, Giovanni Guido; Menezes, Marcos Roberto de

    2016-01-01

    A giant cell tumor (GCT) is an intermediate grade, locally aggressive neoplasia. Despite advances in surgical and clinical treatments, cases located on the spine and pelvic bones remain a significant challenge. Failure of clinical treatment with denosumab and patient refusal of surgical procedures (hemipelvectomy) led to the use of cryoablation. We report the use of percutaneous CT-guided cryoablation as an alternative treatment, shown to be a minimally invasive, safe, and effective option for a GCT with extensive involvement of the pelvic bones and allowed structural and functional preservation of the involved bones

  1. Percutaneous CT-Guided Cryoablation as an Alternative Treatment for an Extensive Pelvic Bone Giant Cell Tumor

    Energy Technology Data Exchange (ETDEWEB)

    Panizza, Pedro Sergio Brito; Albuquerque Cavalcanti, Conrado Furtado de [Sírio Libânes Hospital, Radiology and Imaged Guided Intervention Service (Brazil); Yamaguchi, Nise Hitomi [Instituto Avanços em Medicina (Brazil); Leite, Claudia Costa; Cerri, Giovanni Guido; Menezes, Marcos Roberto de, E-mail: marcos.menezes@hc.fm.usp.br [Sírio Libânes Hospital, Radiology and Imaged Guided Intervention Service (Brazil)

    2016-02-15

    A giant cell tumor (GCT) is an intermediate grade, locally aggressive neoplasia. Despite advances in surgical and clinical treatments, cases located on the spine and pelvic bones remain a significant challenge. Failure of clinical treatment with denosumab and patient refusal of surgical procedures (hemipelvectomy) led to the use of cryoablation. We report the use of percutaneous CT-guided cryoablation as an alternative treatment, shown to be a minimally invasive, safe, and effective option for a GCT with extensive involvement of the pelvic bones and allowed structural and functional preservation of the involved bones.

  2. Single-Session CT-Guided Percutaneous Microwave Ablation of Bilateral Adrenal Gland Hyperplasia Due to Ectopic ACTH Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Sarma, Asha, E-mail: ashasarma@gmail.com; Shyn, Paul B., E-mail: pshyn@partners.org [Brigham and Women’s Hospital, Department of Radiology (United States); Vivian, Mark A. [University of Manitoba, Department of Radiology (Canada); Ng, Ju-Mei [Brigham and Women’s Hospital, Department of Anesthesiology (United States); Tuncali, Kemal [Brigham and Women’s Hospital, Department of Radiology (United States); Lorch, Jorchen H. [Dana Farber Cancer Institute, Department of Medicine (United States); Zaheer, Sarah N.; Gordon, Michael S. [Brigham and Women’s Hospital, Department of Endocrinology (United States); Silverman, Stuart G. [Brigham and Women’s Hospital, Department of Radiology (United States)

    2015-10-15

    Bilateral adrenalectomy is currently the only available treatment for adrenocorticotropic hormone (ACTH)-dependent Cushing’s syndrome (ectopic ACTH syndrome) that is refractory to pharmacologic therapy. We describe two patients with refractory ectopic ACTH syndrome who were treated with CT-guided percutaneous microwave ablation of both hyperplastic adrenal glands in a single session: One was not a surgical candidate, and the other had undergone unsuccessful surgery. Following the procedure, both patients achieved substantial decreases in serum cortisol, symptomatic improvement, and decreased anti-hypertensive medication requirements.

  3. CT-guided percutaneous injection of the fibrin glue by 'double needle' technique for the treatment of sacral cysts

    International Nuclear Information System (INIS)

    Wang Ganggang; Chen Long; Yang Chao; Ni Caifang

    2013-01-01

    Objective: To analyze the efficacy and safety of CT-guided percutaneous injection of the fibrin glue by 'double needle' technique to treat sacral cyst. Methods: Clinical data of 20 cases with 'double-needle' injection of fibrin glue technology to treat sacral cyst were retrospectively analyzed. All patients had varying degrees of sacral nerve root compression symptoms. The treatment for sacral cyst was carried out after clear diagnosis was made. On the basis of CT-guided percutaneous injection of fibrin glue, the improved CT-guided percutaneous injection of fibrin glue by 'double-needle' technique was used to treat these patients. The average dose of fibrin glue was (5.9 ± 2.4) ml. The clinical results of improvement as to pain and neurological function were evaluated after follow-up of an average of 17 months. The assessment criteria were as follows: excellent, complete resolution of signs and symptoms, with the patient returning to his or her regular employment and no recurrence of cysts during 1 year of follow-up, good, symptoms and signs in the legs and perineal region resolved but with persistent pain in the lumbosacral region, which did not interfere with the patient's regular work (the cysts did not recur for 6 months during follow-up), fair, no improvement in clinical symptoms, but a decrease in cyst size on the imaging study, poor, no improvement in clinical symptoms and no observed changes in cyst size in imaging studies or recurrence. Results: Most patients experienced some degree of pain relief and functional improvement after fibrin glue therapy, with most experiencing complete or marked resolution of clinical symptoms. Nine patients reported excellent recovery, 8 reported good recovery, 2 reported fair recovery, and 1 reported poor recovery. The overall percentage of positive outcomes (excellent and good recovery) was 85%. No serious postoperative complications were discovered. Conclusions: CT guided percutaneous injection of the fibrin glue by

  4. Predicting factors for conversion from fluoroscopy guided Percutaneous transthoracic needle biopsy to cone-beam CT guided Percutaneous transthoracic needle biopsy

    International Nuclear Information System (INIS)

    Lee, Kang Ji; Han, Young Min; Jin, Gong Yong; Song, Ji Soo

    2015-01-01

    To evaluate the predicting factors for conversion from fluoroscopy guided percutaneous transthoracic needle biopsy (PTNB) to cone-beam CT guided PTNB. From January 2011 to December 2012, we retrospectively identified 38 patients who underwent cone-beam CT guided PTNB with solid pulmonary lesions, and 76 patients who underwent fluoroscopy guided PTNB were matched to the patients who underwent cone-beam CT guided PTNB for age, sex, and lesion location. We evaluated predicting factors such as, long-axis diameter, short-axis diameter, anterior-posterior diameter, and CT attenuation value of the solid pulmonary lesion affecting conversion from fluoroscopy guided PTNB to cone-beam CT guided PTNB. Pearson χ 2 test, Fisher exact test, and independent t test were used in statistical analyses; in addition, we also used receiver operating characteristics curve to find the proper cut-off values affecting the conversion to cone-beam CT guided PTNB. Short-axis, long-axis, anterior-posterior diameter and CT attenuation value of the solid pulmonary lesion in patients who underwent fluoroscopy guided PTNB were 2.70 ± 1.57 cm, 3.40 ± 1.92 cm, 3.06 ± 1.81 cm, and 35.67 ± 15.70 Hounsfield unit (HU), respectively. Short-axis, long-axis, anterior-posterior diameter and CT attenuation value of the solid pulmonary lesion in patients who underwent cone-beam CT guided PTNB were 1.60 ± 1.30 cm, 2.20 ± 1.45 cm, 1.91 ± 1.99 cm, and 18.32 ± 23.11 HU, respectively. Short-axis, long-axis, anterior-posterior diameter, and CT attenuation value showed a significantly different mean value between the 2 groups (p = 0.001, p < 0.001, p = 0.003, p < 0.001, respectively). Odd ratios of CT attenuation value and short-axis diameter of the solid pulmonary lesion were 0.952 and 0.618, respectively. Proper cut-off values affecting the conversion to cone-beam CT guided PTNB were 1.65 cm (sensitivity 68.4%, specificity 71.1%) in short-axis diameter and 29.50 HU (sensitivity 65.8%, specificity 65.8%) in

  5. The prevention and treatment of biliary complications occurred after CT-guided percutaneous radiofrequency ablation for hepatic neoplasms

    International Nuclear Information System (INIS)

    Li Jianjun; Zheng Jiasheng; Cui Xiongwei; Cui Shichang; Sun Bin

    2011-01-01

    Objective: To discuss the prevention and treatment of biliary complications occurred after CT-guided percutaneous radiofrequency ablation (RFA) for hepatic neoplasms. Methods: A total of 1136 patients, including 920 males and 216 females, with hepatic neoplasms were enrolled in this study. The hepatic tumors consisted of primary hepatocellular carcinoma (n=1037), hepatic metastasis (n=83) and hepatic cavernous hemangioma (n=16). The diameters of the tumors ranged from 0.5 to 16 cm. A total of 1944 RFA procedures were carried out in all patients. Results: Thirty-five patients developed biliary complication (35/1944, 1.80%). Twelve patients developed asymptomatic bile duct dilatation and no special treatment was given. Obstructive jaundice occurred in two patients and percutaneous transhepatic cholangiocholecystic drainage (PTCD) together with subsequent inner stent implantation had to be carried out. Eighteen patients developed biloma, and liver abscess formation secondary to biloma infection occurred in seven of them. Percutaneous transhepatic biloma drainage (PTBD) was adopted in all these patients. One patient suffered from obstructive jaundice complicated by biloma, and both PTCD and PTBD combined with inner stent implantation were simultaneously performed. One patient had the biloma secondary to obstructive jaundice, and PTCD followed by PTBD was conducted in turn. One patient developed obstructive jaundice secondary to biloma, and PTBD followed by PTCD was employed in turn. Conclusion: Obstructive jaundice and biloma are severe biliary complications occurred after CT-guided percutaneous radiofrequency ablation for hepatic tumors, and PTCD and/or PTBD should be carried out without delay to treat these complications. The clinical symptoms can be relieved, or even completely disappear, after treatment. (authors)

  6. A case of transitional cell carcinoma associated with pericalyceal diverticulum diagnosed by CT guided percutaneous cystgraphy

    International Nuclear Information System (INIS)

    Sasaki, Fumio; Koga, Sukehiko; Takeuchi, Akira; Anno, Hirofumi; Hujita, Tamio

    1983-01-01

    Computed tomography (CT) performed on a 42-year-old male patient with a chief complaint of hematuria revealed a renal cyst with a thickened and irregularly shaped wall. CT with contrast medium injected into the cyst by puncture under CT guide detected tumors on the cystic wall preoperatively. (Ueda, J.)

  7. Computed tomography-guided percutaneous catheter drainage of primary and secondary iliopsoas abscesses

    International Nuclear Information System (INIS)

    Cantasdemir, M.; Kara, B.; Cebi, D.; Selcuk, N.D.; Numan, F.

    2003-01-01

    AIM: To report our experience with computed tomography (CT)-guided percutaneous catheter drainage (PCD) of iliopsoas abscesses. MATERIALS AND METHODS: Twenty-two iliopsoas abscesses in 21 patients (11 women, 10 men) aged between 18 and 66 years (mean 36 years) were treated with PCD. Abdominal CT demonstrated the iliopsoas abscesses, which were definitively determined by Gram staining and aspirate cultures. Twenty of the 22 iliopsoas abscesses were primary and two were secondary. All PCD procedures were performed under local anaesthesia using a single-step trocar technique (n=19) or Seldinger technique (n=3). RESULTS: PCD was an effective treatment in 21 out of the 22 iliopsoas abscesses. Recurrence was seen in three abscesses as minimal residual collections. Two of them resolved spontaneously with anti-tuberculous regimen. One required percutaneous needle aspiration. The procedure failed in a diabetic patient with a secondary abscess, who died due to sepsis. The length of time that catheters remained in place ranged from 21 to 75 days (mean 59.7 days). Complications included catheter dislocation in four abscesses, which required removal of dislocated catheters and indwelling new ones. CONCLUSION: CT-guided PCD is a safe and effective front-line treatment of iliopsoas abscesses. Surgery should be reserved for failure of PCD and presence of contraindications to PCD

  8. CT-guided percutaneous gastrostomy: success rate, early and late complications; CT-gesteuerte perkutane Gastrostomie: Technischer Erfolg, Frueh- und Spaetkomplikationen

    Energy Technology Data Exchange (ETDEWEB)

    Gottschalk, A.; Voelk, M. [Radiologie, Bundeswehrkrankenhaus Ulm (Germany); Strotzer, M. [Radiologie, Klinikum Hohe Warte (Germany); Feuerbach, S.; Rogler, G. [Radiologie, Klinikum der Universitaet Regensburg (Germany); Seitz, J. [Radiologie, MVZ Dr. Neumaier und Kollegen (Germany)

    2007-04-15

    Purpose: Percutaneous endoscopic gastrostomy (PEG) and percutaneous radiologic gastrostomy (PRG) are the standard methods of ensuring long-term enteral food intake in patients with dysphagia caused by neoplasia or neurological disorders. High-grade obstructions of the upper digestive tract or inadequate transillumination can prevent PEG. CT-guided percutaneous gastrostomy (PG) represents a special technique for enabling gastrostomy in patients for whom the endoscopic method is impossible. The aim of this study was to evaluate the results and complications of CT-guided percutaneous gastrostomy. Materials and Methods: CT-guided PG was performed in 83 patients, mostly with malignancy of the upper respiratory or digestive tract. Medical records for these patients were reviewed, and the results and complications of the CT-guided PG were analyzed retrospectively. Complications were grouped into four categories: Major and minor complications as well as early and late complications. Results: In 95.2 % of all cases (79/83), CT-guided PG was successful in the first attempt. Within the first 3 days, 5 major complications including 4 tube dislocations and one case of peritonitis were found in 4/79 patients (5.1 %). One of these patients experienced two early major complications. Early minor complications, mainly local skin irritations and temporary stomachache, were observed in 31 patients (39.2 %). Three days after CT-guided PG, 4 cases of major complications were documented, yielding a total rate of major complications was 8.7 % (7/79). Hemorrhage requiring blood transfusion or perforation after gastrostomy was not observed. 29.1 % of the patients (23/79) experienced late minor complications. (orig.)

  9. Resolution of Postural Orthostatic Tachycardia Syndrome After CT-Guided, Percutaneous T2 Ethanol Ablation for Hyperhidrosis

    Energy Technology Data Exchange (ETDEWEB)

    Brock, Malcolm, E-mail: mabrock@jhmni.edu [Johns Hopkins University, Department of Thoracic Surgery, Center for Sweat Disorders (United States); Chung, Tae Hwan, E-mail: Tchang7@jhmi.edu [Johns Hopkins University, Physical Medicine and Rehabilitation (United States); Gaddam, Sathvika Reddy, E-mail: drsathvikareddy@yahoo.com; Kathait, Anjaneya Singh, E-mail: askathait@gmail.com [Johns Hopkins University, Vascular & Interventional Radiology (United States); Ober, Cecily, E-mail: ceober21@gmail.com [Johns Hopkins University, Department of Thoracic Surgery (United States); Georgiades, Christos, E-mail: cgeorgi@jhmi.edu [Johns Hopkins University, Vascular & Interventional Radiology (United States)

    2016-12-15

    Postural orthostatic tachycardia syndrome is characterized by orthostatic intolerance. Orthostasis (or other mild physical stress) triggers a cascade of inappropriate tachycardia, lightheadedness, palpitations, and often fainting. The underlying defect is sympathetic dysregulation of the heart, which receives its sympathetic tone from the cervical and upper thoracic sympathetic ganglia. Primary hyperhidrosis is also thought to be the result of sympathetic dysregulation. We present the case of a patient treated with CT-guided, percutaneous T2 EtOH sympatholysis for craniofacial hyperhidrosis. The patient also suffered from postural orthostatic tachycardia syndrome for many years and was unresponsive to treatment. Immediately after sympatholysis, the patient experienced resolution of both craniofacial hyperhidrosis and postural orthostatic tachycardia syndrome.

  10. Percutaneous CT-Guided Biopsy of C3 Vertebral Body: Modified Approach for an Old Procedure

    International Nuclear Information System (INIS)

    Pua, Uei; Chan, Stephen Yung-Wei

    2013-01-01

    Percutaneous biopsy of upper cervical vertebrae is challenging due to the various critical structures in the location and often requires difficult trajectory such as transoral or paramaxillary approaches. The purpose of this manuscript is to illustrate the utility of head rotation in creating a potential space for direct percutaneous access to C3 vertebral body for safe biopsy.

  11. Percutaneous CT-Guided Biopsy of C3 Vertebral Body: Modified Approach for an Old Procedure

    Energy Technology Data Exchange (ETDEWEB)

    Pua, Uei, E-mail: druei@yahoo.com [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore); Chan, Stephen Yung-Wei [Tan Tock Seng Hospital, Department of Anaesthesiology, Intensive Care and Pain Medicine (Singapore)

    2013-06-15

    Percutaneous biopsy of upper cervical vertebrae is challenging due to the various critical structures in the location and often requires difficult trajectory such as transoral or paramaxillary approaches. The purpose of this manuscript is to illustrate the utility of head rotation in creating a potential space for direct percutaneous access to C3 vertebral body for safe biopsy.

  12. The clinical application of percutaneous auto-biopsy of small lung nodular under CT-Guided

    International Nuclear Information System (INIS)

    Zhou Yuanmin; Ye Genxin; Zhang Chenghui; Wang Yu; Chen Wei

    2008-01-01

    Objective: To evaluated the clinical value of technology of petcutaneous auto-biopsy of small lung nodular under CT- Guide. Methods: 44 cases of small single lung nodular were underwent biopsy with 20G auto-biopsy needle under CT guidance. All cases underwent pathological diagnosis. Results: All 44 cases were punctured successfully. 41 cases were succeeded in first puncturation. The success ratio was 93.02%. Other 3 cases needed second puncturation. 39 of 44 cases pathological diagnosis were malignant. Only 1 case could not be diagnosed. 6 patients had lightly pneumatothorax after biopsy. 10 cases had mild pneumonorrhagia after biopsy. 2 of them had haemptysis. All cases had no complication such as infection, needle track implantation. Conclusion: The technology of CT Guidance auto-biopsy of small lung nodular is safe and effective; it has extreme diagnostic ratio and less complication. (authors)

  13. Percutaneous CT-guided sacroiliac joint sampling for infection: aspiration, biopsy, and technique.

    Science.gov (United States)

    Knipp, David; Simeone, F Joseph; Nelson, Sandra B; Huang, Ambrose J; Chang, Connie Y

    2018-04-01

    To evaluate methods of CT-guided sacroiliac joint sampling in patients with suspected infection. All CT-guided sacroiliac joint sampling procedures for suspected infection were reviewed for sampling type (aspiration, lavage aspiration, biopsy), microbiology results, and clinical and imaging follow-up. The primary gold standard was anatomic pathology. If pathology was not available, then positive blood culture with the same organism as SIJ sampling, imaging and clinical follow-up, or clinical follow-up only were used. Anterior and posterior joint distention was evaluated by MRI within 7 days of the procedure. A total of 34 patients (age 39 ± 20 (range, 6-75) years; 21 F, 13 M) were included. Aspiration samples only were obtained in 13/34 (38%) cases, biopsy samples only in 9/34 (26%) cases, and both samples in 12/34 (35%) cases. There was an overall 54% sensitivity and 86% specificity. For the aspiration samples, sensitivity and specificity were 60 and 81%, respectively, compared to 45 and 90% for the biopsy samples. In cases with both samples, biopsy did not add additional microbial information. Seventeen (17/34, 50%) patients had an MRI. The anterior joint was more distended than the posterior joint in 15/17 (88%) of patients, and this difference was significant (P = 0.0003). All of these 17 patients had an attempted aspiration by a posterior approach; 6/17 (35%) resulted in a successful aspiration. Aspiration of the sacroiliac joint has a higher sensitivity than biopsy and should always be attempted first. MRI may be helpful for procedure planning.

  14. Percutaneous CT-guided sacroiliac joint sampling for infection. Aspiration, biopsy, and technique

    Energy Technology Data Exchange (ETDEWEB)

    Knipp, David; Simeone, F.J.; Huang, Ambrose J.; Chang, Connie Y. [Massachusetts General Hospital, Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); Nelson, Sandra B. [Massachusetts General Hospital, Infectious Disease Unit, Department of Medicine, Boston, MA (United States)

    2018-04-15

    To evaluate methods of CT-guided sacroiliac joint sampling in patients with suspected infection. All CT-guided sacroiliac joint sampling procedures for suspected infection were reviewed for sampling type (aspiration, lavage aspiration, biopsy), microbiology results, and clinical and imaging follow-up. The primary gold standard was anatomic pathology. If pathology was not available, then positive blood culture with the same organism as SIJ sampling, imaging and clinical follow-up, or clinical follow-up only were used. Anterior and posterior joint distention was evaluated by MRI within 7 days of the procedure. A total of 34 patients (age 39 ± 20 (range, 6-75) years; 21 F, 13 M) were included. Aspiration samples only were obtained in 13/34 (38%) cases, biopsy samples only in 9/34 (26%) cases, and both samples in 12/34 (35%) cases. There was an overall 54% sensitivity and 86% specificity. For the aspiration samples, sensitivity and specificity were 60 and 81%, respectively, compared to 45 and 90% for the biopsy samples. In cases with both samples, biopsy did not add additional microbial information. Seventeen (17/34, 50%) patients had an MRI. The anterior joint was more distended than the posterior joint in 15/17 (88%) of patients, and this difference was significant (P = 0.0003). All of these 17 patients had an attempted aspiration by a posterior approach; 6/17 (35%) resulted in a successful aspiration. Aspiration of the sacroiliac joint has a higher sensitivity than biopsy and should always be attempted first. MRI may be helpful for procedure planning. (orig.)

  15. Successful treatment of tumor-induced osteomalacia with CT-guided percutaneous ethanol and cryoablation.

    Science.gov (United States)

    Tutton, Sean; Olson, Erik; King, David; Shaker, Joseph L

    2012-10-01

    Tumor-induced osteomalacia is a rare condition usually caused by benign mesenchymal tumors. When the tumor can be found, patients are usually managed by wide excision of the tumor. We report a 51-yr-old male with clinical and biochemical evidence of tumor-induced osteomalacia caused by a mesenchymal tumor in the right iliac bone. He declined surgery and appears to have been successfully managed by computed tomography-guided percutaneous ethanol ablation and percutaneous cryoablation. Our patient appears to have had an excellent clinical and biochemical response to computed tomography-guided percutaneous ethanol ablation and percutaneous cryoablation. We found one prior case of image-guided ablation using radiofrequency ablation for tumor-induced osteomalacia. Although the standard treatment for tumor-induced osteomalacia is wide excision of the tumor, image-guided ablation may be an option in patients who cannot have appropriate surgery or who decline surgery.

  16. CT-guided thin needles percutaneous cryoablation (PCA) in patients with primary and secondary lung tumors: A preliminary experience

    Energy Technology Data Exchange (ETDEWEB)

    Pusceddu, Claudio, E-mail: clapusceddu@gmail.com [Division of Interventional Radiology, Department of Oncological Radiology, Businco Hospital, Regional Referral Center for Oncologic Diseases, Cagliari, Zip code 09100 (Italy); Sotgia, Barbara, E-mail: barbara.sotgia@gmail.com [Department of Oncological Radiology, Businco Hospital, Regional Referral Center for Oncological Diseases, Cagliari, Zip code 09100 (Italy); Fele, Rosa Maria, E-mail: rosellafele@tiscali.it [Department of Oncological Radiology, Businco Hospital, Regional Referral Center for Oncological Diseases, Cagliari, Zip code 09100 (Italy); Melis, Luca, E-mail: doclucamelis@tiscali.it [Department of Oncological Radiology, Businco Hospital, Regional Referral Center for Oncological Diseases, Cagliari, Zip code 09100 (Italy)

    2013-05-15

    Purpose: To report the data of our initial experience with CT-guided thin cryoprobes for percutaneous cryoablation (PCA) in patients with primary and secondary pulmonary tumors. Material and methods: CT-guided thin needles PCA was performed on 34 lung masses (11 NSCLC = 32%; 23 secondary lung malignancies = 68%) in 32 consecutive patients (24 men and 8 women; mean age 67 ± 10 years) not suitable for surgical resection. Lung masses were treated using two types of cryoprobes: IceRod and IceSeed able to obtain different size of iceball. The number of probes used ranged from 1 to 5 depending on the size of the tumor. After insertion of the cryoprobes into the lesion, the PCA were performed with two 2 (91%) or 3 (9%) cycles each of 12 min of freezing followed by a 4 min active thawing phase and a 4 min passive thawing phase for each one for all treatments. Results: All cryoablation sessions were successfully completed. All primary and metastatic lung tumors were ablated. No procedure-related deaths occurred. Morbidity consisted of 21% (7 of 34) pneumothorax and 3% (1 of 34) cases asymptomatic small pulmonary hemorrhage, respectively, all of CTCAE grade 1 (Common Terminology Criteria for Adverse Events). Low density of entire lesion, central necrosis and solid mass appearance were identify in 21 (62%), 7 (21%) and 6 (17%) of cryoablated tumors, respectively. No lymphadenopathy developed in the region of treated lesions. Technical success (complete lack of enhancement) was achieved in 82%, 97% and 91% of treated lesions at 1-, 3- and 6-months CT follow-up scan, respectively (p < .000). Comparing the tumor longest diameter between the baseline and at 6 month CT images, technical success was revealed in 92% cases (p < .000). Conclusion: Our preliminary experience suggests that PCA is a feasible treatment option. Well-designed clinical trials with a larger patient population are necessary to further investigate the long-term results and prognostic factors.

  17. CT-Guided Percutaneous Step-by-Step Radiofrequency Ablation for the Treatment of Carcinoma in the Caudate Lobe

    Science.gov (United States)

    Dong, Jun; Li, Wang; Zeng, Qi; Li, Sheng; Gong, Xiao; Shen, Lujun; Mao, Siyue; Dong, Annan; Wu, Peihong

    2015-01-01

    Abstract The location of the caudate lobe and its complex anatomy make caudate lobectomy and radiofrequency ablation (RFA) under ultrasound guidance technically challenging. The objective of the exploratory study was to introduce a novel modality of treatment of lesions in caudate lobe and discuss all details with our experiences to make this novel treatment modality repeatable and educational. The study enrolled 39 patients with liver caudate lobe tumor first diagnosed by computerized tomography (CT) or magnetic resonance imaging (MRI). After consultation of multi-disciplinary team, 7 patients with hepatic caudate lobe lesions were enrolled and accepted CT-guided percutaneous step-by-step RFA treatment. A total of 8 caudate lobe lesions of the 7 patients were treated by RFA in 6 cases and RFA combined with percutaneous ethanol injection (PEI) in 1 case. Median tumor diameter was 29 mm (range, 18–69 mm). A right approach was selected for 6 patients and a dorsal approach for 1 patient. Median operative time was 64 min (range, 59–102 min). Median blood loss was 10 mL (range, 8-16 mL) and mainly due to puncture injury. Median hospitalization time was 4 days (range, 2–5 days). All lesions were completely ablated (8/8; 100%) and no recurrence at the site of previous RFA was observed during median 8 months follow-up (range 3–11 months). No major or life-threatening complications or deaths occurred. In conclusion, percutaneous step-by-step RFA under CT guidance is a novel and effective minimally invasive therapy for hepatic caudate lobe lesions with well repeatability. PMID:26426638

  18. Percutaneous catheter drainage of lung abscess

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Shin; Chun, Kyung Ah; Choi, Hyo Sun; Ha, Hyun Kown; Shinn, Kyung Sub [Catholic University Medical college, Seoul (Korea, Republic of)

    1993-09-15

    From March 1987 to July 1989, six patients (five adults and one child) with lung abscess (size, 5-13 cm in diameter) were treated with percutaneous aspiration and drainage. In each case, the puncture was made where the wall of the abscess was in contact with the pleural surface. An 8 to 10 Fr cartheter was inserted for drainage. Five of 6 had a dynamatic clinical response within 24 hours of the drainage. Percutaneous drainage was successful with complete abscess resolution in four and partial resolution in one patient. No response was seen in the rest one. The duration of drainage ranged from 7 to 18 days(average, 15.5 days) in successful cases. One case of the failure in drainage was due tio persistent aspiration of the neurologically impaired patient. In one patient, the abscess resolved after drainage but recurred after inadvertent removal of the catheter 7 days after insertion. In two patients, concurrent pleural empyema was resolved completely by the drainage. Computed tomography provide anatomic details necessary for choosing the puncture site and avoiding a puncture of the lung parenchyma. Percutaneous catheter drainage is safe and effective method for treating patient with lung abscess.

  19. Percutaneous catheter drainage of lung abscess

    International Nuclear Information System (INIS)

    Kim, Young Shin; Chun, Kyung Ah; Choi, Hyo Sun; Ha, Hyun Kown; Shinn, Kyung Sub

    1993-01-01

    From March 1987 to July 1989, six patients (five adults and one child) with lung abscess (size, 5-13 cm in diameter) were treated with percutaneous aspiration and drainage. In each case, the puncture was made where the wall of the abscess was in contact with the pleural surface. An 8 to 10 Fr cartheter was inserted for drainage. Five of 6 had a dynamatic clinical response within 24 hours of the drainage. Percutaneous drainage was successful with complete abscess resolution in four and partial resolution in one patient. No response was seen in the rest one. The duration of drainage ranged from 7 to 18 days(average, 15.5 days) in successful cases. One case of the failure in drainage was due tio persistent aspiration of the neurologically impaired patient. In one patient, the abscess resolved after drainage but recurred after inadvertent removal of the catheter 7 days after insertion. In two patients, concurrent pleural empyema was resolved completely by the drainage. Computed tomography provide anatomic details necessary for choosing the puncture site and avoiding a puncture of the lung parenchyma. Percutaneous catheter drainage is safe and effective method for treating patient with lung abscess

  20. Percutaneous CT-Guided Treatment of Osteochondritis Dissecans of the Sacroiliac Joint

    Energy Technology Data Exchange (ETDEWEB)

    Becce, Fabio, E-mail: fabio.becce@chuv.ch [University of Lausanne, Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois (Switzerland); Mouhsine, Elyazid [Clinique Hirslanden Bois-Cerf, Department of Orthopaedic Surgery (Switzerland); Mosimann, Pascal John; Anaye, Anass [University of Lausanne, Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois (Switzerland); Letovanec, Igor [University Institute of Pathology, Centre Hospitalier Universitaire Vaudois (Switzerland); Theumann, Nicolas [University of Lausanne, Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois (Switzerland)

    2012-08-15

    Osteochondritis dissecans (OCD) is a joint disorder that affects the articular cartilage and subchondral bone, most commonly at the knee. OCD of the sacroiliac joint is extremely rare. Management of OCD remains controversial, and surgery is often needed, especially when conservative treatment fails. We present a rare case of OCD involving the left sacroiliac joint successfully treated by percutaneous computed tomography-guided retrograde drilling and debridement.

  1. Percutaneous CT-Guided Treatment of Osteochondritis Dissecans of the Sacroiliac Joint

    International Nuclear Information System (INIS)

    Becce, Fabio; Mouhsine, Elyazid; Mosimann, Pascal John; Anaye, Anass; Letovanec, Igor; Theumann, Nicolas

    2012-01-01

    Osteochondritis dissecans (OCD) is a joint disorder that affects the articular cartilage and subchondral bone, most commonly at the knee. OCD of the sacroiliac joint is extremely rare. Management of OCD remains controversial, and surgery is often needed, especially when conservative treatment fails. We present a rare case of OCD involving the left sacroiliac joint successfully treated by percutaneous computed tomography—guided retrograde drilling and debridement.

  2. Risk factors for severity of pneumothorax after CT-guided percutaneous lung biopsy using the single-needle method.

    Science.gov (United States)

    Kakizawa, Hideaki; Toyota, Naoyuki; Hieda, Masashi; Hirai, Nobuhiko; Tachikake, Toshihiro; Matsuura, Noriaki; Oda, Miyo; Ito, Katsuhide

    2010-09-01

    The purpose of this study is to evaluate the risk factors for the severity of pneumothorax after computed tomography (CT)-guided percutaneous lung biopsy using the single-needle method. We reviewed 91 biopsy procedures for 90 intrapulmonary lesions in 89 patients. Patient factors were age, sex, history of ipsilateral lung surgery and grade of emphysema. Lesion factors were size, location and pleural contact. Procedure factors were position, needle type, needle size, number of pleural punctures, pleural angle, length of needle passes in the aerated lung and number of harvesting samples. The severity of pneumothorax after biopsy was classified into 4 groups: "none", "mild", "moderate" and "severe". The risk factors for the severity of pneumothorax were determined by multivariate analyzing of the factors derived from univariate analysis. Pneumothorax occurred in 39 (43%) of the 91 procedures. Mild, moderate, and severe pneumothorax occurred in 24 (26%), 8 (9%) and 7 (8%) of all procedures, respectively. Multivariate analysis showed that location, pleural contact, number of pleural punctures and number of harvesting samples were significantly associated with the severity of pneumothorax (p < 0.05). In conclusion, lower locations and non-pleural contact lesions, increased number of pleural punctures and increased number of harvesting samples presented a higher severity of pneumothorax.

  3. Risk factors for severity of pneumothorax after CT-guided percutaneous lung biopsy using the single-needle method

    International Nuclear Information System (INIS)

    Kakizawa, Hideaki; Hieda, Masashi; Oda, Miyo; Toyota, Naoyuki; Hirai, Nobuhiko; Tachikake, Toshihiro; Matsuura, Noriaki; Ito, Katsuhide

    2010-01-01

    The purpose of this study is to evaluate the risk factors for the severity of pneumothorax after computed tomography (CT)-guided percutaneous lung biopsy using the single-needle method. We reviewed 91 biopsy procedures for 90 intrapulmonary lesions in 89 patients. Patient factors were age, sex, history of ipsilateral lung surgery and grade of emphysema. Lesion factors were size, location and pleural contact. Procedure factors were position, needle type, needle size, number of pleural punctures, pleural angle, length of needle passes in the aerated lung and number of harvesting samples. The severity of pneumothorax after biopsy was classified into 4 groups: 'none', 'mild', 'moderate' and 'severe'. The risk factors for the severity of pneumothorax were determined by multivariate analyzing of the factors derived from univariate analysis. Pneumothorax occurred in 39 (43%) of the 91 procedures. Mild, moderate, and severe pneumothorax occurred in 24 (26%), 8 (9%) and 7 (8%) of all procedures, respectively. Multivariate analysis showed that location, pleural contact, number of pleural punctures and number of harvesting samples were significantly associated with the severity of pneumothorax (p<0.05). In conclusion, lower locations and non-pleural contact lesions, increased number of pleural punctures and increased number of harvesting samples presented a higher severity of pneumothorax. (author)

  4. Percutaneous CT-guided needle biopsies of musculoskeletal tumors: a 5-year analysis of non-diagnostic biopsies

    International Nuclear Information System (INIS)

    Chang, Connie Y.; Huang, Ambrose J.; Bredella, Miriam A.; Torriani, Martin; Rosenthal, Daniel I.; Halpern, Elkan F.; Springfield, Dempsey S.

    2015-01-01

    To study non-diagnostic CT-guided musculoskeletal biopsies and take steps to minimize them. Specifically we asked: (1) What malignant diagnoses have a higher non-diagnostic rate? (2) What factors of a non-diagnostic biopsy may warrant more aggressive pursuit? (3) Do intra-procedural frozen pathology (FP) or point-of-care (POC) cytology reduce the non-diagnostic biopsy rate ?This study was IRB-approved and HIPAA-compliant. We retrospectively reviewed 963 consecutive CT-guided musculoskeletal biopsies. We categorized pathology results as malignant, benign, or non-diagnostic and recorded use of FP or POC cytology. Initial biopsy indication, final diagnosis, method of obtaining the final diagnosis of non-diagnostic biopsies, age of the patient, and years of biopsy attending experience were recorded. Groups were compared using Pearson's χ 2 test or Fisher's exact test. In all, 140 of 963 (15 %) biopsies were non-diagnostic. Lymphoma resulted in more non-diagnostic biopsies (P < 0.0001). While 67% of non-diagnostic biopsies yielded benign diagnoses, 33% yielded malignant diagnoses. Patients whose percutaneous biopsy was indicated due to the clinical context without malignancy history almost always generated benign results (96 %). Whereas 56% of biopsies whose indication was an imaging finding of a treatable lesion were malignant, 20% of biopsies whose indication was a history of malignancy were malignant. There was no statistically significant difference in the nondiagnostic biopsy rates of pediatric versus adult patients (P = 0.8) and of biopsy attendings with fewer versus more years of experience (P = 0.5). The non-diagnostic rates of biopsies with FP (8 %), POC cytology (25 %), or neither (24 %) were significantly different (P < 0.0001). Lymphoma is the malignant diagnosis most likely to result in a non-diagnostic biopsy. If the clinical and radiologic suspicion for malignancy is high, repeat biopsy is warranted. If the clinical context suggests a benign

  5. Percutaneous CT-guided needle biopsies of musculoskeletal tumors: a 5-year analysis of non-diagnostic biopsies

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Connie Y.; Huang, Ambrose J.; Bredella, Miriam A.; Torriani, Martin; Rosenthal, Daniel I. [Massachusetts General Hospital, Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); Halpern, Elkan F. [Massachusetts General Hospital, Institute for Technology Assessment, Department of Radiology, Boston, MA (United States); Springfield, Dempsey S. [Massachusetts General Hospital, Department of Orthopedics, Boston, MA (United States)

    2015-12-15

    To study non-diagnostic CT-guided musculoskeletal biopsies and take steps to minimize them. Specifically we asked: (1) What malignant diagnoses have a higher non-diagnostic rate? (2) What factors of a non-diagnostic biopsy may warrant more aggressive pursuit? (3) Do intra-procedural frozen pathology (FP) or point-of-care (POC) cytology reduce the non-diagnostic biopsy rate ?This study was IRB-approved and HIPAA-compliant. We retrospectively reviewed 963 consecutive CT-guided musculoskeletal biopsies. We categorized pathology results as malignant, benign, or non-diagnostic and recorded use of FP or POC cytology. Initial biopsy indication, final diagnosis, method of obtaining the final diagnosis of non-diagnostic biopsies, age of the patient, and years of biopsy attending experience were recorded. Groups were compared using Pearson's χ{sup 2} test or Fisher's exact test. In all, 140 of 963 (15 %) biopsies were non-diagnostic. Lymphoma resulted in more non-diagnostic biopsies (P < 0.0001). While 67% of non-diagnostic biopsies yielded benign diagnoses, 33% yielded malignant diagnoses. Patients whose percutaneous biopsy was indicated due to the clinical context without malignancy history almost always generated benign results (96 %). Whereas 56% of biopsies whose indication was an imaging finding of a treatable lesion were malignant, 20% of biopsies whose indication was a history of malignancy were malignant. There was no statistically significant difference in the nondiagnostic biopsy rates of pediatric versus adult patients (P = 0.8) and of biopsy attendings with fewer versus more years of experience (P = 0.5). The non-diagnostic rates of biopsies with FP (8 %), POC cytology (25 %), or neither (24 %) were significantly different (P < 0.0001). Lymphoma is the malignant diagnosis most likely to result in a non-diagnostic biopsy. If the clinical and radiologic suspicion for malignancy is high, repeat biopsy is warranted. If the clinical context suggests a

  6. Percutaneous CT-guided lung biopsy: sequential versus spiral scanning. A randomized prospective study

    International Nuclear Information System (INIS)

    Ghaye, B.; Dondelinger, R.F.; Dewe, W.

    1999-01-01

    The aim of this study was to evaluate in a prospective and randomized study spiral versus sequential scanning in the guidance of percutaneous lung biopsy. Fifty thoracic lesions occurring in 48 patients were biopsied by a senior and a junior operator. Six different time segments of the procedure were measured. Scanning mode versus length of procedure, pathological results, irradiation and complications were evaluated. Total duration of the procedure and of the first sampling was significantly longer with spiral CT for the senior operator (p < 0.004). No significant time difference was observed for the junior operator. Diameter of the lesion, depth of location, position of the patient and needle entry site did not influence the results. The sensitivity was 90.9, specificity 100, positive predictive value 100 and negative predictive value 60 % for spiral CT, and 94.7, 100, 100 and 85.7 % for sequential CT, respectively. Eleven pneumothoraces and ten perinodular hemorrhages were seen with spiral CT and six and ten, respectively, with sequential CT. The mean dose of irradiation was 4027 mAs for spiral CT and 2358 mAs for conventional CT. Spiral CT does neither reduce procedure time nor the rate of complications. Pathological results do not differ compared with sequential CT, and total dose of irradiation is higher with spiral scanning. (orig.)

  7. CT-guided percutaneous ethanol nerve block therapy of celiac plexus embedded in metastatic lymph nodes for the treatment of intractable carcinomatous abdominal pain

    International Nuclear Information System (INIS)

    Xi Qian; Wang Peijun; Shang Mingyi; Ma Jun; Lu Ying; Huang Zongliang; Tang Junjun; Gao Xiaolong

    2010-01-01

    Objective: To evaluate CT-guided percutaneous ethanol nerve block therapy of celiac plexus embedded in metastatic lymph nodes in treating intractable carcinomatous abdominal pain. Methods: A total of 104 patients with late stage cancers were enrolled in this study. All patients suffered from serious carcinomatous pain at upper abdomen and their retroperitoneal lymph nodes were extensively enlarged and fused, together with the involved celiac plexus, into a hard crumb. As the patients failed to respond to narcotic analgesics CT-guided ethanol nerve block therapy of celiac plexus was carried out by pushing the puncture needle through the fused lymphatic mass to celiac plexus site. The analgesic effects and complications were observed and the therapeutic results were evaluated. Results: The analgesic effective rate of ethanol nerve block therapy immediately after the procedure was 100%, and at 2 weeks, 1, 2, 3 and 4 months after the treatment it was 100%, 100%, 98.0%, 96.9% and 92.6%, respectively. No serious complications occurred during perioperative period. The living quality was markedly improved in all patients. Conclusion: For the treatment of intractable carcinomatous abdominal pain in patients with their celiac plexus being embedded in mass-like metastatic retroperitoneal lymph nodes CT-guided percutaneous ethanol nerve block therapy by pushing the puncture needle through the fused lymphatic mass to celiac plexus site is of great clinical value in relieving carcinomatous abdominal pain. (authors)

  8. Clinical application of CT and CT-guided percutaneous transthoracic needle biopsy in patients with indeterminate pulmonary nodules

    Energy Technology Data Exchange (ETDEWEB)

    Cardoso, Luciana Vargas; Souza Júnior, Arthur Soares, E-mail: fabianonatividade@terra.com.br [Rio Preto-Ultra-X Radiological Diagnosis Institute, São José do Rio Preto, SP (Brazil)

    2014-07-15

    Objective: To investigate the clinical application of CT and CT-guided percutaneous transthoracic needle biopsy (CT-PTNB) in patients with indeterminate pulmonary nodules (IPNs). Methods: We retrospectively studied 113 patients with PNs undergoing CT and CT-PTNB. Variables such as gender, age at diagnosis, smoking status, CT findings, and CT-PTNB techniques were analyzed. Data analysis was performed with the Student's t-test for independent samples the chi-square test, and normal approximation test for comparison of two proportions. Results: Of the 113 patients studied, 68 (60.2%) were male and 78 (69%) were smokers. The diameter of malignant lesions ranged from 2.6 cm to 10.0 cm. Most of the IPNs (85%) were located in the peripheral region. The biopsied IPNs were found to be malignant in 88 patients (77.8%) and benign in 25 (22.2%). Adenocarcinoma was the most common malignant tumor, affecting older patients. The IPN diameter was significantly greater in patients with malignant PNs than in those with benign IPNs (p < 0.001). Having regular contour correlated significantly with an IPN being benign (p = 0.022), whereas spiculated IPNs and bosselated IPNs were more often malignant (in 50.7% and 28.7%, respectively). Homogeneous attenuation and necrosis were more common in patients with malignant lesions (51.9% and 26.9%, respectively). Conclusions: In our sample, CT and CT-PTNB were useful in distinguishing between malignant and benign IPNs. Advanced age and smoking were significantly associated with malignancy. Certain CT findings related to IPNs (larger diameter, spiculated borders, homogeneous attenuation, and necrosis) were associated with malignancy. (author)

  9. CT-guided puncture

    International Nuclear Information System (INIS)

    Noeldge, G.; Richter, G.M.; Grenacher, L.; Brado, M.; Kauffmann, G.W.

    1996-01-01

    Sonographic and CT-guided punctures allow the evaluation of suspected lesions in the head, thorax, abdomen, retroperitoneum and skeletal system. The size of the lesion to be evaluated determines the size and the diameter of the puncture needle. The quantity of the material obtained will be defined by the diameter of the needle, i.e. fine-needle biopsy is more adequate for cytological than for histological evaluation. Strict adherence to the indications and contraindications for puncture and painstaking performance of the procedure go a long why towards minimizing the complications. The advantage of CT-guided puncture, in contrast to an ultrasound-guided procedure, is visualization during the puncture procedure free from overshadowing. This permits punctures of lesions located deep in the thorax or the abdomen which are overshadowed by the lungs, by air in the small or large bowel or by bone structures. Moreover, this technique yields much more information about the tissues and organs surrounding the suspected lesion. This information is much more investigator-related with ultrasoundguided puncture. Therefore, the CT-guided puncture has become mandatory in the evaluation of suspected lesions. Moreover, using the same technique, percutaneous drainage of fluids in the interpleural space, abscesses in organs, hematomas, lymphoceles and urinomas; ablation of metastases; and sympathicolysis can be carried out. CT-guided puncture thus changes from a minimally invasive diagnostic procedure to a minimally invasive therapy. (orig./MG) [de

  10. Percutaneous Management of Postoperative Duodenal Stump Leakage with Foley Catheter

    International Nuclear Information System (INIS)

    Oh, Jung Suk; Lee, Hae Giu; Chun, Ho Jong; Choi, Byung Gil; Lee, Sang Hoon; Hahn, Seong Tai; Ohm, Joon Young

    2013-01-01

    Purpose: This study was designed to evaluate retrospectively the safety and efficacy of the percutaneous management of duodenal stump leakage with a Foley catheter after subtotal gastrectomy. Methods: Ten consecutive patients (M:F = 9:1, median age: 64 years) were included in this retrospective study. The duodenal stump leakages were diagnosed in all the patients within a median of 10 days (range, 6–20). At first, the patients underwent percutaneous drainage on the day of or the day after confirmation of the presence of duodenal stump leakage, and then the Foley catheters were replaced at a median of 9 days (range, 6–38) after the percutaneous drainage. Results: Foley catheters were placed successfully in the duodenal lumen of all the patients under a fluoroscopic guide. No complication was observed during and after the procedures in all the patients. All of the patients started a regular diet 1 day after the Foley catheter placement. The patients were discharged at a median of 7 days (range, 5–14) after the Foley catheter placement. The catheters were removed in an outpatient clinic 10–58 days (median, 28) after the Foley catheter placement. Conclusions: Fluoroscopy-guided percutaneous Foley catheter placement may be a safe and effective treatment option for postoperative duodenal stump leakage and may allow for shorter hospital stays, earlier oral intake, and more effective control of leakage sites

  11. CT-guided injection of botulinic toxin for percutaneous therapy of piriformis muscle syndrome with preliminary MRI results about denervative process

    Energy Technology Data Exchange (ETDEWEB)

    Fanucci, E.; Masala, S.; Sodani, G.; Varrucciu, V.; Romagnoli, A.; Squillaci, E.; Simonetti, G. [Dept. of Radiology, Univ. of Rome (Italy)

    2001-12-01

    Piriformis muscle syndrome (PMS) is a cause of sciatica, leg or buttock pain and disability. The pain is usually increased by muscular contraction, palpation or prolonged sitting. The aim of our paper was to evaluate the feasibility of CT-guided percutaneous botulinic toxin (BTX) injection for the purpose of PMS treatment. Thirty patients suffering from PMS, suspected with clinical and electrophysiological criteria, after imaging examinations excluding other causes of sciatic pain, resulted positive at the lidocaine test and were treated by intramuscular injection of BTX type A under CT guidance. The follow-up (12 months) was performed with clinical examination in all cases and with MR 3 months after the procedure in 9 patients to evaluate the denervative process entity of the treated muscle. In 26 cases relief of symptoms was obtained after 5-7 days. In 4 patients an insufficient relief of pain justified a second percutaneous treatment which was clinically successful. No complications or side effects were recorded after BTX injection. The MR examination showed a signal intensity change of the treated muscle in 7 patients due to the denervative process of PM, whereas in the remaining 2 cases only an atrophy of the treated muscle was detected. Larger series are necessary to confirm these MRI preliminary results. The CT-guided BTX injection in the PMS is an emergent and feasible technique that obtains an excellent local therapeutic effect without risk of imprecise inoculation. (orig.)

  12. Application of Real-Time 3D Navigation System in CT-Guided Percutaneous Interventional Procedures: A Feasibility Study

    Directory of Open Access Journals (Sweden)

    Priya Bhattacharji

    2017-01-01

    Full Text Available Introduction. To evaluate the accuracy of a quantitative 3D navigation system for CT-guided interventional procedures in a two-part study. Materials and Methods. Twenty-two procedures were performed in abdominal and thoracic phantoms. Accuracies of the 3D anatomy map registration and navigation were evaluated. Time used for the navigated procedures was recorded. In the IRB approved clinical evaluation, 21 patients scheduled for CT-guided thoracic and hepatic biopsy and ablations were recruited. CT-guided procedures were performed without following the 3D navigation display. Accuracy of navigation as well as workflow fitness of the system was evaluated. Results. In phantoms, the average 3D anatomy map registration error was 1.79 mm. The average navigated needle placement accuracy for one-pass and two-pass procedures, respectively, was 2.0±0.7 mm and 2.8±1.1 mm in the liver and 2.7±1.7 mm and 3.0±1.4 mm in the lung. The average accuracy of the 3D navigation system in human subjects was 4.6 mm ± 3.1 for all procedures. The system fits the existing workflow of CT-guided interventions with minimum impact. Conclusion. A 3D navigation system can be performed along the existing workflow and has the potential to navigate precision needle placement in CT-guided interventional procedures.

  13. CT-guided percutaneous vertebroplasty combined with 125I-seed implantation for metastatic vertebral carcinoma involving the spinal canal: analysis of 23 cases

    International Nuclear Information System (INIS)

    Xie Xiaoxi; Lu Yinxiang; Ji Yong; Wang Xiaowei; Zhang Guodong

    2014-01-01

    Objective: To evaluate the safety and efficacy of CT-guided percutaneous vertebroplasty (PVP) combined with 125 I-seed implantation for the treatment of metastatic vertebral carcinoma involving the spinal canal. Methods: A total of 28 involved vertebrae were detected in 23 patients with metastatic vertebral carcinoma. Each patient had 1-2 diseased vertebrae. The lesions included cervical vertebra (n=4), thoracic vertebra (n=13) and lumbar vertebra (n=11). Destroyed posterior vertebral wall was seen in all involved vertebrae. Thirteen vertebrae found in 12 patients showed involvement of the epidural space. According to treatment planning system (TPS) CT-guided implantation of 125 I seeds was carried out first for cervical lesions, which was followed by PVP. For the thoracic and lumbar lesions, unilateral or bilateral puncturing with several particle needles was employed to implant the 125 I seeds, then, PVP with bone cement injection was performed. The complications and the clinical efficacy were analyzed. Results: Successful operation was obtained in all patients. The number of implanted 125 I seeds ranged from 4 to 30 per vertebra, and the volume of injected bone cement was 1-6 ml per vertebra. After the operation the pain relief rate was 86.9% (n=20). The incidence of bone cement leakage was 17.8% (5/28). One patient had radicular pain caused by neuropore leakage, which was relieved after medication. No serious complications, such as spinal cord injury or radiation myelitis, occurred. Conclusion: CT-guided PVP combined with 125 I-seed implantation is effective and safe for the treatment of metastatic vertebral carcinoma involving the spinal canal. This therapy can effectively relieve the pain and control the deterioration of tumor, besides, the incidence of bone cement leakage is very low. (authors)

  14. PET/CT-guided percutaneous liver mass biopsies and ablations: Targeting accuracy of a single 20 s breath-hold PET acquisition

    International Nuclear Information System (INIS)

    Shyn, P.B.; Tatli, S.; Sahni, V.A.; Sadow, C.A.; Forgione, K.; Mauri, G.; Morrison, P.R.; Catalano, P.J.; Silverman, S.G.

    2014-01-01

    Aim: To determine whether a single 20 s breath-hold positron-emission tomography (PET) acquisition obtained during combined PET/computed tomography (CT)-guided percutaneous liver biopsy or ablation procedures has the potential to target 2-[ 18 F]-fluoro-2-deoxy-D-glucose (FDG)-avid liver masses as accurately as up to 180 s breath-hold PET acquisitions. Materials and methods: This retrospective study included 10 adult patients with 13 liver masses who underwent FDG PET/CT-guided percutaneous biopsies (n = 5) or ablations (n = 5). PET was acquired as nine sequential 20 s, monitored, same-level breath-hold frames and CT was acquired in one monitored breath-hold. Twenty, 40, 60, and 180 s PET datasets were reconstructed. Two blinded readers marked tumour centres on randomized PET and CT datasets. Three-dimensional spatial localization differences between PET datasets and either 180 s PET or CT were analysed using multiple regression analyses. Statistical tests were two-sided and p < 0.05 was considered significant. Results: Targeting differences between 20 s PET and 180 s PET ranged from 0.7–20.3 mm (mean 5.3 ± 4.4 mm; median 4.3) and were not statistically different from 40 or 60 s PET (p = 0.74 and 0.91, respectively). Targeting differences between 20 s PET and CT ranged from 1.4–36 mm (mean 9.6 ± 7.1 mm; median 8.2 mm) and were not statistically different from 40, 60, or 180 s PET (p = 0.84, 0.77, and 0.35, respectively). Conclusion: Single 20 s breath-hold PET acquisitions from PET/CT-guided percutaneous liver procedures have the potential to target FDG-avid liver masses with equivalent accuracy to 180 s summed, breath-hold PET acquisitions and may facilitate strategies that improve image registration and shorten procedure times

  15. The side effects and complications of percutaneous iodine-125 seeds implantation under CT-guide for patients with advanced pancreatic cancer.

    Science.gov (United States)

    Lv, Wei-Fu; Lu, Dong; Xiao, Jing-Kun; Mukhiya, Gauri; Tan, Zhong-Xiao; Cheng, De-Lei; Zhou, Chun-Ze; Zhang, Xing-Min; Zhang, Zheng-Feng; Hou, Chang-Long

    2017-12-01

    The present study investigates the side effects and complications of computed tomography (CT)-guided percutaneous iodine-125 (I-125) seeds implantation for advanced pancreatic cancer. The clinical data were retrospectively analyzed for patients treated with implantation of I-125 seeds under CT-guide in our hospital from May 2010 to April 2015. The side effects and complications were collected and their possible reasons were analyzed. A total of 78 patients were enrolled. The side effects were categorized as fever in 29 cases (37.18%), abdominal pain in 26 cases (33.33%), nausea and vomiting in 9 cases (11.54%), diarrhea in 5 cases (6.41%), and constipation in 4 cases (5.13%). Complications were composed of pancreatitis in 9 cases (11.54%), infection in 5 cases (6.41%), seed migration in 2 cases (2.56%), intestinal perforation in 1 case (1.28%), and intestinal obstruction in 1 case. The incidence of complication was 23.08% (18/78). The difference in incidence of complication was statistically significant between patients implanted with ≤27 seeds and those with >27 seeds (P = .032). The side effects and complications frequently occur in implantation of I-125 seeds for patients with advanced pancreatic cancer. More concern should be given to the patients treated by this technique. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  16. CT-guided percutaneous laser disc decompression with Ceralas D, a diode laser with 980-nm wavelength and 200-μm fiber optics

    International Nuclear Information System (INIS)

    Gevargez, A.; Groenemeyer, D.W.H.; Czerwinski, F.

    2000-01-01

    The aim of this study was to evaluate the compact, portable Ceralas-D diode laser (CeramOptec; 980+30 nm wavelength, 200-μm optical fiber) concerning clinical usefulness, handling, and clinical results in the CT-guided treatment of herniated lumbar discs. The positioning of the canula in intradiscal space, the placement of the laser fiber into the disc through the lying canula, and the vaporization itself were carried out under CT-guidance. Due to the thin fiber optic, it was possible to use a thin 23-gauge canula. The laser procedure was performed in 0.1- to 1-s shots with 1-s pulse pause and 4-W power output. A total of 1650-2300 J was applied on each percutaneous laser disc decompression (PLDD). Results in 26 patients were established with a visual-analogue scale (VAS). On the follow-up examinations, 46% of the patients were absolutely pain free (>85% VAS) and fully active in everyday life after 4 postoperative weeks. Thirty-one percent of patients were relieved of the leg pain but had occasional back pain without sensorimotor impairment. Fifteen percent sensed a slight alleviation (>50% VAS) of the radiate pain. Eight percent did not experience radicular or pseudo-radicular pain alleviation (<25% VAS). Cerales-D proves to be an efficient tool for CT-guided PLDD on non-sequestered herniated lumbar discs. (orig.)

  17. CT-guided percutaneous core needle biopsy in deep seated musculoskeletal lesions: a prospective study of 128 cases

    International Nuclear Information System (INIS)

    Puri, A.; Shingade, V.U.; Agarwal, M.G.; Anchan, C.; Juvekar, S.; Desai, S.; Jambhekar, N.A.

    2006-01-01

    Although large lesions of the limbs can easily be biopsied without image guidance, lesions in the spine, paraspinal area and pelvis are difficult to target, and benefit from CT guidance to improve the accuracy of targeting the lesion for biopsy purposes. A prospective study of CT-guided core needle biopsies for deep-seated musculoskeletal lesions was conducted at a referral cancer institute over a 4-year period with the aim of assessing the safety and efficacy of the procedure. From January 2000 to December 2003, 136 consecutive CT-guided biopsy sessions were undertaken for musculoskeletal lesions in 128 patients comprising 73 males and 55 females. The following data was recorded in all patients: demographic data, suspected clinicoradiological diagnosis, data related to core biopsy session (date, site, approach, total time required in minutes, number of cores, surgeon satisfaction with adequacy of cores), patient discomfort, complications, histopathology report and number of further sessions if material obtained during the first biopsy session was not confirmatory. The sample obtained during the biopsy session was considered inconclusive if, in the opinion of the pathologist, inadequate or non-representative tissue had been obtained. The diagnosis was considered inaccurate if the final histopathological diagnosis did not match with the biopsy diagnosis, or if subsequent clinicoradiological evaluation at follow up did not correlate with the biopsy diagnosis in those patients who were treated with modalities other than surgery. In 121 patients, a single session was sufficient to obtain representative material, whilst for six patients two sessions, and for one patient three sessions were necessary. The time taken for biopsy, including the pre-biopsy CT examination time, varied from 15 min to 60 min (median 30 min). For 110 bony lesions 116 sessions were required, and for 18 soft-tissue lesions 20 sessions were required. 108 biopsy sessions yielded a diagnosis, whilst

  18. Dosimetric impact of interfraction catheter movement and organ motion on MRI/CT guided HDR interstitial brachytherapy for gynecologic cancer

    International Nuclear Information System (INIS)

    Rey, Felipe; Chang, Chang; Mesina, Carmen; Dixit, Nayha; Kevin Teo, Boon-Keng; Lin, Lilie L.

    2013-01-01

    Purpose: To determine the dosimetric impact of catheter movement for MRI/CT image guided high dose rate (HDR) interstitial brachytherapy (ISBT) for gynecologic cancers. Materials and methods: Ten patients were treated with HDR ISBT. The CTV and organs at risk were contoured using a postimplant MRI and CT. 5 fractions were delivered twice daily on 3 consecutive days. The first fraction was delivered on day 1 (d1), fraction 2–3 on d2 and fraction 4–5 on d3. MRI/CT was acquired prior to the second and fourth fractions. Four scenarios were modeled. (1) The d1 plan was applied to the d2 and d3 CT, using the updated catheter positions. (2) Replanning was performed for d2 and d3. (3) We applied the dwell positions/times from the d2 replan over the d3 CT and compared with a d3 CT replan. (4) Based on daily MRI, target volumes were recontoured and replanned. Dosimetry was analyzed for each plan and compared to the d1 dose distribution. Results: (1) When using the d1 plan on the d2 and d3 CT with the updated catheter positions, the mean CTV D90 was reduced from 93.4% on d1 to 89.3% (p = 0.08) on d2 and to 87.7% (p = 0.005) on d3. (2) Replanning on d2 and d3 compensated for catheter movement, mean CTV D90 of 95.4% on d2 and 94.6% (p = 0.36) on d3. (3) When compared to the replan of d2 applied on the d3 CT vs the d3 replan, there was no significant difference in coverage, mean CTV D90 of 90.9% (p = 0.09). (4) Reoptimization based on daily MRI, significantly improved the CTV coverage for each day. The mean D2 cc for the rectum was significantly higher with model 1 vs model 3 59.1 ± 4.7 vs 60.9 ± 4.8 (p = 0.04) Gy EQD2. There were no significant differences in D2 cc of bladder and sigmoid between models. Conclusions: Interfraction dosimetric changes significantly decreased the CTV coverage of the third day. Rather than replanning on each day, replanning on the day 2 CT before the second or third fraction would give an optimal solution that would compensate for

  19. Influence able and Avoidable Risk Factors for Systemic Air Embolism due to Percutaneous CT-Guided Lung Biopsy: Patient Positioning and Coaxial Biopsy Technique-Case Report, Systematic Literature Review, and a Technical Note

    International Nuclear Information System (INIS)

    Rott, G.; Boecker, F.

    2014-01-01

    Following the first case of a systemic air embolism due to percutaneous CT-guided lung biopsy in our clinic we analysed the literature regarding this matter in view of influence able or avoidable risk factors. A systematic review of literature reporting cases of systemic air embolism due to CT-guided lung biopsy was performed to find out whether prone positioning might be a risk factor regarding this issue. In addition, a technical note concerning coaxial biopsy practice is presented. Prone position seems to have relevance for the development and/or clinical manifestation of air embolism due to CT-guided lung biopsy and should be considered a risk factor, at least as far as lesions in the lower parts of the lung are concerned. Biopsies of small or cavitary lesions in coaxial technique should be performed using a hemo static valve.

  20. CT-guided percutaneous screw fixation plus cementoplasty in the treatment of painful bone metastases with fractures or a high risk of pathological fracture

    Energy Technology Data Exchange (ETDEWEB)

    Pusceddu, Claudio; Ballicu, Nicola; Fele, Rosa Maria; Sotgia, Barbara; Melis, Luca [Oncological Hospital ' ' A. Businco' ' , Regional Referral Center for Oncologic Diseases, Division of Interventional Radiology, Department of Oncological Radiology, Cagliari (Italy); Fancellu, Alessandro [University of Sassari, Department of Clinical and Experimental Medicine, Sassari (Italy)

    2017-04-15

    To evaluate the feasibility and effectiveness of computed tomography (CT)-guided percutaneous screw fixation plus cementoplasty (PSFPC), for either treatment of painful metastatic fractures or prevention of pathological fractures, in patients who are not candidates for surgical stabilization. Twenty-seven patients with 34 metastatic bone lesions underwent CT-guided PSFPC. Bone metastases were located in the vertebral column, femur, and pelvis. The primary end point was the evaluation of feasibility and complications of the procedure, in addition to the length of hospital stay. Pain severity was estimated before treatment and 1 and 6 months after the procedure using the visual analog scale (VAS). Functional outcome was assessed by improved patient walking ability. All sessions were completed and well tolerated. There were no complications related to either incorrect positioning of the screws during bone fixation or leakage of cement. All patients were able to walk within 6 h after the procedure and the average length of hospital stay was 2 days. The mean VAS score decreased from 7.1 (range, 4-9) before treatment to 1.6 (range, 0-6), 1 month after treatment, and to 1.4 (range 0-6) 6 months after treatment. Neither loosening of the screws nor additional bone fractures occurred during a median follow-up of 6 months. Our results suggest that PSFPC might be a safe and effective procedure that allows the stabilization of the fracture and the prevention of pathological fractures with significant pain relief and good recovery of walking ability, although further studies are required to confirm this preliminary experience. (orig.)

  1. Graphics Processing Unit-Accelerated Nonrigid Registration of MR Images to CT Images During CT-Guided Percutaneous Liver Tumor Ablations.

    Science.gov (United States)

    Tokuda, Junichi; Plishker, William; Torabi, Meysam; Olubiyi, Olutayo I; Zaki, George; Tatli, Servet; Silverman, Stuart G; Shekher, Raj; Hata, Nobuhiko

    2015-06-01

    Accuracy and speed are essential for the intraprocedural nonrigid magnetic resonance (MR) to computed tomography (CT) image registration in the assessment of tumor margins during CT-guided liver tumor ablations. Although both accuracy and speed can be improved by limiting the registration to a region of interest (ROI), manual contouring of the ROI prolongs the registration process substantially. To achieve accurate and fast registration without the use of an ROI, we combined a nonrigid registration technique on the basis of volume subdivision with hardware acceleration using a graphics processing unit (GPU). We compared the registration accuracy and processing time of GPU-accelerated volume subdivision-based nonrigid registration technique to the conventional nonrigid B-spline registration technique. Fourteen image data sets of preprocedural MR and intraprocedural CT images for percutaneous CT-guided liver tumor ablations were obtained. Each set of images was registered using the GPU-accelerated volume subdivision technique and the B-spline technique. Manual contouring of ROI was used only for the B-spline technique. Registration accuracies (Dice similarity coefficient [DSC] and 95% Hausdorff distance [HD]) and total processing time including contouring of ROIs and computation were compared using a paired Student t test. Accuracies of the GPU-accelerated registrations and B-spline registrations, respectively, were 88.3 ± 3.7% versus 89.3 ± 4.9% (P = .41) for DSC and 13.1 ± 5.2 versus 11.4 ± 6.3 mm (P = .15) for HD. Total processing time of the GPU-accelerated registration and B-spline registration techniques was 88 ± 14 versus 557 ± 116 seconds (P processing time. The GPU-accelerated volume subdivision technique may enable the implementation of nonrigid registration into routine clinical practice. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  2. Percutaneous catheter drainage of pancreatic pseudocysts

    International Nuclear Information System (INIS)

    Karnel, F.; Gebauer, A.; Jantsch, H.; Prayer, L.; Schurawitzki, H.; Feil, W.

    1991-01-01

    The results of CT/US-guided percutaneous drainage in 35 patients with pancreatic pseudocysts are reported. 27 patients recovered without surgery and no further treatment was required. 8 patients required a subsequent surgery due to recurrence. The role of CT/US-guided percutaneous drainage in pancreatic pseudocysts as well as an analysis of the technical aspects associated with a successful procedure are discussed. Although US may be used, we believe CT is safer and allows more precise localisation and guidance in the treatment of pseudocysts. (orig.) [de

  3. CT-Guided Microwave Ablation of 45 Renal Tumors: Analysis of Procedure Complexity Utilizing a Percutaneous Renal Ablation Complexity Scoring System.

    Science.gov (United States)

    Mansilla, Alberto V; Bivins, Eugene E; Contreras, Francisco; Hernandez, Manuel A; Kohler, Nathan; Pepe, Julie W

    2017-02-01

    To develop a scoring system that stratifies complexity of percutaneous ablation of renal tumors. Analysis was performed of 36 consecutive patients (mean age, 64 y; range, 30-89 y) who underwent CT-guided microwave (MW) ablation of 45 renal tumors (mean tumor diameter, 2.4 cm; range, 1.2-4.0 cm). Technical success and effectiveness were determined based on intraprocedural and follow-up imaging studies. The RENAL score and the proposed percutaneous renal ablation complexity (P-RAC) score were calculated for each tumor. Technical success was 93.3% (n = 42). Biopsy of 38 of 45 renal tumors revealed 23 renal cell carcinomas. Median follow-up period was 9.7 months (range, 2.9-46.8 months). There were no tumor recurrences. One major complication, ureteropelvic junction stricture, occurred (2.6%). The P-RAC score was found to differ statistically from the RENAL score (t = 3.754, df = 44, P = .001). A positive correlation was found between the P-RAC score and number of antenna insertions (r = .378, n = 45, P = .011) and procedure duration (r = .328, n = 45, P = .028). No correlation was found between the RENAL score and number of MW antenna insertions (r = .110, n = 45, P = .472) or procedure duration (r = .263, n = 45, P = .081). Hydrodissection was significantly more common in the P-RAC high-complexity category than in low-complexity category (χ 2 = 12.073, df = 2, P = .002). The P-RAC score may be useful in stratifying percutaneous renal ablation complexity. Further studies with larger sample sizes are necessary to validate the P-RAC score and to determine if it can predict risk of complications. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

  4. Pathologic fracture through a unicameral bone cyst of the pelvis: CT-guided percutaneous curettage, biopsy, and bone matrix injection.

    Science.gov (United States)

    Tynan, Jennifer R; Schachar, Norman S; Marshall, Geoffrey B; Gray, Robin R

    2005-02-01

    Unicameral bone cysts of the pelvis are extremely rare. A 19-year old man presented with a pathologic fracture through a pelvic unicameral bone cyst. He was treated with computed tomography-guided percutaneous curettage, biopsy, and demineralized bone matrix injection. Treatment has proven successful in short-term follow-up.

  5. PET/CT-guided percutaneous biopsy of FDG-avid metastatic bone lesions in patients with advanced lung cancer: a safe and effective technique

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Wei; Hao, Bing; Chen, Hao-jun; Zhao, Long; Luo, Zuo-ming; Wu, Hua; Sun, Long [The First Affiliated Hospital of Xiamen University, Department of Nuclear Medicine and Minnan PET Center, Xiamen Cancer Hospital, Xiamen (China)

    2017-01-15

    {sup 18}F-FDG PET/CT should be performed before a diagnostic biopsy site is chosen in patients with a high clinical suspicion of aggressive, advanced tumour. The aim of this study was to evaluate the safety and efficacy of {sup 18}F-FDG PET/CT in guiding biopsy of bone metastases in patients with advanced lung cancer. PET/CT-guided percutaneous core biopsies were performed in 51 consecutive patients with suspected lung cancer and {sup 18}F-FDG-avid bone lesions after whole-body {sup 18}F-FDG PET/CT scans. Generally, one tissue sample was obtained from each patient. The final diagnoses were established on the basis of the histology results. The histopathological and molecular testing results were systematically evaluated. A total of 53 samples were obtained for histological examination or molecular testing as a second biopsy was required in two patients in whom the pathological diagnosis was unclear following the first biopsy. The pathological diagnosis and lung cancer classification were confirmed in 48 patients. The epidermal growth factor receptor mutation status was determined in 23 biopsies, and the mutation rate was 30.4 % (7/23). The anaplastic lymphoma kinase mutation status was determined in 19 biopsies, and the mutation rate was 31.6 % (6/19). Two of the 51 biopsies were positive for non-Hodgkin's lymphoma and one was positive for metastatic renal cell carcinoma. The first-time diagnostic success rate of biopsy was 96.1 % (49/51) and the overall diagnostic success rate and sensitivity were 100 %. All 51 patients were eventually confirmed as having stage IV disease. No serious complications were encountered and the average biopsy time was 30 min. PET/CT-guided percutaneous biopsy of {sup 18}F-FDG-avid bone metastases is an effective and safe method that yields a high diagnostic success rate in the evaluation of hypermetabolic bone lesions in patients with suspected advanced lung cancer. (orig.)

  6. CT-guided brachytherapy. A novel percutaneous technique for interstitial ablation of liver malignancies; CT-gesteuerte Brachytherapie. Eine neue perkutane Technik zur interstitiellen Ablation von Lebermetastasen

    Energy Technology Data Exchange (ETDEWEB)

    Ricke, J.; Wust, P.; Stohlmann, A.; Beck, A.; Cho, C.H.; Pech, M.; Wieners, G.; Spors, B.; Werk, M.; Rosner, C.; Haenninen, E.L.; Felix, R. [Klinik fuer Strahlenheilkunde, Charite Virchow-Klinikum, Humboldt-Univ. zu Berlin (Germany)

    2004-05-01

    Purpose: to assess safety and efficacy of CT-guided brachytherapy of liver malignancies. Patients and methods: 21 patients with 21 liver malignancies (19 metastases, two primary liver tumors) were treated with interstitial CT-guided brachytherapy applying a {sup 192}Ir source. In all patients, the use of image-guided thermal tumor ablation such as by radiofrequency or laser-induced thermotherapy (LITT) was impeded either by tumor size {>=} 5 cm in seven, adjacent portal or hepatic vein in ten, or adjacent bile duct bifurcation in four patients. Dosimetry was performed using three-dimensional CT data sets acquired after CT-guided positioning of the brachytherapy catheters. Results: the mean tumor diameter was 4.6 cm (2.5-11 cm). The mean minimal tumor dose inside the tumor margin amounted to 17 Gy (12-20 Gy). The proportion of the liver parenchyma exposed to > 5 gy was 18% (5-39%) of total liver parenchyma minus tumor volume. Nausea and vomiting were observed in six patients after brachytherapy (28%). One patient demonstrated obstructive jaundice due to tumor edema after irradiation of a metastasis adjacent to the bile duct bifurcation. We commonly encountered asymptomatic increases of liver enzymes. Local control rates after 6 and 12 months were 87% and 70%, respectively. Conclusion: CT-guided brachytherapy is safe and effective. This technique displays broader indications compared to image-guided thermal ablation by radiofrequency or LITT with respect to tumor size or localization. (orig.) [German] Ziel: Analyse der Sicherheit und Effektivitaet CT-gesteuerter Brachytherapie zur Ablation von Lebermalignomen. Patienten und Methodik: 21 Patienten mit 21 Lebermalignomen (19 Metastasen, zwei primaere Lebermalignome) wurden mit perkutaner, CT-gesteuerter interstitieller Brachytherapie mit {sup 192}Ir behandelt. Alle Patienten wiesen Umstaende auf, die eine bildgefuehrte thermische Ablation mit Radiofrequenz oder laserinduzierter Thermotherapie (LITT) einschraenkten

  7. Major complications of high-energy microwave ablation for percutaneous CT-guided treatment of lung malignancies: single-centre experience after 4 years

    International Nuclear Information System (INIS)

    Splatt, Alexander M.; Steinke, Karin

    2015-01-01

    To evaluate the rate of major complications related to percutaneous computed tomography (CT)-guided microwave ablation (MWA) of primary and secondary lung malignancies performed at our institution over a 4-year period. From May 2010 to September 2014, 70 MWAs were performed on 51 patients. All major intra- and post-procedural complications (as defined by the classification proposed by the Society of Interventional Radiology) were retrospectively analysed. The results were correlated with a systematic review of the available literature on MWA in the lung. Major complications were encountered in 14 out of 70 ablations (20%). Twenty-one separate major complications were encountered (some ablations lead to more than one major complication). One death occurred within 30 days of ablation, though the relationship to the procedure remains uncertain. Other major complications included: nine pneumothoraces requiring drain insertion (12.9%), four cases of large effusion requiring drainage (5.7%), two cases of significant pulmonary haemorrhage altering clinical management (2.9%), two infections (2.9%), one case of mechanical failure (1.4%), one chest wall burn (1.4%) and one case of pleural seeding (1.4%). Major complications were much more likely to occur if the nodule was located within 7 mm from the pleura. MWA of pulmonary tumours carries moderate risk; nevertheless, the usually manageable complications should not deter from undertaking a potentially curative therapy for poor surgical candidates.

  8. Transpulmonary CT-guided percutaneous ethanol injection therapy (CT-PEIT) for hepatocellular carcinoma located in the subphrenic region of liver

    International Nuclear Information System (INIS)

    Ueda, Kazushige; Ohkawara, Tohru; Minami, Masahito; Sawa, Yoshihiko; Morinaga, Osamu; Kohli, Yoshihiro; Ohkawara, Yasuo

    2000-01-01

    The purpose of this study is to evaluate the feasibility of transpulmonary CT-guided percutaneous ethanol injection therapy (CT-PEIT) for hepatocellular carcinoma (HCC, 15 lesions) located in the subphrenic region and untreatable by ultrasonography-guided PEIT. The HCC was localized on Lipiodol CT image with a graduated grid system. We advanced a PEIT needle in a stepwise fashion, perpendicularly to the major axis of body through the lung with intermittent localization scans to position the tip of the needle in the lesion. Ethanol was injected with monitoring scans obtained after incremental volumes of injection, until perfusion was judged to be complete. A total of 20 CT-PEIT sessions were performed. The average number of needles passed from skin to liver in each CT-PEIT session was 2.7, the average volume of ethanol injected was 11.7 ml, and the average time required was 53.6 minutes. Complete perfusion of the lesion by ethanol was achieved in all lesions with only a single or double CT-PEIT procedure without severe complications. Local recurrence was detected in 3 to 15 followed up lesions for 14 months on average. In conclusion, transpulmonary CT-PEIT should prove to be a feasible, acceptable treatment for challenging cases of HCC located in the subphrenic region. (author)

  9. Percutaneous placement of peritoneal port-catheter in oncologic patients

    International Nuclear Information System (INIS)

    Orsi, Franco; Vigna, Paolo Della; Bonomo, Guido; Penco, Silvia; Lovati, Elena; Bellomi, Massimo

    2004-01-01

    The aim of this paper is to describe the technique of percutaneous ultrasound (US)-guided placement of a peritoneal port-catheter in an interventional radiological setting. Nineteen patients with peritoneal carcinomatosis were selected for intraperitoneal port-catheter placement in order to perform intracavitary receptor-immuno- or radio-immunotherapy with Ytrium-90. All the procedures were performed percutaneously under US and fluoro guidance; the insertion site for catheters was chosen according to abdominal conditions and US findings: all devices were implanted at the lower abdominal quadrants. All patients were followed up with CT and US according to the therapy protocol. The procedure was successfully completed in 15/19 patients, in 4 being contraindicated by peritoneal adhesions. No procedure-related complications and device occlusions during therapy were observed; one catheter displaced 7 months later the placement. In our experience, this procedure was feasible, reliable and easy to perform, allowing the correct administration of the planned intracavitary therapy. Peritoneal adhesions are the main limitation of peritoneal port placement. (orig.)

  10. Evaluation of the safety of latrogenic lntestinal perforation during placement of percutaneous drainage catheter in rabbit

    International Nuclear Information System (INIS)

    Lee, Choon Hyeong; Oh, Joo Hyung; Park, Ga Young; Shin, Hong Sub; Kim, In Sub; Yoon, Yup; Lee, Dong Ho; Ko, Young Tae; Choi, Woo Suk; Lim, Joo Won

    1996-01-01

    To evaluate the safety of transgression of the bowel during intraperitoneal percutaneous catheter placement in an animal model. Eight 8-F straight catheters were percutaneously inserted into the small and large bowel of eight rabbits. In four animals, the catheters were left in place until autopsy, whereas in the remaining four, the catheters were withdrawn five days after insertion. Autopsy was performed in all animals ten days after catheter placement, and gross and microscopic examination was carried out. Transgressing the bowel during intraperitoneal percutaneous catheter placement did not contribute to any clinically significant complications. At autopsy, there was no bowel leakage, peritonitis, or abscess, although peritoneal adhesions were found around the catheter tract. Although further study is warranted, our study with an animal model indicated that transgression of the intestine during percutaneous placement of an intraabdominal catheter did not produce significant complications

  11. Evaluation of the safety of latrogenic lntestinal perforation during placement of percutaneous drainage catheter in rabbit

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Choon Hyeong; Oh, Joo Hyung; Park, Ga Young; Shin, Hong Sub; Kim, In Sub; Yoon, Yup; Lee, Dong Ho; Ko, Young Tae; Choi, Woo Suk; Lim, Joo Won [Kyunghee Univ. Hospital, Seoul (Korea, Republic of)

    1996-10-01

    To evaluate the safety of transgression of the bowel during intraperitoneal percutaneous catheter placement in an animal model. Eight 8-F straight catheters were percutaneously inserted into the small and large bowel of eight rabbits. In four animals, the catheters were left in place until autopsy, whereas in the remaining four, the catheters were withdrawn five days after insertion. Autopsy was performed in all animals ten days after catheter placement, and gross and microscopic examination was carried out. Transgressing the bowel during intraperitoneal percutaneous catheter placement did not contribute to any clinically significant complications. At autopsy, there was no bowel leakage, peritonitis, or abscess, although peritoneal adhesions were found around the catheter tract. Although further study is warranted, our study with an animal model indicated that transgression of the intestine during percutaneous placement of an intraabdominal catheter did not produce significant complications.

  12. Long-term results after CT-guided percutaneous ethanol ablation for the treatment of hyper functioning adrenal disorders

    International Nuclear Information System (INIS)

    Frenk, Nathan Elie; Sebastianes, Fernando; Lerario, Antonio Marcondes; Fragoso, Maria Candida Barisson Villares; Mendonca, Berenice Bilharinho

    2016-01-01

    Objectives: To evaluate the safety and long-term efficacy of computed tomography-guided percutaneous ethanol ablation for benign primary and secondary hyper functioning adrenal disorders. Method: We retrospectively evaluated the long-term results of nine patients treated with computed tomography guided percutaneous ethanol ablation: eight subjects who presented with primary adrenal disorders, such as pheochromocytoma, primary macro nodular adrenal hyperplasia and aldosterone-producing adenoma, and one subject with Cushing disease refractory to conventional treatment. Eleven sessions were performed for the nine patients. The patient data were reviewed for the clinical outcome and procedure-related complications over ten years. Results: Patients with aldosterone-producing adenoma had clinical improvement: symptoms recurred in one case 96 months after ethanol ablation, and the other patient was still in remission 110 months later. All patients with pheochromocytoma had clinical improvement but were eventually submitted to surgery for complete remission. No significant clinical improvement was seen in patients with hypercortisolism due to primary macro nodular adrenal hyperplasia or Cushing disease. Major complications were seen in five of the eleven procedures and included cardiovascular instability and myocardial infarction. Minor complications attributed to sedation were seen in two patients. Conclusion: Computed tomography-guided ethanol ablation does not appear to be suitable for the long-term treatment of hyper functioning adrenal disorders and is not without risks. (author)

  13. Long-term Results after CT-Guided Percutaneous Ethanol Ablation for the Treatment of Hyperfunctioning Adrenal Disorders

    Directory of Open Access Journals (Sweden)

    Nathan Elie Frenk

    Full Text Available OBJECTIVES: To evaluate the safety and long-term efficacy of computed tomography-guided percutaneous ethanol ablation for benign primary and secondary hyperfunctioning adrenal disorders. METHOD: We retrospectively evaluated the long-term results of nine patients treated with computed tomography-guided percutaneous ethanol ablation: eight subjects who presented with primary adrenal disorders, such as pheochromocytoma, primary macronodular adrenal hyperplasia and aldosterone-producing adenoma, and one subject with Cushing disease refractory to conventional treatment. Eleven sessions were performed for the nine patients. The patient data were reviewed for the clinical outcome and procedure-related complications over ten years. RESULTS: Patients with aldosterone-producing adenoma had clinical improvement: symptoms recurred in one case 96 months after ethanol ablation, and the other patient was still in remission 110 months later. All patients with pheochromocytoma had clinical improvement but were eventually submitted to surgery for complete remission. No significant clinical improvement was seen in patients with hypercortisolism due to primary macronodular adrenal hyperplasia or Cushing disease. Major complications were seen in five of the eleven procedures and included cardiovascular instability and myocardial infarction. Minor complications attributed to sedation were seen in two patients. CONCLUSION: Computed tomography-guided ethanol ablation does not appear to be suitable for the long-term treatment of hyperfunctioning adrenal disorders and is not without risks.

  14. Long-term results after CT-guided percutaneous ethanol ablation for the treatment of hyper functioning adrenal disorders

    Energy Technology Data Exchange (ETDEWEB)

    Frenk, Nathan Elie; Sebastianes, Fernando; Lerario, Antonio Marcondes; Fragoso, Maria Candida Barisson Villares; Mendonca, Berenice Bilharinho [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina; Menezes, Marcos Roberto de, E-mail: menezesmr@gmail.com [Instituto do Cancer do Estado de Sao Paulo, SP (Brazil)

    2016-10-15

    Objectives: To evaluate the safety and long-term efficacy of computed tomography-guided percutaneous ethanol ablation for benign primary and secondary hyper functioning adrenal disorders. Method: We retrospectively evaluated the long-term results of nine patients treated with computed tomography guided percutaneous ethanol ablation: eight subjects who presented with primary adrenal disorders, such as pheochromocytoma, primary macro nodular adrenal hyperplasia and aldosterone-producing adenoma, and one subject with Cushing disease refractory to conventional treatment. Eleven sessions were performed for the nine patients. The patient data were reviewed for the clinical outcome and procedure-related complications over ten years. Results: Patients with aldosterone-producing adenoma had clinical improvement: symptoms recurred in one case 96 months after ethanol ablation, and the other patient was still in remission 110 months later. All patients with pheochromocytoma had clinical improvement but were eventually submitted to surgery for complete remission. No significant clinical improvement was seen in patients with hypercortisolism due to primary macro nodular adrenal hyperplasia or Cushing disease. Major complications were seen in five of the eleven procedures and included cardiovascular instability and myocardial infarction. Minor complications attributed to sedation were seen in two patients. Conclusion: Computed tomography-guided ethanol ablation does not appear to be suitable for the long-term treatment of hyper functioning adrenal disorders and is not without risks. (author)

  15. Percutaneous CT-Guided Core Needle Biopsy Versus Fine Needle Aspiration in Diagnosing Pneumonia and Mimics of Pneumonia

    International Nuclear Information System (INIS)

    Thanos, Loukas; Galani, Panagiota; Mylona, Sophia; Pomoni, Maria; Mpatakis, Nikolaos

    2004-01-01

    The purpose of this study was to determine the diagnostic value of percutaneous core needle biopsy (CNB) relative to fine needle aspiration (FNA) in patients with pneumonia and pneumonia mimics. In this prospective study we present our experience with 48 thoracic FNAs and CNBs carried out on 48 patients with pneumonia and pneumonia mimics. Samples were obtained from all patients using both CNB (with an automated 18-G core biopsy needle and a gun) and FNA (with a 22-G needle). A specific diagnosis was made in 10/48 cases (20.83%) by FNA and in 42/48 (87.5%) by CNB. The main complications encountered were pneumothorax (n = 4) and hemoptysis (n = 2), yielding a total complication rate of 12.5%. We concluded that CNB using an automated biopsy gun results in a higher diagnostic accuracy for pneumonia and pneumonia mimic biopsies than FNA. Complications should be considered and proper patient observation should follow the procedure

  16. Percutaneous CT-guided high frequency induced thermotherapy as a treatment hepatocellular carcinoma and hepatic metastatic lesions

    International Nuclear Information System (INIS)

    Lu Ligong; Luo Pengfei; Chen Xiaoming

    2004-01-01

    Objective: To analyze the efficacy, side effects and complications of percutaneous high frequency induced thermotherapy (HiTT) performed under CT guidance involving 36 patients with hepatocellular carcinomas (HCC) and hepatic metastatic lesions. Methods: HiTT was performed in treatment of 36 patients (24 men and 12 women) with 42 hepatocellular carcinoma and hepatic metastatic carcinoma (six patient out of 36 had two nidi). The diameter of the tumors ranged from 1.6 to 7.8 cm (mean, 3.2 cm). The efficacy of HiTT was evaluated with triphasic spiral CT performed 1 month after the procedure. Results: The post-treatment CT scan showed complete necrosis in 33 nidi (78%) out of 42 nidi of hepatocellular carcinoma and hepatic metastatic carcinoma in 30 patients out of 36. Complete necrosis was obtained in 18 (95%) of 19 tumors no larger than 3 cm in diameter, 13 (72%) of 18 tumors between 3.0 and 5.0 cm in diameter. Eleven tumors showed incomplete necrosis. In our study, none of the patients experienced severe complications. All the patients are alive in the follow-up ranging from 2 to 12 months (mean, 7 months). Conclusion: Our research suggests that HiTT can be a safe and effective treatment of hepatocellular carcinomas and hepatic metastatic carcinoma when the lesion is no larger than 3 cm. The treatment is relatively effective for hepatocellular carcinoma between 3 and 5 cm in size. (authors)

  17. A New CT-Guided Modified Trocar Technique for Drainage of Difficult Locations Abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Tyng, Chiang J., E-mail: chiangjengtyng@gmail.com; Amoedo, Maurício K.; Bohrer, Yves; Bitencourt, Almir G. V.; Barbosa, Paula N. V.; Almeida, Maria Fernanda A.; Zurstrassen, Charles E. [AC Camargo Cancer Center, Department of Imaging (Brazil); Coimbra, Felipe J. F.; Costa, Wilson L. da [AC Camargo Cancer Center, Department of Abdominal Surgery (Brazil); Chojniak, Rubens [AC Camargo Cancer Center, Department of Imaging (Brazil)

    2017-05-15

    PurposeComputed tomography (CT) is commonly used to guide drainage of deep-seated abdominal fluid collections. However, in some cases, these collections seem to be inaccessible due to surrounding organs or their being in difficult locations. The aim of this study is to describe a modified Trocar technique to drain collections in difficult locations, especially those in the subphrenic space, without passing through intervening organs.Materials and MethodsThis retrospective case series study describes seven inpatients who underwent CT-guided drainage using a modified Trocar technique for abscesses that are difficult to access percutaneously. All patients provided written informed consent prior to the procedure. After placement of a 12–14F catheter inside the peritoneum, the Trocar stylet was removed so that the tip of the catheter became blunt and flexible to avoid injury to organs and structures in the catheter route, and the catheter was slowly advanced towards the collection using CT guidance and tactile sensation. After reaching the target, the stylet was reintroduced to enter the abscess wall.ResultsAll procedures were performed using an anterior abdominal wall access with adequate catheter positioning and resulted in clinical status improvement in the days after the drainage. No complications related to the procedure were identified in any of the patients.ConclusionsThe modified Trocar technique for percutaneous CT-guided drainage of abdominal abscesses may be feasible for lesions that are difficult to access with conventional methods.

  18. Fluoroscopy guided percutaneous catheter drainage of pneumothorax in good mid-term patency with tube drainage

    International Nuclear Information System (INIS)

    Park, Ga Young; Oh, Joo Hyung; Yoon, Yup; Sung, Dong Wook

    1995-01-01

    To evaluate efficacy and the safety of percutaneous catheter drainage in patients with pneumothorax that is difficult to treat with closed thoracotomy. We retrospectively reviewed effectiveness of percutaneous catheter drainage (PCD) in 10 patients with pneumothorax. The catheter was inserted under fluoroscopic guidance. Seven patients had spontaneous pneumothorax caused by tuberculosis (n =4), reptured bullae (n = 2), and histiocytosis-X (n = 1). Three patients had iatrogenic pneumothorax caused by trauma (n = 1) and surgery (n = 2). All procedures were performed by modified Seldinger's method by using 8F-20F catheter. All catheter were inserted successfully. In 9 of 10 patients, the procedure was curative without further therapy. Duration of catheter insertion ranged from 1 day to 26 days. In the remaining 1 patient in whom multiple pneumothorax occurred after operation, catheter insertion was performed twice. Percutaneous catheter drainage under fluoroscopic guidance is effective and safe procedure for treatment of pneumothorax in patients with failed closed thoracotomy

  19. Fluoroscopy guided percutaneous catheter drainage of pneumothorax in good mid-term patency with tube drainage

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ga Young; Oh, Joo Hyung; Yoon, Yup; Sung, Dong Wook [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1995-10-15

    To evaluate efficacy and the safety of percutaneous catheter drainage in patients with pneumothorax that is difficult to treat with closed thoracotomy. We retrospectively reviewed effectiveness of percutaneous catheter drainage (PCD) in 10 patients with pneumothorax. The catheter was inserted under fluoroscopic guidance. Seven patients had spontaneous pneumothorax caused by tuberculosis (n =4), reptured bullae (n = 2), and histiocytosis-X (n = 1). Three patients had iatrogenic pneumothorax caused by trauma (n = 1) and surgery (n = 2). All procedures were performed by modified Seldinger's method by using 8F-20F catheter. All catheter were inserted successfully. In 9 of 10 patients, the procedure was curative without further therapy. Duration of catheter insertion ranged from 1 day to 26 days. In the remaining 1 patient in whom multiple pneumothorax occurred after operation, catheter insertion was performed twice. Percutaneous catheter drainage under fluoroscopic guidance is effective and safe procedure for treatment of pneumothorax in patients with failed closed thoracotomy.

  20. Pleural fluid drainage: Percutaneous catheter drainage versus surgical chest tube drainage

    International Nuclear Information System (INIS)

    Illescas, F.F.; Reinhold, C.; Atri, M.; Bret, P.M.

    1987-01-01

    Over the past 4 years, 55 cases (one transudate, 28 exudates, and 26 empymas) were drained. Surgical chest tubes alone were used in 35 drainages, percutaneous catheters alone in five drainages, and both types in 15 drainages. Percutaneous catheter drainage was successful in 12 of 20 drainages (60%). Surgical tube drainage was successful in 18 of 50 drainages (36%). The success rate for the nonempyema group was 45% with both types of drainage. For the empyema group, the success rate for percutaneous catheter drainage was 66% vs 23% for surgical tube drainage. Seven major complications occurred with surgical tube drainage, but only one major complication occurred with percutaneous catheter drainage. Radiologically guided percutaneous catheter drainage should be the procedure of choice for pleural fluid drainage. It has a higher success rate for empyemas and is associated with less complications

  1. Concurrent use of pigtail and loop snare catheters for percutaneous retrieval of dislodged central venous port catheter

    Directory of Open Access Journals (Sweden)

    Ming-Tsung Chuang

    2011-11-01

    Full Text Available The purpose of this study was to report our experience of percutaneous retrieval of dislodged port catheters with concurrent use of pigtail and loop snare catheters. During a 5-year period at our institute (June 2005 to July 2010, a total of 23 dislodged port catheters were retrieved. The interval between port catheter implantation and dislodged catheter retrieval ranged from 43 days to 1,414 days (mean 586.7 days. The time of delayed retrieval ranged from 1 day to 45 days (mean 4.6 days. All dislodged catheters were retrieved with the concurrent use of pigtail and loop snare catheters via femoral venous route. The prevalence of port catheter dislodgement at our institute was 3.4%. All dislodged port catheters were removed successfully with pigtail and loop snare catheters together. No procedure-related complications were encountered, except for transient arrhythmia in two patients, which required no medication. In conclusion, the concurrent use of pigtail and loop snare catheters is a feasible and easy way for percutaneous retrieval of a dislodged central venous port catheter.

  2. CT-guided percutaneous neurolysis methods. State of the art and first results; CT-gesteuerte Neurolysen. Stand der Technik und aktuelle Ergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, B. [Abt. Radiodiagnostik, Radiologische Universitaetsklinik Heidelberg (Germany); Richter, G.M. [Abt. Radiodiagnostik, Radiologische Universitaetsklinik Heidelberg (Germany); Roeren, T. [Abt. Radiodiagnostik, Radiologische Universitaetsklinik Heidelberg (Germany); Kauffmann, G.W. [Abt. Radiodiagnostik, Radiologische Universitaetsklinik Heidelberg (Germany)

    1996-09-01

    We used 21G or 22G fine needles. All CT-guided percutaneous neurolysis methods require a proper blood coagulation. Most common CT scanners are suitable for neurolysis if there is enough room for maintaining sterile conditions. All neurolysis methods involve sterile puncture of the ganglia under local anesthesia, a test block with anesthetic and contrast agent to assess the clinical effect and the definitive block with a mixture of 96% ethanol and local anesthetic. This allows us to correct the position of the needle if we see improper distribution of the test block or unwanted side effects. Though inflammatory complications of the peritoneum due to puncture are rarely seen, we prefer the dorsal approach whenever possible. Results: Seven of 20 legs showed at least transient clinical improvement after CT-guided lumbar sympathectomies; 13 legs had to be amputated. Results of the methods in the literature differ. For lumbar sympathectomy, improved perfusion is reported in 39-89%, depending on the pre-selection of the patient group. Discussion: It was recently proved that sympathectomy not only improves perfusion of the skin but also of the muscle. The hypothesis of a steal effect after sympathectomy towards skin perfusion was disproved. Modern aggressive surgical and interventional treatment often leaves patients to sympathectomy whose reservers of collateralization are nearly exhausted. We presume this is the reason for the different results we found in our patient group. For thoracic sympathectomy the clinical treatment depends very much on the indications. Whereas palmar hyperhidrosis offers nearly 100% success, only 60-70% of patients with disturbance of perfusion have benefited. Results in celiac ganglia block also differ. Patients with carcinoma of the pancreas and other organs of the upper abdomen benefit in 80-100% of all cases, patients with chronic pancreatitis in 60-80%. (orig./VHE) [Deutsch] Thorakale und lumbale Sympathikolyse sowie die Zoeliakusblockade

  3. Removal of a Trapped Endoscopic Catheter from the Gallbladder via Percutaneous Transhepatic Cholecystostomy: Technical Innovation

    International Nuclear Information System (INIS)

    Stay, Rourke M.; Sonnenberg, Eric van; Goodacre, Brian W.; Ozkan, Orhan S.; Wittich, Gerhard R.

    2006-01-01

    Background. Percutaneous cholecystostomy is used for a variety of clinical problems. Methods. Percutaneous cholecystostomy was utilized in a novel setting to resolve a problematic endoscopic situation. Observations. Percutaneous cholecystostomy permitted successful removal of a broken and trapped endoscopic biliary catheter, in addition to helping treat cholecystitis. Conclusion. Another valuable use of percutaneous cholecystostomy is demonstrated, as well as emphasizing the importance of the interplay between endoscopists and interventional radiologists

  4. Percutaneous catheter drainage of empyema and loculated pleural effusion

    Energy Technology Data Exchange (ETDEWEB)

    Im, Jung Gi; Park, Kyung Joo; Park, Jae Hyung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1988-08-15

    Closed thoracotomy by using a chest tube in cases of thoracic empyema is known to be an effective and popular way of treatment. However, it happens commonly that chest tube drainage is not appropriate because of either malpositioning of the tube or undesirable patient's general condition such as bleeding tendency or debilitation. We performed fluoroscopy-guided percutaneous catheter drainage (PCD) in 14 cases of empyema and loculated pleural effusion and in 2 cases of lung abscess. In most of the patients, PCDs were performed because chest tube drainage was considered to be inappropriate or after failed chest tube drainage. In all patients, catheters were successfully placed into the fluid collections, which were drained effectively. Ten of the 11 febrile patient showed improvement of feverishness within 24 hours after PCD. 10 patients were cured without further treatment. Complications were few and minimal. We believe that the safety, effectiveness and good patients tolerance of PCD makes it an excellent alternative method of treatment in cases of empyema and loculated pleural effusion.

  5. Stabilization of a percutaneously implanted port catheter system for hepatic artery chemotherapy infusion

    International Nuclear Information System (INIS)

    Shindoh, Noboru; Ozaki, Yutaka; Kyogoku, Shinsuke; Yamana, Daigo; Sumi, Yukiharu; Katayama, Hitoshi

    1999-01-01

    A port catheter system for hepatic artery infusion chemotherapy was implanted percutaneously via the left subclavian artery in 41 patients for treatment of unresectable liver metastases. The catheter tip was inserted into the gastroduodenal artery (GDA), the end hole was occluded with a guidewire fragment, and a side-hole for infusion was positioned at the bifurcation of the proper hepatic artery and the GDA. The GDA was embolized with steel coils around the infusion catheter tip via a transfemoral catheter. This procedure is designed to reduce the incidence of hepatic artery occlusion and infusion catheter dislocation.

  6. Evaluation of percutaneous radiologic placement of peritoneal dialysis catheters: technical aspects, results, and complications

    International Nuclear Information System (INIS)

    Hong, Hyun Pyo; Oh, Joo Hyeong; Yoon, Yub; Lee, Tae Won; Ihm, Chun Gyoo

    2001-01-01

    To evaluate the technical aspects, results and complications of the percutaneous radiologic placement of peritoneal dialysis catheters. Between December 1999 and April 2001, 26 peritoneal dialysis catheters were placed percutaneously in 26 consecutive patients by interventional radiologists. The patient group consisted of 16 men and ten women with a mean age of 55 (range, 30-77) years. The results and complications arising were reviewed, and the expected patency of the catheters was determined by means of Kaplan-Meier survival analysis. The technical success rate for catheter placement was 100% (26/26 patients). Severe local bleeding occurred in one patient due to by inferior epigastric artery puncture, and was treated by compression and electronic cautery. The duration of catheter implantation ranged from 1 to 510 days and the patency rate was 416±45 days. Catheter malfunction occurred in four patients. In two, this was restored by manipulation in the intervention room, and in one, through the use of urokinase. In three patients, peritonitis occurred. Catheters were removed from four patients due to malfunction (n=2), peritonitis (n=1), and death (n=1). Percutaneous radiologic placement of a peritoneal dialysis catheter is a relatively simple procedure that reduces the complication rate and improves catheter patency

  7. Evaluation of percutaneous radiologic placement of peritoneal dialysis catheters: technical aspects, results, and complications

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Hyun Pyo; Oh, Joo Hyeong; Yoon, Yub; Lee, Tae Won; Ihm, Chun Gyoo [Kyunghee University Hospital, seoul (Korea, Republic of)

    2001-01-01

    To evaluate the technical aspects, results and complications of the percutaneous radiologic placement of peritoneal dialysis catheters. Between December 1999 and April 2001, 26 peritoneal dialysis catheters were placed percutaneously in 26 consecutive patients by interventional radiologists. The patient group consisted of 16 men and ten women with a mean age of 55 (range, 30-77) years. The results and complications arising were reviewed, and the expected patency of the catheters was determined by means of Kaplan-Meier survival analysis. The technical success rate for catheter placement was 100% (26/26 patients). Severe local bleeding occurred in one patient due to by inferior epigastric artery puncture, and was treated by compression and electronic cautery. The duration of catheter implantation ranged from 1 to 510 days and the patency rate was 416{+-}45 days. Catheter malfunction occurred in four patients. In two, this was restored by manipulation in the intervention room, and in one, through the use of urokinase. In three patients, peritonitis occurred. Catheters were removed from four patients due to malfunction (n=2), peritonitis (n=1), and death (n=1). Percutaneous radiologic placement of a peritoneal dialysis catheter is a relatively simple procedure that reduces the complication rate and improves catheter patency.

  8. CT-guided core biopsy and percutaneous fiducial seed placement in the lung: Can these procedures be combined without an increase in complication rate or decrease in technical success?

    Energy Technology Data Exchange (ETDEWEB)

    Mendiratta-Lala, Mishal [Henry Ford Hospital, Department of Radiology, Abdominal Interventional Radiology, 2799 West Grand Blvd, Detroit, MI 48202 (United States); Sheiman, Robert, E-mail: rsheiman@bidmc.harvard.edu [Beth Israel Deaconess Hospital, Department of Radiology, Abdominal Imaging, One Deaconess Road, Boston, MA 02215 (United States); Brook, Olga R. [Beth Israel Deaconess Hospital, Department of Radiology, Abdominal Imaging, One Deaconess Road, Boston, MA 02215 (United States); Gourtsoyianni, Sofia [King' s College London, St Thomas’ Hospital, Lambeth Palace Road, SE1 7EH London (United Kingdom); Mahadevan, Anand [Beth Israel Deaconess Hospital, Radiation Oncology, One Deaconess Road, Boston, MA 02215 (United States); Siewert, Bettina [Beth Israel Deaconess Hospital, Department of Radiology, Abdominal Imaging, One Deaconess Road, Boston, MA 02215 (United States)

    2014-04-15

    Objective: To determine if concomitant CT-guided biopsy and percutaneous fiducial seed placement in the lung can be performed in a selective patient population without increased complication or decreased success rates compared to either procedure alone. Materials and methods: An IRB approved retrospective analysis of 285 consecutive patients that underwent CT-guided placement of fiducial seeds in the lung alone (N = 63), with concomitant core biopsy (N = 53) or only core biopsy (N = 169) was performed. Variables compared included: patient demographics, lesion size, depth from pleura, needle size, number of passes through pleura, number and size of core biopsies, number of seeds placed and technical success rates. Statistical analysis was performed using univariate and multivariate pair-wise comparisons. Results: A pathologic diagnosis of malignancy was confirmed in all cases undergoing seed placement alone and seed placement with concurrent biopsy, and in 144 of the biopsy alone lesions. On univariate analysis, major complication rates were similar for all three groups as were lesion size, depth, number of pleural passes, and technical success. Pair-wise comparisons of the remaining variables demonstrated a significant younger age and smaller needle size in the biopsy only group, and less minor complications in the fiducial only group. Overall there were 80/285 (28.1%) minor and 29/285 (10.2%) major complications. All major complications leading to admission consisted of either pneumothorax or hemothorax, while minor complications included asymptomatic stable or resolving pneumothoraces, transient hemoptysis or small hemothoraces. Conclusions: A combined procedure of percutaneous pulmonary core biopsy and stereotactic seed placement can be performed without additional risk of a major complication when compared to performing these separately.

  9. Long-term results of CT-guided percutaneous radiofrequency ablation of inoperable patients with stage Ia non-small cell lung cancer: A retrospective cohort study.

    Science.gov (United States)

    Huang, Bing-Yang; Li, Xin-Min; Song, Xiao-Yong; Zhou, Jun-Jun; Shao, Zhuang; Yu, Zhi-Qi; Lin, Yi; Guo, Xin-Yu; Liu, Da-Jiang; Li, Lu

    2018-05-01

    This study was performed to retrospectively evaluate the 10-year overall survival (OS), progression-free survival (PFS), and local control rates of patients with inoperable stage Ia non-small cell lung cancer (NSCLC) who underwent computed tomography (CT)-guided radiofrequency ablation (RFA) in a single center. Fifty patients with inoperable NSCLC underwent RFA between 2004 and 2016. Thoracic surgeons evaluated the patients and performed RFA under CT guidance. Follow-up CT and positron emission tomography/CT scans were obtained. Local control rates and recurrence patterns were analyzed. Seventy-three lesions in 50 patients (M:F = 22:28; median age: 73 years; range: 52-82 years) were treated with CT-guided RFA. The mean lesion size was 2.2 cm (range: 1-3 cm). No procedure-related deaths occurred. Low-grade fever was the most common post-ablation complication, with an incidence rate of 36%. The 1-, 2-, 3-, 5-, and 10-year OS rates of patients with Ia NSCLC were 96.0%, 86.5%, 67.1%, 36.3%, and 1%, respectively, and the 1-, 2-, 3-, and 5-year PFS rates were 94.0%, 77.5%, 43.5%, and 10.8%, respectively. The most common pattern of recurrence was local, and 15 patients with recurrence were treated with repeat RFA. Tumor size Ia NSCLC. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  10. Retrospective analysis of technical success rate and procedure-related complications of 867 percutaneous CT-guided needle biopsies of lung lesions.

    Science.gov (United States)

    Mills, M; Choi, J; El-Haddad, G; Sweeney, J; Biebel, B; Robinson, L; Antonia, S; Kumar, A; Kis, B

    2017-12-01

    To investigate the technical success rate and procedure-related complications of computed tomography (CT)-guided needle biopsy of lung lesions and to identify the factors that are correlated with the occurrence of procedure-related complications. This was a single- institution retrospective study of 867 consecutive CT-guided needle biopsies of lung lesions performed on 772 patients in a tertiary cancer centre. The technical success rate and complications were correlated with patient, lung lesion, and procedure-related variables. The technical success rate was 87.2% and the mortality rate was 0.12%. Of the 867 total biopsies 25.7% were associated with pneumothorax, and 6.5% required chest tube drainage. The haemothorax rate was 1.8%. There was positive correlation between the development of pneumothorax and smaller lesion diameter (ptechnical success and a low rate of major complications. The present study has revealed several variables that can be used to identify high-risk procedures. A post-procedural chest X-ray within hours after the procedure is highly recommended to identify high-risk patients who require chest tube placement. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  11. Treatment of lung abscess: effectiveness of percutaneous catheter drainage in 14 patients

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Su Hyun; Han, Young Min; Kim, Chong Soo; Chung, Gyung Ho; Ryu, Chun Su; Sohn, Myung Hee; Choi, Ki Chul [Chonbuk National University Medical School, Cheonju (Korea, Republic of)

    1995-01-15

    To evaluate the effectiveness of percutaneous catheter drainage in treatment of the lung abscess. We treated the lung abscesses in 14 patients (12 mean, 2 women), who did not respond to medical therapy, by percutaneous catheter drainage under fluoroscopic or ultrasound guidance. One abscess due to infacted bulla was managed by combination treatment with alcohol sclerosing therapy. Patients were followed by serial chest radiographs every three days and the amount of drained or aspirated pus evaluated. The treatment effect and recurrence were followed by chest PA and lateral chest at one week after removal of drainage catheter. Thirteen patients (93%) recovered clinically and radiologically within 3 days. In 10 patients, drainage catheter could be removed within 2 weeks, and three patients, the catheter was kept longer. Most complications were mild; vague to moderate chest pain (n = 14), mild hemoptysis (n = 2), and pneumothorax (n = 1). One man who suffered from far advanced pulmonary tuberculosis died of asphyxia caused by massive hemoptysis 16 days after percutaneous drainage. Percutaneous catheter drainage is a safe and effective method for treating lung abscess.

  12. Percutaneous transvenous retrieval of CVP catheter emboli in S. V. C.-A case report-

    International Nuclear Information System (INIS)

    Zeon, Seok Kil; Lee, Deock Hee; Kim, Hong; Kim, Ok Bae

    1987-01-01

    The increasing use of the indwelling venous catheters and cardiovascular catheters has led to many iatrogenic complications. One of the most serious complications is catheter embolization, caused by inadvertent fracture of a fragment of catheter remaining within cardiovascular systems. In the catheter embolization, there are serious consequence such as thromboembolism, sepsis, cardiac arrhythmia and others. Fisher and Ferreyro (1978) reported a 71% incidence of serious morbidity or death following to intravascular foreign bodies in patients without removal. The authors experienced a case of retained central venous pressure monitoring catheter (CVP catheter) fragment extending from superior vena cava to hepatic segment of inferior vena cava. CVP catheter wa introduced into right subclavian venous route for hyperalimentation, because of poor general condition for operation of afferent loop syndrome following to resection of the gastric carcinoma with Billoth II operation (5 years age). On attempting removal of CVP catheter on recovery from afferent loop syndrome, a large portion of the CVP catheter was cut off in S.V.C. Percutaneous puncture of right femoral vein with Seldinger technique was done and 9F introducer sheath was indwelled. The helical basket of Dotter intravascular retriever set was advance through the sheath up to retained CVP catheter, and it was grasped. The retrieved CVP catheter fragment showed several tiny blood clots on surface. The patient was uneventfully recovered and was discharged asymptomatic on second day of the procedure.

  13. Percutaneous central venous catheters versus peripheral cannulae for delivery of parenteral nutrition in neonates.

    Science.gov (United States)

    Ainsworth, S B; Clerihew, L; McGuire, W

    2007-07-18

    Parenteral nutrition for neonates may be delivered via a short peripheral cannula or a central venous catheter. The latter may either be inserted via the umbilicus or percutaneously. Because of the complications associated with umbilical venous catheter use, many neonatal units prefer to use percutaneously inserted catheters following the initial stabilisation period. The method of parenteral nutrition delivery may affect nutrient input and consequently growth and development. Although potentially more difficult to place, percutaneous central venous catheters may be more stable than peripheral cannulae, and need less frequent replacement. These delivery methods may also be associated with different risks of adverse events, including acquired systemic infection and extravasation injury. To determine the effect of infusion via a percutaneous central venous catheter versus a peripheral cannula on nutrient input, growth and development, and complications including systemic infection, or extravasation injuries in newborn infants who require parenteral nutrition. The standard search strategy of the Cochrane Neonatal Review Group was used. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2007), MEDLINE (1966 - February 2007), EMBASE (1980 - February 2007), conference proceedings, and previous reviews. Randomised controlled trials that compared the effect of delivering parenteral nutrition via a percutaneous central venous catheter versus a peripheral cannulae in neonates. Data were extracted the data using the standard methods of the Cochrane Neonatal Review Group, with separate evaluation of trial quality and data extraction by each author, and synthesis of data using relative risk, risk difference and mean difference. Four trials eligible for inclusion were found. These trials recruited a total of 368 infants and reported a number of different outcomes. One study showed that the use of a percutaneous

  14. CT-guided percutaneous intratumoral chemotherapy with a novel cisplatin/epinephrine injectable gel for the treatment of unresectable malignant liver tumors

    International Nuclear Information System (INIS)

    Engelmann, K.; Mack, M.G.; Straub, R.; Eichler, K.; Zangos, S.; Vogl, T.J.

    2000-01-01

    Purpose: To evaluate prospectively the volumetric changes of tumor and necrosis in unresectable malignant liver tumors and the clinical aspects after CT-guided direct intratumoral administration of a novel cisplatin/epinephrine injectable gel in a clinical phase II study. Patients and methods: 8 patients with 17 colorectal liver metastases with a mean volume of 42 ml were treated with a mean of 5.1 injections and 8 patients with 11 HCC nodules (mean volume of 22.1 ml) with a mean of 3.25 treatments with CT-guided local administration of a novel cisplatin/epinephrine gel. This method of administration provides a higher local and lower systemic drug concentration. Volumes of tumor and necrosis prior to and after treatment were measured by computer-generated volumetric analysis. Results: Contrast-enhanced studies verified pretherapeutic tumor necrosis with a value of 12.6% in the metastases and 0.6% in the HCC nodules. Intratumoral drug administration resulted in a necrotic volume of 110% in metastases and 128% in HCC versus the mean initial tumor volume, at least 4 treatments resulted in 122% necrosis in metastases and 130% in HCC. Local therapy control rate for the follow-up to 6 months was 38% and 83.3% for the group of metastases and HCC, respectively. Conclusions: Direct intratumoral injection of a novel cisplatin/epinephrine injectable gel results in an induction of a relevant necrosis in malignant liver tumors, with a substantially higher local therapy control rate for HCC compared to colorectal metastases. (orig.) [de

  15. Unresectable colorectal liver metastases. Percutaneous ablation using CT-guided high-dose-rate brachytherapy (CT-HDBRT); Nicht resektable kolorektale Lebermetastasen. Perkutane Ablation mittels CT-gesteuerter Hochdosisbrachytherapie (CT-HDBRT)

    Energy Technology Data Exchange (ETDEWEB)

    Collettini, F.; Lutter, A.; Schnapauff, D.; Denecke, T.; Gebauer, B. [Charite, Campus Virchow-Klinikum, Berlin (Germany). Dept. of Diagnostic and Interventional Radiology; Hildebrandt, B. [Charite, Campus Virchow-Klinikum, Berlin (Germany). Dept. of Oncology; Puhl, G. [Charite, Campus Virchow-Klinikum, Berlin (Germany). Dept. of General, Visceral and Transplantation Surgery; Wust, P. [Charite, Campus Virchow-Klinikum, Berlin (Germany). Dept. of Radiation Oncology

    2014-06-15

    Purpose: To evaluate the clinical outcome of CT-guided high-dose-rate brachytherapy (CT-HDRBT) of unresectable colorectal liver metastases (CRLMs). Materials and Methods: Retrospective analysis of all consecutive patients with unresectable CRLMs treated with CT-HDRBT between January 2008 and November 2012. Treatment was performed by CT-guided catheter placement and high-dose-rate brachytherapy with an iridium-192 source. MRI follow-up was performed after 6 weeks and then every 3 months post-intervention. The primary endpoint was local tumor control (LTC); secondary endpoints included time to progression (TTP) and overall survival (OS). Results: 80 heavily pretreated patients with 179 metastases were available for MRI evaluation for a mean follow-up time of 16.9 months. The mean tumor diameter was 28.5 mm (range: 8 - 107 mm). No major complications were observed. A total of 23 (12.9%) local tumor progressions were observed. Lesions ≥ 4 cm in diameter showed significantly more local progression than smaller lesions (< 4 cm). 50 patients (62.5%) experienced systemic tumor progression. The median TTP was 6 months. 28 (43%) patients died during the follow-up period. The median OS after ablation was 18 months. Conclusion: CT-HDRBT is an effective technique for the treatment of unresectable CRLMs and warrants promising LTC rates compared to thermal ablative techniques. A combination with other local and systemic therapies should be evaluated in patients with lesions > 4 cm in diameter, in which higher progression rates are expected. (orig.)

  16. Percutaneous transfemoral repositioning of malpositioned central venous catheters.

    Science.gov (United States)

    Hartnell, G G; Roizental, M

    1995-04-01

    Central venous catheters inserted by blind surgical placement may not advance into a satisfactory position and may require repositioning. Malpositioning via surgical insertion is common in patients in whom central venous catheters have previously been placed, as these patients are more likely to have central venous thrombosis and distortion of central venous anatomy. This is less of a problem when catheter placement is guided by imaging; however, even when insertion is satisfactory, central venous catheters may become displaced spontaneously after insertion (Fig. 1). Repositioning can be effected by direct manipulation using guidewires or tip-deflecting wires [1, 2], by manipulation via a transfemoral venous approach [3-5], and by injection of contrast material or saline [6]. Limitations of the direct approach include (1) the number and type of maneuvers that can be performed to effect repositioning when anatomy is distorted, (2) difficulty in accessing the catheter, and (3) the risk of introducing infection. Moreover, these patients are often immunosuppressed, and there is a risk of introducing infection by exposing and directly manipulating the venous catheter. Vigorous injection of contrast material or saline may be unsuccessful for the same reasons: It seldom exerts sufficient force to reposition large-caliber central venous catheters and may cause vessel damage or rupture if injection is made into a small or thrombosed vessel. We illustrate several alternative methods for catheter repositioning via a transfemoral venous approach.

  17. An epidural catheter removal after recent percutaneous coronary intervention and coronary artery stenting: Epidural catheter and antiaggregation therapy

    Directory of Open Access Journals (Sweden)

    Joksić Nikola

    2016-01-01

    Full Text Available Introduction: Anticoagulation and antiplatelet therapy in the presence of the epidural catheter is still controversial. It is well known that dual antiplatelet therapy is indicated for 12 months after the placement of drug-eluting stents (DES. Removal of an epidural catheter during that period is related to an increased risk of stent occlusion in case of discontinuation of platelet function inhibitors or, on the other hand, increased risk of epidural hematoma associated with neurological deficit if suppressed platelet function is still present. Case Report: Here we present a case of a 63-year-old man who was admitted to Institute for Cardiovascular Diseases Dedinje for elective aortic surgery. Before the induction, an epidural catheter was inserted at the Th10-Th11 epidural space. Uneventful surgery was performed under the combined epidural and general anesthesia. On the 2nd postoperative day, the patient sustained a ST depression myocardial infarction treated with percutaneous coronary intervention with DES placement, while epidural catheter was still in place. Dual antiplatelet therapy with 600mg of clopidogrel, 100 mg of acetilsalicylic acid (ASA and low molecular weight heparin (LMWH were started during the procedure. The next day, clopidogrel (75 mg and ASA (100 mg were continued as well as LMWH. The decision to remove the epidural catheter was made on the 9th postoperative day, after platelet aggregation assays were performed. Six hours after catheter removal the patient again received clopidogrel, ASA and LMWH. There were no signs of epidural hematoma. Conclusion: This case shows that point-of-care testing with platelet aggregation assays may be useful in increasing the margin of safety for epidural catheter removal during dual antiplatelet therapy.

  18. Percutaneous catheter drainage of pancreatic pseudocysts. Perkutane Katheterdrainage von Pankreaspseudozysten

    Energy Technology Data Exchange (ETDEWEB)

    Karnel, F.; Gebauer, A.; Jantsch, H.; Prayer, L.; Schurawitzki, H. (Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria) Ludwig-Boltzmann-Institut fuer Radiologisch-Physikalische Tumordiagnostik, Vienna (Austria)); Feil, W. (1. Chirurgische Universitaetsklinik, Vienna (Austria))

    1991-09-01

    The results of CT/US-guided percutaneous drainage in 35 patients with pancreatic pseudocysts are reported. 27 patients recovered without surgery and no further treatment was required. 8 patients required a subsequent surgery due to recurrence. The role of CT/US-guided percutaneous drainage in pancreatic pseudocysts as well as an analysis of the technical aspects associated with a successful procedure are discussed. Although US may be used, we believe CT is safer and allows more precise localisation and guidance in the treatment of pseudocysts. (orig.).

  19. Percutaneous cystostomy drainage for early removing urethral catheter in robotic-assisted laparoscopic radical prostatectomy: Improving on patients' discomfort

    Directory of Open Access Journals (Sweden)

    Che-Jui Yang

    2015-12-01

    Conclusion: The use of a percutaneous cystostomy device is feasible and safe for the early removal of urethral Foley catheter in robotic-assisted laparoscopic radical prostatectomy to decrease penile pain and patient discomfort.

  20. Massive Pulmonary Embolism: Percutaneous Emergency Treatment Using an Aspirex Thrombectomy Catheter

    International Nuclear Information System (INIS)

    Popovic, Peter; Bunc, Matjaz

    2010-01-01

    Massive pulmonary embolism (PE) is a life-threatening condition with a high early mortality rate caused by acute right ventricular failure and cardiogenic shock. A 51-year-old woman with a massive PE and contraindication for thrombolytic therapy was treated with percutaneous mechanical thrombectomy using an Aspirex 11F catheter (Straub Medical AG, Wangs, Switzerland). The procedure was successfully performed and showed a good immediate angiographic result. The patient made a full recovery from the acute episode and was discharged on heparin treatment. Our case report indicates that in patients with contraindications to systemic thrombolysis, catheter thrombectomy may constitute a life-saving intervention for massive PE.

  1. Clinical implications of acute pelvicaliceal hematoma formation during percutaneous catheter nephrostomy insertion.

    Science.gov (United States)

    Stewart, Jessica K; Smith, Tony P; Kim, Charles Y

    To determine the clinical implications of acute pelvicaliceal hematoma formation during percutaneous catheter nephrostomy (PCN) insertion. Collecting system hematoma burden was retrospectively assessed for 694 PCN insertions in 502 patients. Pelvicaliceal hematoma formation occurred in 146 kidneys (21%) in 136 patients. Clinically significant blood loss occurred in 3 patients with hematomas within one week compared to 4 patients without hematomas (p=0.39). Twenty-four patients with hematomas underwent catheter exchange within one week, compared to 55 patients without hematomas (p=0.49). Pelvicaliceal hematoma formation after PCN insertion is not uncommon and is associated with very rare clinical sequelae. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Treatment of infected bulla with alcohol sclerosis combined with percutaneous catheter drainage: a preliminary report

    International Nuclear Information System (INIS)

    Han, Young Min; Lee, Jeong Min; Kim, Chong Soo; Chung, Gyung Ho; Rhee, Yang Keen; Lee, Yong Chul; Sohn, Myung Hee; Choi, Ki Chul

    1995-01-01

    To evaluate effectiveness of alcohol sclerosis combined with percutaneous catheter drainage (PCD) for treatment of infected bulla. Infected bulla in four consecutive patients were treated. In all patients, percutaneous catheter drainage of the bulla was performed. Instillation of sterile alcohol (99% ethanol) was carried out into the cavity of the bulla. Alcohol was left in the cavity for approximately 30 minutes in each session. Alcohol instillation was repeated according to the size of bulla. Patients were subsequently followed up with serial chest radiographs and CT scans. All patients showed significant improvement both clinically and radiologically. Disappearance of the bulla and reexpansion of surrounding lung parenchyma was observed in two patients and partial resolution (80% reduction in size) was seen in another two patients. Complications included mild chest pain during instillation of alcohol in all patients and delayed radiating shoulder pain in one patient. We provisionally conclude that intracavitary alcohol instillation combined with PCD is effective in the treatment of the infected bulla

  3. The GuideLiner catheter: A supportive tool in percutaneous coronary intervention of chronic total occlusion

    Directory of Open Access Journals (Sweden)

    Jan-Erik Guelker

    2018-04-01

    Full Text Available Background: Failure of delivering a stent or a balloon across the target lesion during percutaneous coronary intervention (PCI of chronic total occlusion (CTO, especially in arteries with calcified tortuous anatomy, is often due to insufficient backup support from the guiding catheter. The purpose of this study was to assess the feasibility of the GuideLiner (GL catheter use. Methods: We examined 18 patients and used the GL catheter to overcome poor support and excessive friction in standardized antegrade and retrograde CTO procedures. The GL is a coaxial, monorail guiding catheter extension delivered through a standard guiding catheter and is available in different sizes. Results: Almost all lesions were classified as severely calcified (94.4 ± 0.24%. The Japanese CTO score reflecting lesion complexity was 3.56 ± 0.78. All procedures were performed femorally; the retrograde approach was used in 27.8 ± 0.46% of cases. The overall success rate was 88.9 ± 0.32%; there were no relevant complications. Conclusions: The GL catheter is an adjunctive interventional device which enhances and amplifies CTO-PCI. Its use is indicated in cases in which back-up force needs to be strengthened to pass a CTO despite advanced calcification. It can be recommended as an important additional tool in advanced interventional cardiology such as antegrade and retrograde CTO-PCI if other techniques like anchor balloon or anchor wire are not possible. Keywords: Chronic total occlusion, GuideLiner catheter, Percutaneous coronary intervention, Severe calcification

  4. CT guided puncture aspiration and sclerosing treatment of ovary cyst

    International Nuclear Information System (INIS)

    Peng Yongjun; Du Xiumei; Yuan Jinrong; Chen Chanqing

    2007-01-01

    Objective: To analyze the method and the curative effect with CT guided percutaneous puncture aspiration and sclerosing treatment of ovary cyst. Method: 22 ovary cysts in 22 patients were treated with percutaneous puncture aspiration and underwent repeated sclerotherapy with 99.7% ethanol injection. Among the 22 patients, 18 patients had solitary ovary cyst and was aspirated with an 18-22G gauge aspiration needle. The amount of aspirated fluid varied from 30ml-500ml and 25%-30% cyst volume was replaced by appropriate ethanol Post treatment follow-up were achieved every 3 months. Results All the Punctures were successfully completed. During the 3 months to one year follow-up, 16 ovary cyst disappeared, 6 cysts were small over 50%, without main complication. Conclusion CT guided percutaneous puncture aspiration and sclerosing treatment of ovary cyst is a treatment of choice because of its safety, low complication, and high curative effect. (authors)

  5. Intra-Arterial Hepatic Chemotherapy: A Comparison of Percutaneous Versus Surgical Implantation of Port-Catheters

    International Nuclear Information System (INIS)

    Deschamps, F.; Elias, D.; Goere, D.; Malka, D.; Ducreux, M.; Boige, V.; Auperin, A.; Baere, T. de

    2011-01-01

    Purpose: To compare retrospectively the safety and efficacy of percutaneous and surgical implantations of port-catheters for intra-arterial hepatic chemotherapy (IAHC). Materials and Methods: Between January 2004 and December 2008, 126 consecutive patients (mean age 58 years) suffering from liver colorectal metastases were referred for intra-arterial hepatic chemotherapy (IAHC). Port-catheters were percutaneously implanted (P) through femoral access with the patient under conscious sedation when no other surgery was planned or were surgically implanted (S) when laparotomy was performed for another purpose. We report the implantation success rate, primary functionality, functionality after revision, and complications of IAHC. Results: The success rates of implantation were 97% (n = 65 of 67) for P and 98% (n = 58 of 59) for S. One hundred eleven patients received IAHC in our institution (n = 56P and n = 55S). Primary functionality was the same for P and S (4.80 vs. 4.82 courses), but functionality after revision was significantly higher for P (9.18 vs. 5.95 courses, p = 0.004) than for S. Forty-five complications occurred during 516 courses for P and 28 complications occurred during 331 courses for S. The rates of discontinuation of IAHC linked to complications of the port-catheters were 21% (n = 12 of 56) for P and 34% (n = 19 of 55) for S. Conclusion: Overall, significantly better functionality and similar complication rates occurred after P versus S port-catheters.

  6. [A clinical observation of percutaneous balloon dilation and maintenance percutaneous transhepatic cholangial catheter drainage for treatment of 21 patients with benign biliary strictures and difficult endoscopy].

    Science.gov (United States)

    Pan, Jie; Shi, Hai-feng; Li, Xiao-guang; Zhang, Xiao-bo; Liu, Wei; Jin, Zheng-yu; Hong, Tao; Yang, Ai-ming; Yang, Ning

    2012-06-01

    To investigate the value of percutaneous balloon dilation and percutaneous transhepatic cholangial drainage (PTCD) catheter maintenance in the treatment of benign biliary strictures. The clinical data of 21 patients with benign biliary strictures at Peking Union Medical College Hospital from June 2005 to June 2011 were retrospectively studied, in which 12 patients in severe stricture (stenosis > 70%) were treated with percutaneous balloon dilation and PTCD catheter placed across the stricture, while another 9 patients in median stricture (stenosis stenosis was seen in 2 patients. A severe complication with biliary artery branch rupture and massive hemobilia was seen in 1 patient during balloon dilation. Of the 9 patients only treated with 1 - 12 months (median: 6 months) of PTCD catheter placement, 7 patients had the catheter successfully removed. In the follow-up of 5 - 18 months (median: 8 months), patency of bile duct was preserved in 5 of 7 patients, and recurrent stenosis was seen in 2 patients. No severe complication occurred. When endoscopy therapy is failed or the patient can't undergo endoscopy therapy, the percutaneous balloon dilation and PTCD catheter maintenance method is an effective alternative therapeutic approach in the treatment of benign biliary strictures. The moderate benign biliary stricture may be effectively treated only by the PTCD catheter maintenance method.

  7. Breath-hold after forced expiration before removal of the biopsy needle decreased the rate of pneumothorax in CT-guided transthoracic lung biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Min, Lingfeng; Xu, Xingxiang [Subei People' s Hospital of Jiangsu Province, Clinical Medical School of Yangzhou University, Yangzhou 225001, Jiangsu (China); Song, Yong [Jinling Hospital, Nanjing University School of Medical, Nanjing 210002, Jiangsu (China); Issahar, Ben-Dov [Pulmonary Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Wu, Jingtao; Zhang, Le; Huang, Qian [Subei People' s Hospital of Jiangsu Province, Clinical Medical School of Yangzhou University, Yangzhou 225001, Jiangsu (China); Chen, Mingxiang, E-mail: chenmx1129@126.com [Subei People' s Hospital of Jiangsu Province, Clinical Medical School of Yangzhou University, Yangzhou 225001, Jiangsu (China)

    2013-01-15

    Purpose: To assess the effect of a breath-hold after forced expiration on the rate of pneumothorax after computed tomography (CT)-guided transthoracic needle biopsy of pulmonary lesions. Materials and methods: Between January 2008 and December 2011, percutaneous CT-guided lung biopsy was performed in 440 patients. Two hundred and twenty-one biopsies were performed without (control group) and two hundred and nineteen biopsies were performed with (study group) the study maneuver – a breath-hold after forced expiratory approach. Multivariate analysis was performed between groups for risk factors for pneumothorax, including patient demographics, lesion characteristics, and biopsy technique. Results: A reduced number of pneumothoraces (18 [8.2%] vs 35 [15.8%]; P = 0.014) but no significant difference in rate of drainage catheter insertions (2 [0.9%] vs (4 [1.8%]; P = 0.418) were noted in the study group as compared with the control group. By logistic regression analysis, three factors significantly and independently affected the risk for pneumothorax including lesion size (transverse and longitudinal diameter), distance from pleura and utilizing or avoiding the breath-hold after deep expiration maneuver. Conclusion: Breath-holding after forced expiration before removal of the biopsy needle during the percutaneous CT-guided transthoracic lung biopsy almost halved the rate of overall pneumothorax. Small lesion size (longitudinal diameter) and the distance from pleura were also predictors of pneumothorax in our study.

  8. Breath-hold after forced expiration before removal of the biopsy needle decreased the rate of pneumothorax in CT-guided transthoracic lung biopsy

    International Nuclear Information System (INIS)

    Min, Lingfeng; Xu, Xingxiang; Song, Yong; Issahar, Ben-Dov; Wu, Jingtao; Zhang, Le; Huang, Qian; Chen, Mingxiang

    2013-01-01

    Purpose: To assess the effect of a breath-hold after forced expiration on the rate of pneumothorax after computed tomography (CT)-guided transthoracic needle biopsy of pulmonary lesions. Materials and methods: Between January 2008 and December 2011, percutaneous CT-guided lung biopsy was performed in 440 patients. Two hundred and twenty-one biopsies were performed without (control group) and two hundred and nineteen biopsies were performed with (study group) the study maneuver – a breath-hold after forced expiratory approach. Multivariate analysis was performed between groups for risk factors for pneumothorax, including patient demographics, lesion characteristics, and biopsy technique. Results: A reduced number of pneumothoraces (18 [8.2%] vs 35 [15.8%]; P = 0.014) but no significant difference in rate of drainage catheter insertions (2 [0.9%] vs (4 [1.8%]; P = 0.418) were noted in the study group as compared with the control group. By logistic regression analysis, three factors significantly and independently affected the risk for pneumothorax including lesion size (transverse and longitudinal diameter), distance from pleura and utilizing or avoiding the breath-hold after deep expiration maneuver. Conclusion: Breath-holding after forced expiration before removal of the biopsy needle during the percutaneous CT-guided transthoracic lung biopsy almost halved the rate of overall pneumothorax. Small lesion size (longitudinal diameter) and the distance from pleura were also predictors of pneumothorax in our study

  9. CT-Guided Superior Vena Cava Puncture: A Solution to Re-Establishing Access in Haemodialysis-Related Central Venous Occlusion Refractory to Conventional Endovascular Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Khalifa, Mohamed, E-mail: mkhalifa@nhs.net; Patel, Neeral R., E-mail: neeral.patel06@gmail.com; Moser, Steven, E-mail: steven.moser@imperial.nhs.uk [Hammersmith Hospital, Department of Radiology, Imperial College Healthcare NHS Trust (United Kingdom)

    2016-04-15

    PurposeThe purpose of this technical note is to demonstrate the novel use of CT-guided superior vena cava (SVC) puncture and subsequent tunnelled haemodialysis (HD) line placement in end-stage renal failure (ESRF) patients with central venous obstruction refractory to conventional percutaneous venoplasty (PTV) and wire transgression, thereby allowing resumption of HD.MethodsThree successive ESRF patients underwent CT-guided SVC puncture with subsequent tract recanalisation. Ultrasound-guided puncture of the right internal jugular vein was performed, the needle advanced to the patent SVC under CT guidance, with subsequent insertion of a stabilisation guidewire. Following appropriate tract angioplasty, twin-tunnelled HD catheters were inserted and HD resumed.ResultsNo immediate complications were identified. There was resumption of HD in all three patients with a 100 % success rate. One patient’s HD catheter remained in use for 2 years post-procedure, and another remains functional 1 year to the present day. One patient died 2 weeks after the procedure due to pancreatitis-related abdominal sepsis unrelated to the Tesio lines.ConclusionCT-guided SVC puncture and tunnelled HD line insertion in HD-related central venous occlusion (CVO) refractory to conventional recanalisation options can be performed safely, requires no extra equipment and lies within the skill set and resources of most interventional radiology departments involved in the management of HD patients.

  10. Usefulness of a Biliary Manipulation Catheter in Percutaneous Transhepatic Biliary Drainage

    Energy Technology Data Exchange (ETDEWEB)

    Paek, Auh Whan [Dept. of Radiology, Virginia University Heath Center, Charlottesville (United States); Won, Je Hwan; Lee, Jei Hee; Sun, Joo Sung; Kwak, Kyu Sung; Bae, Jae Ik [Dept. of Radiology, Ajou University School of Medicine, Suwon (Korea, Republic of)

    2011-04-15

    To evaluate usefulness of a manipulation catheter in percutaneous transhepatic biliary drainage (PTBD). A biliary manipulation catheter was used for the aspiration of retained bile and lesion crossing during an initial PTBD in 91 consecutive patients over a 6 month period. This catheter allowed for a 0.035 inch guide wire made of 5F short steel braided polyurethane. The terminal 1 cm segment was tapered and 45 degree angulated. Two side holes were made in the terminal segment to facilitate the aspiration of bile. The safety of this procedure was evaluated based on whether the catheters caused complications during insertion and manipulation, and whether cholangitis was aggravated after the procedure. Effectiveness of the procedure was evaluated based on the ability to aspirate retained bile and to cross the lesion. Both the insertion of a 0.035 inch hydrophilic guide wire and aspiration of sufficient retained bile were successful with the catheter. Crossing the common bile duct (CBD) lesion had a 98.1% success rate during the initial PTBD. Crossing the hilar obstruction lesion was had a 94.7% success rate to the CBD and 92.1% to the contralateral lobe. Cholangitis improved in 97% of cases, and aggravated transiently in only 3% of cases after PTBD.

  11. Usefulness of a Biliary Manipulation Catheter in Percutaneous Transhepatic Biliary Drainage

    International Nuclear Information System (INIS)

    Paek, Auh Whan; Won, Je Hwan; Lee, Jei Hee; Sun, Joo Sung; Kwak, Kyu Sung; Bae, Jae Ik

    2011-01-01

    To evaluate usefulness of a manipulation catheter in percutaneous transhepatic biliary drainage (PTBD). A biliary manipulation catheter was used for the aspiration of retained bile and lesion crossing during an initial PTBD in 91 consecutive patients over a 6 month period. This catheter allowed for a 0.035 inch guide wire made of 5F short steel braided polyurethane. The terminal 1 cm segment was tapered and 45 degree angulated. Two side holes were made in the terminal segment to facilitate the aspiration of bile. The safety of this procedure was evaluated based on whether the catheters caused complications during insertion and manipulation, and whether cholangitis was aggravated after the procedure. Effectiveness of the procedure was evaluated based on the ability to aspirate retained bile and to cross the lesion. Both the insertion of a 0.035 inch hydrophilic guide wire and aspiration of sufficient retained bile were successful with the catheter. Crossing the common bile duct (CBD) lesion had a 98.1% success rate during the initial PTBD. Crossing the hilar obstruction lesion was had a 94.7% success rate to the CBD and 92.1% to the contralateral lobe. Cholangitis improved in 97% of cases, and aggravated transiently in only 3% of cases after PTBD.

  12. A COMPARATIVE ANALYSIS OF PERCUTANEOUS AND OPEN SURGICAL TECHNIQUESFOR PERITONEAL CATHETER PLACEMENT.

    LENUS (Irish Health Repository)

    Medani, Samar

    2012-05-01

    BACKGROUND: Peritoneal dialysis (PD) is the preferred available option of renal replacement therapy for a significant number of end-stage kidney disease patients. A major limiting factor to the successful continuation of PD is the long-term viability of the PD catheter (PDC). Bedside percutaneous placement of the PDC is not commonly practiced despite published data encouraging use of this technique. Its advantages include faster recovery and avoidance of general anesthesia.♢ METHODS: We carried out a retrospective analysis of the outcomes of 313 PDC insertions at our center, comparing all percutaneous PDC insertions between July 1998 and April 2010 (group P, n = 151) with all surgical PDC insertions between January 2003 and April 2010 (group S, n = 162).♢ RESULTS: Compared with group P patients, significantly more group S patients had undergone previous abdominal surgery or PDC insertion (41.8% vs 9.3% and 33.3% vs 3.3% respectively, p = 0.00). More exit-site leaks occurred in group P than in group S (20.5% vs 6.8%, p = 0.002). The overall incidence of peritonitis was higher in group S than in group P (1 episode in 19 catheter-months vs 1 episode in 26 catheter-months, p = 0.017), but the groups showed no significant difference in the peritonitis rate within 1 month of catheter insertion (5% in group P vs 7.4% in group S, p =0.4) or in poor initial drainage or secondary drainage failure (9.9% vs 11.7%, p = 0.1, and 7.9% vs 12.3%, p = 0.38, for groups P and S respectively). Technical survival at 3 months was significantly better for group P than for group S (86.6% vs 77%, p = 0.037); at 12 months, it was 77.7% and 68.7% respectively (p = 0.126). No life-threatening complications attributable to the insertion of the PDC occurred in either group.♢ CONCLUSIONS: Our analysis demonstrates further encouraging outcomes of percutaneous PDC placement compared with open surgical placement. However, the members of the percutaneous insertion group were primarily a

  13. CT-guided core-needle biopsy in omental pathology

    International Nuclear Information System (INIS)

    Pombo, F.; Rodriguez, E.; Martin, R.; Lago, M.

    1997-01-01

    Purpose: To assess the accuracy and clinical usefulness of CT-guided core-needle biopsy in the diagnosis of omental pathology. Material and Methods: We retrospectively reviewed the results of CT-guided percutaneous core biopsies in 25 patients with focal (n=2) or diffuse (n=23) omental pathology. These results were compared to the final diagnoses as determined by laparotomy (n=15), laparoscopic biopsy (n=3), endoscopic biopsy (n=1), or by the results of percutaneous biopsy and clinical-radiological and bacteriological modalities (n=6). The final diagnoses showed 4 patients with isolated omental pathology and 21 with widespread peritoneal involvement. The CT-guided biopsies were performed with 1.0=1.8-mm Surecut core-needles. Results: In 16 patients, the final diagnosis was metastatic adenocarcinoma - with the primary tumor sites in the ovary (n=3), stomach (n=1), appendix (n=2), and unknown (n=10). In the remaining 9 patients, the final diagnosis was hepatocellular carcinoma, lymphoma, and mesothelioma in 1 patient each; tuberculosis in 5; and actinomycosis in 1. Sufficient histological (n=16) or cytological (n=8) material was obtained by CT biopsy in 24/25 (96%) cases; the specimen was insufficient for diagnosis in 1 case. In differentiating benign from malignant disease, CT-guided biopsy showed a sensitivity, specificity and accuracy of respectively 89.5%, 100% and 92%. It gave a specific diagnosis in 78.9% (15/19) of patients with malignant conditions and in 50% (3/6) of patients with benign disorders. There were no biopsy-related complications. Conclusion: CT-guided percutaneous core-needle biopsy of the omentum is a safe, useful and highly accurate procedure for diagnosing malignant omental pathology. (orig.)

  14. Bilhemia: a fatal complication following percutaneous placement of a transhepatic inferior vena cava catheter in a child

    International Nuclear Information System (INIS)

    Sierre, Sergio; Lipsich, Jose; Questa, Horacio

    2007-01-01

    A transhepatic central venous catheter was implanted in a 2-year-old child with a history of multiple venous access procedures and superior and inferior vena cava thrombosis. After 2 weeks, inadvertent dislodgement of the catheter was complicated by a biloma. The biloma was percutaneously drained, but a biliary-venous fistula led to a rapidly progressive and fatal bilhemia. We report this case as an infrequent complication of transhepatic catheterization. (orig.)

  15. Successful Left-Heart Decompression during Extracorporeal Membrane Oxygenation in an Adult Patient by Percutaneous Transaortic Catheter Venting

    Directory of Open Access Journals (Sweden)

    Tae Hee Hong

    2015-06-01

    Full Text Available Venoarterial extracorporeal membrane oxygenation (VA ECMO is widely used in patients with cardiogenic shock. Insufficient decompression of the left ventricle (LV is considered a major factor preventing adequate LV recovery. A 40-year-old male was diagnosed with acute myocardial infarction, and revascularization was performed using percutaneous stenting. However, cardiogenic shock occurred, and VA ECMO was initiated. Severe LV failure developed, and percutaneous transaortic catheter venting (TACV was incorporated into the venous circuit of VA ECMO under transthoracic echocardiography guidance. The patient was successfully weaned from VA ECMO. Percutaneous TACV is an effective, relatively noninvasive, and rapid method of LV decompression in patients undergoing VA ECMO.

  16. [Percutaneous catheter-based implantation of artificial pulmonary valves in patients with congenital heart defects].

    Science.gov (United States)

    Wyller, Vegard Bruun; Aaberge, Lars; Thaulow, Erik; Døhlen, Gaute

    2011-07-01

    Percutaneous catheter-based implantation of artificial heart valves is a new technique that may supplement surgery and which may be used more in the future. We here report our first experience with implantation of artificial pulmonary valves in children with congenital heart defects. Eligible patients were those with symptoms of heart failure combined with stenosis and/or insufficiency in an established artificial right ventricular outflow tract. The valve was inserted through a catheter from a vein in the groin or neck. Symptoms, echocardiography, invasive measurements and angiography were assessed for evaluation of treatment effect. Our treatment results are reported for the period April 2007-September 2009. Ten patients (seven men and three women, median age 17 years) were assessed. The procedure reduced pressure in the right ventricle (p = 0.008) and resolved the pulmonary insufficiency in all patients. The median time in hospital was two days. No patients had complications that were directly associated with the implantation procedure. One patient developed a pseudoaneurysm in the femoral artery, another had a short-lasting fever two days after the procedure and one patient experienced a stent fracture that required surgery 9 months after the implantation. After 6 months all patients had a reduced pressure gradient in the right ventricular outflow tract (p = 0.008), the pulmonary insufficiency had improved (p = 0.006) and they all reported improval of symptoms. These results persisted for at least 24 months for the four patients who were monitored until then. Percutaneous catheter-based implantation of artificial pulmonary valves improves hemodynamics in the right ventricle of selected patients with congenital heart defects. A randomized controlled study should be undertaken to provide a stronger evidence-base for usefulness of this procedure.

  17. CT-guided stereotactic neurosurgery

    International Nuclear Information System (INIS)

    Takizawa, Takaaki; Sato, Shoju; Matsumoto, Akira; Sano, Akira; Takahashi, Kazunori; Murakami, Yuji; Ohta, Kosuke

    1985-01-01

    Brown-Roberts-Wells stereotactic instruments were used for CT guided stereotactic surgery in 54 cases (65 operations). Stereotactic biopsy was done in 9 cases and successive regional chemotherapy was done in 3 cases. Stereotactic drainage was done in 2 cases of bacterial abcess, 3 cases of cystic neoplasm and 33 cases (43 operations) of intracerebral hematoma. CT guided stereotactic procedure was valuable for the correct cannulation to the center of the cavity. We tried to utilize CT image for the selection of targets for stereotactic functional neurosurgical procedures in 6 cases. In the cases of thalamotomy, the information derived from CT made the operation safer than that by contrast ventriculography alone. In all cases of electrode implantation for deep brain stimulation, accurate and precise electrode placement was achieved from CT images alone. This rapid and easy surgical technique was useful also for poor risk patients. (author)

  18. CT guided fine needle aspiration biopsy of biliopancreatic lesions

    International Nuclear Information System (INIS)

    Geng, Jia-Zheng; Qin, Pan-Rui; Hui, Liu-De; Po, Pei-Dong

    1987-01-01

    CT guided percutaneous fine needle aspiration biopsy was performed on 30 patients with pancreatic and periampullary neoplasms, in the Department of Surgery, China-Japan Friendship Hospital, between March 1985 and January 1986. We obtained positive cytodiagnosis from all cases of carcinoma of the pancreatic head (9 cases), body and tail (4 cases), and ampullary carcinomas (5 cases) (100 per cent). In 2 of 3 duodenal carcinomas (66.6 per cent), and 6 of 7 distal common duct carcinomas (86 per cent), a positive cytodiagnosis was also obtained. On the other hand, 2 cases of pancreatitis both gave a negative cytodiagnosis, i.e. no false positives were obtained. Out of the 30 cases who underwent CT guided biopsy, a correct diagnosis was obtained in 28, i.e. a diagnostic accuracy of 93.3 per cent. The cytodiagnosis of the other two cases was either suspicious or false negative. There have been no clinical complications noted. (author)

  19. Percutaneous removal of pulmonary artery emboli with hydrolyser catheter in pigs

    International Nuclear Information System (INIS)

    Lacoursiere, L.; Millward, S.; Veinot, J.P.; Labinaz, M.

    2001-01-01

    To evaluate the efficacy and safety of the Hydrolyser catheter for per,cutaneous treatment of massive pulmonary embolism in pigs. Twelve pigs, each weighing between 55 kg and 89 kg, were used. Radio-opaque 9 cm x 0.8 cm and 4.5 cm x 0.8 cm clots, produced by mixing pig blood with iodinated contrast agent in vacutainers, were injected via the jugular vein until central pulmonary embolism (main and proximal lobar arteries) was obtained with significant systemic and pulmonary hemodynamic modifications. From a femoral approach, the 7-French Hydrolyser thrombectomy catheter was run over a 0.025-inch (0.64-mm) guide wire to remove the pulmonary emboli. Hemodynamic, gasometric and angiographic monitoring was performed before and after treatment. The procedure's safety and completeness of emboli removal was assessed by cardiopulmonary autopsy. Three of the 12 pigs died during embolization. Thrombectomy was therefore performed in 9, and central emboli could be obtained in 7 of the 9. The Hydrolyser could be manipulated only in central pulmonary arteries and could aspirate only central emboli in 5 of the 7 pigs that had them. Despite minimal angiographic improvement seen in these 5, there was no significant hemodynamic and gasometric improvement after treatment. The procedure induced an increase in free hemoglobin blood levels. Autopsies revealed an average of 2 endothelial injuries per pig (mainly adherent endocardial thrombi) in both nontreated (n = 3) and Hydrolyser-treated (n = 9) groups. The Hydrolyser thrombectomy catheter can be promptly positioned and easily steered in central pulmonary arteries. It can be used to partially remove central emboli, but not peripheral pulmonary emboli. Most of the injuries observed may not have been strictly related to Hydrolyser use. The pig might not be a suitable animal model for treatment of massive pulmonary embolism. (author)

  20. Percutaneous insertion of peritoneal dialysis catheters using ultrasound and fluoroscopic guidance: A single centre experience and review of literature

    International Nuclear Information System (INIS)

    De Boo, Diederick W.; Mott, Nigel; Tregaskis, Peter; Quach, Trung; Menahem, Solomon; Walker, Rowan G.; Koukounaras, Jim

    2015-01-01

    Various methods of peritoneal dialysis (PD) catheter insertion are available. The purpose of this study was to evaluate a percutaneous insertion technique using ultrasound (US) and fluoroscopy performed under conscious sedation and as day case procedure. Data of 87 percutaneous inserted dialysis catheters were prospectively collected, including patients' age, gender, body mass index, history of previous abdominal surgery and cause of end stage renal failure. Length of hospital stay, early complications and time to first use were also recorded. Institutional review board approval was obtained. A 100% technical success rate was observed. Early complications included bleeding (n = 3), catheter dysfunction (n = 6), exit site infection (n = 1) and exit site leakage (n = 1). All cases of catheter dysfunction and one case of bleeding required surgical revision. Median time of follow-up was 18 months (range 3–35), and median time from insertion to first use was days 14 (1–47). Of the 82 patients who started dialysis, 20 (23%) ceased PD at some stage during follow-up. Most frequently encountered reasons include deteriorating patient cognitive or functional status (n = 5), successful transplant kidney (n = 4) and pleuro-peritoneal fistula (n = 4). Sixty-two (71%) PD catheter insertions were performed as day case. The remaining insertions were performed on patients already admitted to the hospital. Percutaneous insertion of dialysis catheter using US and fluoroscopy is not only safe but can be performed as day case procedure in most patients, even with a medical history of abdominal surgery and/or obesity.

  1. Effectiveness of Fluoroscopic and US - Guided Percutaneous Catheter Drainage for Iliopsoas Abscess through the Anterolateral Transabdominal Approach

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Ho Cheol; Shin, Tae Beom; Park, Mee Jung; Kim, Ji Eun; Choi, Hye Young; Bae, Kyung Soo; Choi, Dae Seob; Na, Jae Boem; Jeong, Seong Hoon [Gyeongsang National University Hospital, College of Medicine, Jinju (Korea, Republic of)

    2011-02-15

    We evaluated the effectiveness of performing fluoroscopic and ultrasonography guided percutaneous catheter drainage (PCD) through the anterolateral transabdominal approach for treating iliopsoas abscess. From January 2008 to December 2009, fluoroscopic and US-guided PCD through the anterolateral transabdominal approach was performed on sixteen iliopsoas abscesses of fourteen patients (7 males and 7 females; mean age: 63 years; age range: 30-87 years). Six abscesses were on the right side and ten abscesses were on the left side. The location of the abscesses were the psoas muscle (n=7), the iliacus muscle (n=7) and the iliopsoas muscle (n=2). All the procedures were performed under fluoroscopy and US guidance in the angiography room. The clinical findings before and after the procedure, the duration of catheter insertion and the procedure-related complications were evaluated. 15 out of the 16 iliopsoas abscesses were effectively treated. The duration of catheter insertion was 5- 27 days (mean: 14.6) days. No patient had significant complications during or after drainage. One patient died of uncontrolled diabetes complications and shock on the 9th day after percutaneous catheter drainage. One recurrence was noted 5 months after removal of the catheter. This patient underwent aspiration and antibiotic treatment for this lesion and the patient improved. Fluoroscopic and US-guided PCD for iliopsoas abscess through the anterolateral transabdominal approach is an effective and safe procedure

  2. Incidence of delayed complications following percutaneous CT-guided biopsy of bone and soft tissue lesions of the spine and extremities: A 2-year prospective study and analysis of risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Ambrose J.; Rosenthal, Daniel I. [Massachusetts General Hospital, Boston, MA (United States); Halpern, Elkan F. [Massachusetts General Hospital, Institute of Technology Assessment, Boston, MA (United States)

    2013-01-15

    To prospectively evaluate the incidence of delayed complications (bleeding, pain, infection) following CT-guided biopsies of bone or soft tissue lesions and to identify risk factors that predispose to their occurrence. All adults presenting for CT-guided biopsy of a bone or soft tissue lesion were eligible for the study. Risk factors considered included patient gender and age, bone versus soft tissue, lesion location, lesion depth, anticoagulation, conscious sedation, coaxial biopsy technique, bleeding during the biopsy, dressing type and duration of placement, final diagnosis, needle gauge, number of passes, and number of days to follow-up. Outcomes measured included fever, pain, bruising/hematoma formation, and swelling and were collected by a follow-up phone call within 14 days of the biopsy. Fisher's exact test, the Wald Chi-square test, and univariate, multivariate, and stepwise logistic regression were performed to evaluate the influence of the risk factors on the outcomes. A total of 386 patients participated in the study. The rates of post-biopsy fever, pain, bruising, and swelling were 1.0, 16.1, 15.6, and 9.6 %, respectively. Anticoagulants were identified as a risk factor for fever. Increasing patient age was identified as a risk factor for pain. Female gender and lesion location were identified as risk factors for bruising. Increasing patient age and lesion location were identified as risk factors for swelling. Patient age, female gender, and lesion location are risk factors for delayed minor complications following CT-guided biopsy of a bone or soft tissue lesion. There were no major complications. None of the complications in this series altered patient management. (orig.)

  3. Incidence of delayed complications following percutaneous CT-guided biopsy of bone and soft tissue lesions of the spine and extremities: A 2-year prospective study and analysis of risk factors

    International Nuclear Information System (INIS)

    Huang, Ambrose J.; Rosenthal, Daniel I.; Halpern, Elkan F.

    2013-01-01

    To prospectively evaluate the incidence of delayed complications (bleeding, pain, infection) following CT-guided biopsies of bone or soft tissue lesions and to identify risk factors that predispose to their occurrence. All adults presenting for CT-guided biopsy of a bone or soft tissue lesion were eligible for the study. Risk factors considered included patient gender and age, bone versus soft tissue, lesion location, lesion depth, anticoagulation, conscious sedation, coaxial biopsy technique, bleeding during the biopsy, dressing type and duration of placement, final diagnosis, needle gauge, number of passes, and number of days to follow-up. Outcomes measured included fever, pain, bruising/hematoma formation, and swelling and were collected by a follow-up phone call within 14 days of the biopsy. Fisher's exact test, the Wald Chi-square test, and univariate, multivariate, and stepwise logistic regression were performed to evaluate the influence of the risk factors on the outcomes. A total of 386 patients participated in the study. The rates of post-biopsy fever, pain, bruising, and swelling were 1.0, 16.1, 15.6, and 9.6 %, respectively. Anticoagulants were identified as a risk factor for fever. Increasing patient age was identified as a risk factor for pain. Female gender and lesion location were identified as risk factors for bruising. Increasing patient age and lesion location were identified as risk factors for swelling. Patient age, female gender, and lesion location are risk factors for delayed minor complications following CT-guided biopsy of a bone or soft tissue lesion. There were no major complications. None of the complications in this series altered patient management. (orig.)

  4. CT-guided conformal cryoablation for peripheral NSCLC: Initial experience

    International Nuclear Information System (INIS)

    Zhang, Xiao; Tian, Jinlin; Zhao, Lei; Wu, Bin; Kacher, Daniel S.; Ma, Xuyang; Liu, Shurong; Ren, Chao; Xiao, Yue-Yong

    2012-01-01

    Purpose: To study the feasibility of CT-guided and monitored percutaneous conformal cryoablation of Non-Small Cell Lung Cancer for patients who are not suitable for surgical resection. Materials and method: CT-guided percutaneous conformal cryoablation was performed on 46 patients with peripheral Non-Small Cell Lung Cancer. Patients with tumor sizes less than 3 cm in diameter were treated with double-needle clamping cryoablation, while the patients with 3–5 cm tumor sizes were treated with multiple-needle conformal cryoablation. CT was used to monitor the extent of cryoablation during the procedures. At month 1, 3, 6, 12, and 24 post-procedure, enhanced CT scans and/or PET-CT scans were performed to evaluate the impact of the therapy. Results: The average tumor CT values were 32 ± 10 HU and −21 ± 8 HU before and after cryoablation, respectively. The largest diameters of the lesions at month 1, 3, 6, 12, and 24 post-procedure were 2.63 ± 0.56 cm, 1.93 ± 0.51 cm, 1.55 ± 0.39 cm, 1.43 ± 0.40 cm, and 1.38 ± 0.38 cm, respectively, in patients with tumor diameter less than 3 cm, and 3.63 ± 0.39 cm, 2.98 ± 0.31 cm, 2.62 ± 0.32 cm, 2.54 ± 0.34 cm, and 2.56 ± 0.37 cm respectively in patients with the tumor diameters between 3 and 5 cm. At the 24th month, there were 36 cases of complete response (83.7%), 7 cases of partial response (16.3%), and no cases of stable disease or progressive disease. 3 patients died due to multiple metastases. Conclusion: CT-guided percutaneous conformal cryoablation is a safe, effective, and minimally invasive therapeutic method for peripheral lung cancer.

  5. Percutaneous Selective Embolectomy using a Fogarty Thru-Lumen Catheter for Pancreas Graft Thrombosis: A Case Report

    International Nuclear Information System (INIS)

    Izaki, Kenta; Yamaguchi, Masato; Matsumoto, Ippei; Shinzeki, Makoto; Ku, Yonson; Sugimura, Kazuro; Sugimoto, Koji

    2011-01-01

    A 57-year-old woman with a history of diabetes mellitus underwent simultaneous pancreas–kidney transplantation. The pancreaticoduodenal graft was implanted in the right iliac fossa. The donor’s portal vein was anastomosed to the recipient’s inferior vena cava (IVC). Seven days after the surgery, a thrombus was detected in the graft veins. Percutaneous thrombolysis was immediately performed; however, venous congestion was still present. We therefore attempted selective embolectomy using a Fogarty Thru-Lumen Catheter. Thrombi were directed from the graft veins toward the IVC and captured in the IVC filter with complete elimination of the thrombus without any major complications. We present our technique for the successful treatment of pancreas graft thrombosis within a short time period by percutaneous selective embolectomy using a Fogarty Thru-Lumen Catheter.

  6. Application of C-arm CT-guided targeted puncturing technique in performing non-vascular interventional biopsy or interventional therapy

    International Nuclear Information System (INIS)

    Li Zhen; Han Xinwei; Jiao Dechao; Ren Jianzhuang; Su Yu; Ye Hui

    2011-01-01

    Objective: to investigate the clinical value of C-arm CT-guided targeted puncturing technique in performing non, vascular interventional biopsy or interventional therapy. Methods: Thirty, one patients, who were encountered in authors' hospital during the period from July 2010 to September 2010, were involved in this study. C-arm CT-guided percutaneous targeted puncturing biopsy or interventional therapy was performed in all 31 patients. All patients had complete clinical data. The complications and positive rate of biopsy were recorded and analyzed. Results: Under C-arm CT-guidance, percutaneous interventional therapy was carried out in 13 patients. The interventional procedures included radiofrequency ablation therapy for hepatic cellular carcinoma (n=2), pelvic abscess draining (n=1), hepatic abscess draining (n=1), ethanol injection for liver cancer (n=4), sclerotic therapy with ethanol injection for renal cyst (n=2), sclerotic therapy with ethanol injection for liver cyst (n=2) and catheter-indwelling drainage for pancreatic pseudocyst (n=1). percutaneous interventional biopsy was performed in the remaining 18 cases, including liver (n=4), lung (n=7), mediastinum (n=2), bone and soft tissue (n=4) and neck mass (n=1). All the procedures were successfully accomplished, no technique, related complications occurred during the operation. For biopsy examination in 18 cases, the positive rate was 94.4% (17/18) and false, negative results was seen in one case with lung lesion. Conclusion: The percutaneous targeted puncturing technique with C, arm CT-guidance combines the advantages of both CT scanning and fluoroscopy. The use of real, time road, mapping function can effectively guide the puncturing and therapeutic management, which can not only optimize the workflow, save the operation time, but also improve the success rate and technical safety. Therefore, it is of great value to popularize this targeted puncturing technique. (authors)

  7. Removal of non-deflatable retained foley catheter in the bladder by percutaneous puncture of catheter balloon

    International Nuclear Information System (INIS)

    Yoo, Jae Duk; Kim, Jae Kyu; Park, Jin Gyun; Chung, Hyon De

    1988-01-01

    Nondeflatable Foley catheter in the bladder is an uncommon event. We recently experienced a patient in whom the urologist were unable to remove a Foley catheter with cystoscope due to public bone fractures. The procedure, which was successfully carried out, consists of puncturing the ballon under fluoroscope.

  8. Accuracy of CT-guided biopsies in 158 patients with thoracic spinal lesions

    International Nuclear Information System (INIS)

    Hao, D.J.; He, B.R.; Liu, T.J.; Zhao, Q.P.; Sun, H.H.; Jiang, Y.H.

    2011-01-01

    Background. Inconsistent accuracies of CT-guided thoracic spinal biopsies have been reported in previous studies. Purpose. To determine the accuracy of CT-guided thoracic spinal biopsy, to compare the results with those previously reported, and to determine if there are any factors that influence the accuracy of CT-guided thoracic spinal biopsy. Material and Methods. In total, 158 consecutive CT-guided percutaneous thoracic spine procedures (performed at the Dept. of Spinal Surgery, Xian Red Cross Hospital between April 2000 and July 2010) were reviewed. The 158 lesions were categorized by location and radiographic features. Pathological and clinical follow-up were used to determine accuracy. Results. The diagnostic accuracy of CT-guided thoracic spinal biopsy was 90.5% overall. Biopsy of metastatic bone disease (98.2%) was significantly more accurate than biopsies of primary tumors (80.9%) and of hematological malignancies (47.0%) (P < 0.05 and P < 0.005, respectively). The diagnostic accuracy of CT-guided thoracic spinal biopsy was significantly higher for the lower thoracic spine (97.6%) than for the middle (90.0%) or upper thoracic spine (80.4%) (P < 0.05 and P < 0.025, respectively). The diagnostic accuracy was significantly higher for lytic lesions (96.4%) than for sclerotic lesions (81.3%) (P < 0.010). The accuracy of biopsies performed using the transpedicular approach (91.0%) was not significantly different from that of biopsies performed using posterolateral approaches (91.5%) (0.25 < P < 0.5). Conclusion. Percutaneous CT-guided thoracic spinal biopsy is a viable alternative to open surgical biopsy. The diagnostic accuracy was not affected by any of the variables except for lesion level, histology, and radiographic features

  9. Accuracy of CT-guided biopsies in 158 patients with thoracic spinal lesions

    Energy Technology Data Exchange (ETDEWEB)

    Hao, D.J.; He, B.R.; Liu, T.J.; Zhao, Q.P. (Dept. of Spinal Surgery, Xian Red Cross Hospital, Xian Shaanxi (China)), email: zqpddn1@gmail.com; Sun, H.H. (Dept. of Orthopaedic, Tangdu Hospital, Fourth Military Medical Univ., Xian Shaanxi (China)); Jiang, Y.H. (Dept. of Radiology, Xian Red Cross Hospital, Xian Shaanxi (China))

    2011-11-15

    Background. Inconsistent accuracies of CT-guided thoracic spinal biopsies have been reported in previous studies. Purpose. To determine the accuracy of CT-guided thoracic spinal biopsy, to compare the results with those previously reported, and to determine if there are any factors that influence the accuracy of CT-guided thoracic spinal biopsy. Material and Methods. In total, 158 consecutive CT-guided percutaneous thoracic spine procedures (performed at the Dept. of Spinal Surgery, Xian Red Cross Hospital between April 2000 and July 2010) were reviewed. The 158 lesions were categorized by location and radiographic features. Pathological and clinical follow-up were used to determine accuracy. Results. The diagnostic accuracy of CT-guided thoracic spinal biopsy was 90.5% overall. Biopsy of metastatic bone disease (98.2%) was significantly more accurate than biopsies of primary tumors (80.9%) and of hematological malignancies (47.0%) (P < 0.05 and P < 0.005, respectively). The diagnostic accuracy of CT-guided thoracic spinal biopsy was significantly higher for the lower thoracic spine (97.6%) than for the middle (90.0%) or upper thoracic spine (80.4%) (P < 0.05 and P < 0.025, respectively). The diagnostic accuracy was significantly higher for lytic lesions (96.4%) than for sclerotic lesions (81.3%) (P < 0.010). The accuracy of biopsies performed using the transpedicular approach (91.0%) was not significantly different from that of biopsies performed using posterolateral approaches (91.5%) (0.25 < P < 0.5). Conclusion. Percutaneous CT-guided thoracic spinal biopsy is a viable alternative to open surgical biopsy. The diagnostic accuracy was not affected by any of the variables except for lesion level, histology, and radiographic features

  10. Percutaneous untying of a knot in a retained Swan-Ganz catheter

    International Nuclear Information System (INIS)

    Bhatti, Waqar A.; Sinha, Sankar; Rowlands, Peter

    2000-01-01

    A patient was referred to us with a tightly knotted Swan-Ganz catheter. The catheter could not be removed by conventional simple methods. We describe a minimally invasive means of removal of the catheter using an Amplatz gooseneck snare and an angioplasty balloon. This allowed the Catheter to be removed without trauma.

  11. Percutaneous pigtail catheter in the treatment of pneumothorax in major burns: the best alternative? Case report and review of literature.

    Science.gov (United States)

    Sebastian, Raul; Ghanem, Omar; Diroma, Frank; Milner, Stephen M; Gerold, Kevin B; Price, Leigh A

    2015-05-01

    Multiple factors place burn patients at a high risk of pneumothorax development. Currently, no specific recommendations for the management of pneumothorax in large total body surface area (TBSA) burn patients exist. We present a case of a major burn patient who developed pneumothorax after central line insertion. After the traditional large bore (24 Fr) chest tube failed to resolve the pneumothorax, the pneumothorax was ultimately managed by a percutaneous placed pigtail catheter thoracostomy placement and resulted in its complete resolution. We will review the current recommendations of pneumothorax treatment and will highlight on the use of pigtail catheters in pneumothorax management in burn patients. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  12. Post-marketing surveillance in the published medical and grey literature for percutaneous transluminal coronary angioplasty catheters: a systematic review.

    Science.gov (United States)

    Polisena, Julie; Forster, Alan J; Cimon, Karen; Rabb, Danielle

    2013-10-10

    Post-marketing surveillance (PMS) may identify rare serious incidents or adverse events due to the long-term use of a medical device, which was not captured in the pre-market process. Percutaneous transluminal coronary angioplasty (PTCA) is a non-surgical procedure that uses a balloon-tipped catheter to enlarge a narrowed artery. In 2011, 1,942 adverse event reports related to the use of PTCA catheters were submitted to the FDA by the manufacturers, an increase from the 883 reported in 2008. The primary research objective is to conduct a systematic review of the published and grey literature published between 2007 and 2012 for the frequency of incidents, adverse events and malfunctions associated with the use of PTCA catheters in patients with coronary artery disease (CAD). Grey literature has not been commercially published. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and PubMed for medical literature on PMS for PTCA catheters in patients with CAD published between January 2007 and July 2012. We also searched the grey literature. This review included 11 studies. The in-hospital adverse events reported were individual cases of myocardial infarction and hematoma. In studies of patients with coronary perforation, more patients with balloon angioplasty were identified compared with patients who required stenting. Our systematic review illustrates that the volume and quality of PMS studies associated with the use of PTCA catheters in patients with CAD are low in the published and grey literature, and may not be useful sources of information for decisions on safety. In most studies, the objectives were not to monitor the long-term safety of the use of PTCA catheters in clinical practice. Future studies can explore the strengths and limitations of PMS databases administered by regulatory authorities.

  13. Percutaneous CT-guided high-dose brachytherapy (CT-HDRBT) ablation of primary and metastatic lung tumors in nonsurgical candidates; Perkutane CT-gesteuerte Hochdosis-Brachytherapie (CT-HDRBT) von primaeren und metastatischen Lungentumoren in nicht chirurgischen Kandidaten

    Energy Technology Data Exchange (ETDEWEB)

    Collettini, F.; Schnapauff, D.; Poellinger, A.; Denecke, T.; Banzer, J.; Golenia, M.J.; Gebauer, B. [Charite - Universitatesmedizin Berlin (Germany). Inst. fuer Radiologie; Wust, P. [Charite - Universitatesmedizin Berlin (Germany). Klinik fuer Strahlentherapie

    2012-04-15

    To evaluate the safety and efficacy of CT-guided high-dose brachytherapy (CT-HDRBT) ablation of primary and metastatic lung tumors. Between November 2007 and May 2010, all consecutive patients with primary or metastatic lung tumors, unsuitable for surgery, were treated with CT-HDRBT. Imaging follow-up after treatment was performed with contrast-enhanced CT at 6 weeks, 3 months and every 6 months after the procedure. The endpoints of the study were local tumor control and time to progression. The Kaplan-Meier method was used to estimate survival functions and local tumor progression rates. 34 procedures were carried out on 33 lesions in 22 patients. The mean diameter of the tumors was 33.3 mm (SD = 20.4). The first contrast-enhanced CT showed that complete ablation was achieved in all lesions. The mean minimal tumor enclosing dose was 18.9 Gy (SD = 2). Three patients developed a pneumothorax after the procedure. The mean follow-up time was 13.7 (3 - 29) months. 2 of 32 lesions (6.25 %) developed a local tumor progression. 8 patients (36.3 %) developed a distant tumor progression. After 17.7 months, 13 patients were alive and 9 patients had died. CT-HDRBT ablation is a safe and attractive treatment option for patients with lung malignancies and allows targeted destruction of tumor tissue with simultaneous preservation of important lung structures. Furthermore, CT-HDRBT is independent of the size of the lesion and its location within the lung parenchyma. (orig.)

  14. Percutaneous cardiopulmonary support for catheter ablation of unstable ventricular arrhythmias in high-risk patients.

    Science.gov (United States)

    Carbucicchio, Corrado; Della Bella, Paolo; Fassini, Gaetano; Trevisi, Nicola; Riva, Stefania; Giraldi, Francesco; Baratto, Francesca; Marenzi, Giancarlo; Sisillo, Erminio; Bartorelli, Antonio; Alamanni, Francesco

    2009-11-01

    In patients with severe cardiomyopathy, recurrent episodes of nontolerated ventricular tachycardia (VT) or electrical storm (ES) frequently cause acute heart failure and cardiac death; the suppression of the arrhythmia is therefore lifesaving, but feasibility of catheter ablation (CA) is precluded by the adverse hemodynamic conditions together with the characteristics of the arrhythmia that interdicts efficacious mapping. The use of the percutaneous cardiopulmonary support (CPS) for circulatory assistance may allow patient's stabilization and enhance efficacy and safety of CA in this emergency setting. 19 patients (19 males; mean age 61 +/- 6 years; chronic ischemic cardiomyopathy, eleven patients; primary dilated cardiomyopathy, six patients; arrhythmogenic right ventricular dysplasia/ cardiomyopathy, two patients) with recurrent nontolerated VT episodes undergoing CPS-assisted CA were retrospectively evaluated. Twelve patients had acute hemodynamic failure refractory to inotropic agents and ventilatory assistance, seven patients had undergone a failing nonconventional CA procedure. 14 patients presented with ES, and in twelve the procedure was undertaken under emergency conditions within 24 h from admission. Patients were ventilated under general anesthesia and assisted by a multidisciplinary team. The CPS system consisted in a Medtronic Bio-Medicus centrifugal pump and in a Maxima Plus oxygenator, a 15-F arterial cannula, and a 17-F venous cannula. Flows between 2 and 3 l/min were activated after induction of 56/62 forms of nontolerated VT, achieving hemodynamic stabilization in all patients. CA was mainly guided by conventional activation mapping and was effective in abolishing 45/56 supported VTs; in 10/19 patients all clinical VTs were suppressed by CA. Mean procedural time was 4 h and 20 min. Complete stabilization was achieved in 13 patients (68%) without VT recurrence during a 7-day in-hospital monitoring. A significant clinical improvement was observed in

  15. Percutaneous transgluteal drainage of pelvic abscesses in interventional radiology: A safe alternative to surgery.

    Science.gov (United States)

    Robert, B; Chivot, C; Rebibo, L; Sabbagh, C; Regimbeau, J-M; Yzet, T

    2016-02-01

    Interventional radiology plays an important role in the management of deep pelvic abscesses. Percutaneous drainage is currently considered as the first-line alternative to surgery. A transgluteal computed tomography (CT)-guided approach allows to access to deep infected collections avoiding many anatomical obstacles (vessels, nerves, bowel, bladder). The objective of this study was to assess the safety and efficacy of a transgluteal approach by reviewing our clinical experience. We reviewed medical records of patients having undergone percutaneous CT-guided transgluteal drainage for deep pelvic abscesses. We focused on the duration of catheter drainage, the complications related to the procedures and the rate of complete resolution. Between 2005 and 2013, 39patients (27women and 12men; mean age: 52.5) underwent transgluteal approach CT-guided percutaneous drainage of pelvis abscesses in our department. The origins of abscesses were postoperative complications in 34patients (87.2%) and infectious intra-abdominal disease in 5patients (12.8%). The mean duration of drainage was 8.3days (range: 3-33). Laboratory cultures were positive in 35patients (89.7%) and Escherichia coli was present in 71.4% of the positive samples. No major complication was observed. Drainage was successful in 38patients (97.4%). A transpiriformis approach was more significantly associated with intra-procedural pain (P=0.003). Percutaneous CT-guided drainage with a transgluteal approach is a safe, well-tolerated and effective alternative to surgery for deep pelvic abscesses. This approach should be considered as the first-line intention for the treatment of deep pelvic abscesses. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. PET/CT-guided interventions: Indications, advantages, disadvantages and the state of the art.

    Science.gov (United States)

    Cazzato, Roberto Luigi; Garnon, Julien; Shaygi, Behnam; Koch, Guillaume; Tsoumakidou, Georgia; Caudrelier, Jean; Addeo, Pietro; Bachellier, Philippe; Namer, Izzie Jacques; Gangi, Afshin

    2018-02-01

    Positron emission tomography/computed tomography (PET/CT) represents an emerging imaging guidance modality that has been applied to successfully guide percutaneous procedures such as biopsies and tumour ablations. The aim of the present narrative review is to report the indications, advantages and disadvantages of PET/CT-guided procedures in the field of interventional oncology and to briefly describe the experience gained with this new emerging technique while performing biopsies and tumor ablations.

  17. PET/CT-guided biopsies of metabolically active bone lesions: applications and clinical impact

    Energy Technology Data Exchange (ETDEWEB)

    Klaeser, Bernd; Wartenberg, Jan; Weitzel, Thilo; Krause, Thomas [Bern University Hospital and University of Bern, Department of Nuclear Medicine, Inselspital, Bern (Switzerland); Wiskirchen, Jakub [Bern University Hospital and University of Bern, Department of Nuclear Medicine, Inselspital, Bern (Switzerland); University Hospital Tuebingen, Department of Radiology, Neuroradiology, and Nuclear Medicine, Tuebingen (Germany); Schmid, Ralph A. [Bern University Hospital and University of Bern, Department of Thoracic Surgery, Inselspital, Bern (Switzerland); Mueller, Michel D. [Bern University Hospital and University of Bern, Department of Obstetrics and Gynaecology, Inselspital, Bern (Switzerland)

    2010-11-15

    In a minority of cases a definite diagnosis and stage grouping in cancer patients is not possible based on the imaging information of PET/CT. We report our experience with percutaneous PET/CT-guided bone biopsies to histologically verify the aetiology of hypermetabolic bone lesions. We retrospectively reviewed the data of 20 consecutive patients who underwent multimodal image-guided bone biopsies using a dedicated PET/CT system in a step-by-step technique. Technical and clinical success rates of PET/CT-guided biopsies were evaluated. Questionnaires were sent to the referring physicians to assess the impact of biopsies on patient management and to check the clinical need for PET/CT-guided biopsies. Clinical indications for biopsy were to histologically verify the aetiology of metabolically active bone lesions without a morphological correlate confirming the suspicion of metastases in 15 patients, to determine the origin of suspected metastases in 3 patients and to evaluate the appropriateness of targeted therapy options in 2 patients. Biopsies were technically successful in all patients. In 19 of 20 patients a definite histological diagnosis was possible. No complications or adverse effects occurred. The result of PET/CT-guided bone biopsies determined a change of the planned treatment in overall 56% of patients, with intramodality changes, e.g. chemotherapy with palliative instead of curative intent, and intermodality changes, e.g. systemic therapy instead of surgery, in 22 and 50%, respectively. PET/CT-guided bone biopsies are a promising alternative to conventional techniques to make metabolically active bone lesions - especially without a distinctive morphological correlate - accessible for histological verification. PET/CT-guided biopsies had a major clinical impact in patients who otherwise cannot be reliably stage grouped at the time of treatment decisions. (orig.)

  18. Percutaneous CT-guided treatment of osteoidosteomas: combination of drill biopsy and subsequent ethanol injection; Perkutane CT-gesteuerte Behandlung von Osteoidosteomen: kombiniertes Vorgehen mit einem Hohlbohrer und nachfolgender Aethanolinjektion

    Energy Technology Data Exchange (ETDEWEB)

    Adam, G. [Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany); Keulers, P. [Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany); Vorwerk, D. [Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany); Heller, K.D. [Orthopaedische Klinik, RWTH Aachen (Germany); Fuezesi, L. [Inst. fuer Pathologie, RWTH Aachen (Germany); Guenther, R.W. [Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany)

    1995-03-01

    The purpose of this study was the clinical evaluation of a percutaneous treatment modality in patients with an osteoidosteoma. 6 patients with an osteoidosteoma of the upper (n=1) and lower (n=5) extremity which were confirmed on plain film radiographs and computed tomography underwent CT controlled drill biopsy of the nidus with subsequent injection of 96% ethanol into the biopsy channel to sclerose probably remaining remnants of the nidus. The procedure was started under local anaesthesia, but drilling of the nidus was carried out under a short general anaesthesia using ketamine. The intervention was successful in all patients. No postinterventional infection occurred and no recurrence was observed in any of the patients in a follow-up time between 0.5 and 2 years. (orig./MG) [Deutsch] Zielsetzung der Untersuchungen war die klinische Erprobung eines perkutanen Verfahrens zur Behandlung von Osteoidosteomen. Bei 6 Patienten mit einem nativradiologisch und computertomographisch nachgewiesenen Osteoidosteom im Bereich der oberen (n=1) und der unteren Extremitaet (n=5) wurde perkutan unter CT-Kontrolle der Nidus ausgebohrt und ueber den Bohrkanal 96%iger Alkohol nachinjiziert, um etwaige Nidusreste zu sklerosieren. Der Eingriff wurde in Lokalanaesthesie begonnen, die Ausbohrung des Nidus unter einer Ketanestkurznarkose durchgefuehrt. Das Vorgehen war bei allen Patienten erfolgreich. In keinem Fall wurde eine postinterventionelle Infektion beobachtet. Ueber den Nachbeobachtungszeitraum von 0,5 bis zu 2,5 Jahren trat bei keinem der Patienten ein Rezidiv auf. (orig./MG)

  19. Radiation dose associated with CT-guided drain placement for pediatric patients

    International Nuclear Information System (INIS)

    Schwartz, Cody J.; Isaacson, Ari J.; Fordham, Lynn Ansley; Ivanovic, Marija; Dixon, Robert G.; Taylor, J.B.

    2017-01-01

    To date, there are limited radiation dose data on CT-guided procedures in pediatric patients. Our goal was to quantify the radiation dose associated with pediatric CT-guided drain placement and follow-up drain evaluations in order to estimate effective dose. We searched the electronic medical record and picture archiving and communication system (PACS) to identify all pediatric (<18 years old) CT-guided drain placements performed between January 2008 and December 2013 at our institution. We compiled patient data and radiation dose information from CT-guided drain placements as well as pre-procedural diagnostic CTs and post-procedural follow-up fluoroscopic abscess catheter injections (sinograms). Then we converted dose-length product, fluoroscopy time and number of acquisitions to effective doses using Monte Carlo simulations and age-appropriate conversion factors based on annual quality-control testing. Fifty-two drainages were identified with mean patient age of 11.0 years (5 weeks to 17 years). Most children had diagnoses of appendicitis (n=23) or inflammatory bowel disease (n=11). Forty-seven patients had diagnostic CTs, with a mean effective dose of 7.3 mSv (range 1.1-25.5 mSv). Drains remained in place for an average of 16.9 days (range 0-75 days), with an average of 0.9 (0-5) sinograms per patient in follow-up. The mean effective dose for all drainages and follow-up exams was 5.3 mSv (0.7-17.1) and 62% (32/52) of the children had effective doses less than 5 mSv. The majority of pediatric patients who have undergone CT-guided drain placements at our institution have received total radiation doses on par with diagnostic ranges. This information could be useful when describing the dose of radiation to parents and providers when CT-guided drain placement is necessary. (orig.)

  20. Radiation dose associated with CT-guided drain placement for pediatric patients

    Energy Technology Data Exchange (ETDEWEB)

    Schwartz, Cody J.; Isaacson, Ari J.; Fordham, Lynn Ansley; Ivanovic, Marija; Dixon, Robert G. [University of North Carolina at Chapel Hill, Department of Radiology, UNC Health Care, Chapel Hill, NC (United States); Taylor, J.B. [University of North Carolina at Chapel Hill, Environment, Health and Safety, Chapel Hill, NC (United States)

    2017-05-15

    To date, there are limited radiation dose data on CT-guided procedures in pediatric patients. Our goal was to quantify the radiation dose associated with pediatric CT-guided drain placement and follow-up drain evaluations in order to estimate effective dose. We searched the electronic medical record and picture archiving and communication system (PACS) to identify all pediatric (<18 years old) CT-guided drain placements performed between January 2008 and December 2013 at our institution. We compiled patient data and radiation dose information from CT-guided drain placements as well as pre-procedural diagnostic CTs and post-procedural follow-up fluoroscopic abscess catheter injections (sinograms). Then we converted dose-length product, fluoroscopy time and number of acquisitions to effective doses using Monte Carlo simulations and age-appropriate conversion factors based on annual quality-control testing. Fifty-two drainages were identified with mean patient age of 11.0 years (5 weeks to 17 years). Most children had diagnoses of appendicitis (n=23) or inflammatory bowel disease (n=11). Forty-seven patients had diagnostic CTs, with a mean effective dose of 7.3 mSv (range 1.1-25.5 mSv). Drains remained in place for an average of 16.9 days (range 0-75 days), with an average of 0.9 (0-5) sinograms per patient in follow-up. The mean effective dose for all drainages and follow-up exams was 5.3 mSv (0.7-17.1) and 62% (32/52) of the children had effective doses less than 5 mSv. The majority of pediatric patients who have undergone CT-guided drain placements at our institution have received total radiation doses on par with diagnostic ranges. This information could be useful when describing the dose of radiation to parents and providers when CT-guided drain placement is necessary. (orig.)

  1. Treatment of osteoid osteoma using CT-guided radiofrequency ablation versus MR-guided laser ablation: A cost comparison

    International Nuclear Information System (INIS)

    Maurer, M.H.; Gebauer, B.; Wieners, G.; De Bucourt, M.; Renz, D.M.; Hamm, B.; Streitparth, F.

    2012-01-01

    Objective: To compare the costs of CT-guided radiofrequency ablation (RFA) and MR-guided laser ablation (LA) for minimally invasive percutaneous treatment of osteoid osteoma. Materials and methods: Between November 2005 and October 2011, 20 patients (14 males, 6 females, mean age 20.3 ± 9.1 years) underwent CT-guided RFA and 24 patients (18 males, 6 females; mean age, 23.8 ± 13.8 years) MR-guided LA (open 1.0 Tesla, Panorama HFO, Philips, Best, Netherlands) for osteoid osteoma diagnosed on the basis of clinical presentation and imaging findings. Prorated costs of equipment use (purchase, depreciation, and maintenance), staff costs, and expenditure for disposables were identified for CT-guided RFA and MR-guided LA procedures. Results: The average total costs per patient were EUR 1762 for CT-guided RFA and EUR 1417 for MR-guided LA. These were (RFA/LA) EUR 92/260 for equipment use, EUR 149/208 for staff, and EUR 870/300 for disposables. Conclusion: MR-guided LA is less expensive than CT-guided RFA for minimally invasive percutaneous ablation of osteoid osteoma. The higher costs of RFA are primarily due to the higher price of the disposable RFA probes.

  2. Comparison of conventional straight and swan-neck straight catheters inserted by percutaneous method for continuous ambulatory peritoneal dialysis: a single-center study.

    Science.gov (United States)

    Singh, Shivendra; Prakash, Jai; Singh, R G; Dole, P K; Pant, Pragya

    2015-10-01

    To evaluate the incidence of mechanical and infectious complications of conventional straight catheter (SC) versus swan-neck straight catheter (SNSC) implanted by percutaneous method. We retrospectively analyzed 45 catheter insertions being done by percutaneous method from January 1, 2011, to May 31, 2014. SC was inserted in 24 patients, and SNSC was inserted in 21 patients. Baseline characteristics for the two groups were similar with respect to age, sex and diabetic nephropathy as the cause for end-stage renal disease. Incidence of mechanical and infectious complications in SNSC group was found to be low as compared to the SC group and was statistically significant (1 in 11.6 patient months vs. 1 in 14.4 patient months, p = 0.02). Catheter migration was found to be the most common mechanical complication (20 %), and peritonitis was found to be the most common infectious complication in conventional SC group (27 episodes in 420 patient months vs. 11 episodes in 333 patient months, p = 0.03). The incidence of exit site and tunnel infection rates revealed no difference between the groups. SNSC insertion by percutaneous method is associated with low mechanical and infectious complications.

  3. Cerebrospinal Fluid Leak at Percutaneous Exit of Ventricular Catheter as a Crucial Risk Factor for External Ventricular Drainage-Related Infection in Adult Neurosurgical Patients.

    Science.gov (United States)

    Park, Jaechan; Choi, Yeon-Ju; Ohk, Boram; Chang, Hyun-Ha

    2018-01-01

    The placement of a ventricular catheter for temporary cerebrospinal fluid (CSF) diversion is associated with a considerable risk of CSF infection. The authors investigated the effect of a CSF leak on CSF-related infection and the predisposing factors for a CSF leak. Fifty-two patients who underwent external ventricular drainage (EVD) for acute hydrocephalus associated with a subarachnoid hemorrhage or intraventricular hemorrhage (IVH) were enrolled in this prospective study. A CSF leak-detection paper (small sterilized filter paper) was applied at the percutaneous catheter exit site to check for any bloody CSF leak. In addition, radiologic and clinical data were collected. Four of the 52 patients (7.7%) developed an EVD-related CSF infection from organisms including Staphylococcus epidermidis (n = 3) and Staphylococcus hominis (n = 1). A prolonged CSF leak >1 day was detected in 9 patients (17.3%) and revealed as a significant risk factor for CSF infection with a 44.4% positive predictive value. Moreover, an IVH >10 mL was found in 11 patients (21.2%) and revealed as a significant predisposing factor for a CSF leak at the percutaneous catheter exit. A prolonged CSF leak for >1 day at the percutaneous catheter exit site is a crucial risk factor for EVD-related CSF infection and an IVH >10 mL is a predisposing factor for a CSF leak. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Liver CT-guided aspirative biopsies

    International Nuclear Information System (INIS)

    Santos, Gilda da Cunha; Carvalho, Leda Viegas de; Chojniak, Rubens; Morini, Sandra Regina

    1996-01-01

    Sixty-eight CT-guided aspirative biopsies of hepatic nodules were performed at A.C. Camargo Hospital, Sao Paulo, Brazil, from 1992 to 1995. The cases were distributed as follow: 44(64.7%) with a positive diagnosis for neoplastic cells, 6(8.8%) with a negative diagnosis, and 14 (20.5%) with insufficient material. Of the positive cases (primary neoplasias and metastases), the cytological diagnosis was achieved in 39 cases. There were 36 cases of carcinoma (7 hepato carcinomas, 18 adenocarcinomas, 1 small cell carcinoma and 10 cases of unspecified differentiation), 2 cases of melanoma and 1 case of melanoma and 1 case of sarcoma. The correlation with histopathological exams showed no false positive cases and concordance between cytological and histopathological diagnosis. The results demonstrate that CT-guided aspirative biopsy of hepatic nodules permits a rapid diagnosis of neoplastic lesions, especially for the evaluation of metastases. (author)

  5. Efficacy and safety of transradial percutaneous coronary intervention using sheathless guide catheter technique

    Directory of Open Access Journals (Sweden)

    Mohamed Aboel-Kassem F. Abdelmegid

    2014-03-01

    Conclusions: TR PCI via standard and sheathless hydrophilic-coated GC techniques are effective and safe with high rate of procedural success and low rate of asymptomatic radial artery occlusion. Moreover, TR PCI using sheathless GC technique has the advantage of performing complex intervention requiring large bore catheters that can not be performed via standard TR PCI using 6F GC.

  6. CT-guided interventions in children

    International Nuclear Information System (INIS)

    Honnef, D.; Wildberger, J.E.; Schubert, H.; Hohl, C.; Guenther, R.W.; Mahnken, A.

    2007-01-01

    In pediatric CT-guided interventions specific features have to be taken into account. Due to a lack of cooperation or limited ability to cooperate, procedures are often performed using analgosedation or general anesthesia. To provide radiation protection, justified indication for CT-guided intervention is necessary and sonography and MRI are to be preferred whenever possible. CT examinations also need to be dose-adapted with sequential scanning and a tube voltage and tube current reduction compared to pediatric diagnostic CT studies must be ensured. Gonad shields are recommended for male patients. Biopsy device selection depends on the assumed tumor entity since histology and also immunohistochemical, molecular pathological and cytogenetical analysis are necessary to differentiate pediatric tumors (small, round, blue cell tumors). In addition to diagnostic procedures, therapeutic interventions (drainage, injection therapies, neurolysis, and radiofrequency ablation) can also be used in children and can provide an alternative to surgery in selected cases. With justified indications and precise performance, CT-guided interventions can be successful in pediatric patients with limited risks. (orig.)

  7. Radiation exposure in CT-guided interventions

    Energy Technology Data Exchange (ETDEWEB)

    Kloeckner, Roman, E-mail: Roman.Kloeckner@unimedizin-mainz.de [Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University, Langenbeckstraße 1, 55131 Mainz (Germany); Santos, Daniel Pinto dos; Schneider, Jens [Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University, Langenbeckstraße 1, 55131 Mainz (Germany); Kara, Levent [Department of Radiology, Inselspital Bern, Freiburgstraße 18, 3010 Bern (Switzerland); Dueber, Christoph; Pitton, Michael B. [Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University, Langenbeckstraße 1, 55131 Mainz (Germany)

    2013-12-01

    Purpose: To investigate radiation exposure in computed tomography (CT)-guided interventions, to establish reference levels for exposure, and to discuss strategies for dose reduction. Materials and methods: We analyzed 1576 consecutive CT-guided procedures in 1284 patients performed over 4.5 years, including drainage placements; biopsies of different organs; radiofrequency and microwave ablations (RFA/MWA) of liver, bone, and lung tumors; pain blockages, and vertebroplasties. Data were analyzed with respect to scanner settings, overall radiation doses, and individual doses of planning CT series, CT intervention, and control CT series. Results: Eighy-five percent of the total radiation dose was applied during the pre- and post-interventional CT series, leaving only 15% applied by the CT-guided intervention itself. Single slice acquisition was associated with lower doses than continuous CT-fluoroscopy (37 mGy cm vs. 153 mGy cm, p < 0.001). The third quartile of radiation doses varied considerably for different interventions. The highest doses were observed in complex interventions like RFA/MWA of the liver, followed by vertebroplasty and RFA/MWA of the lung. Conclusions: This paper suggests preliminary reference levels for various intervention types and discusses strategies for dose reduction. A multicenter registry of radiation exposure including a broader spectrum of scanners and intervention types is needed to develop definitive reference levels.

  8. Repositioning and Leaving In Situ the Central Venous Catheter During Percutaneous Treatment of Associated Superior Vena Cava Syndrome: A Report of Eight Cases

    International Nuclear Information System (INIS)

    Stockx, Luc; Raat, Henricus; Donck, Jan; Wilms, Guy; Marchal, Guy

    1999-01-01

    Purpose: To describe a combined procedure of repositioning and leaving in situ a central venous catheter followed by immediate percutaneous treatment of associated superior vena cava syndrome (SVCS). Methods: Eight patients are presented who have central venous catheter-associated SVCS (n = 6 Hickman catheters, n = 2 Port-a-cath) caused by central vein stenosis (n = 4) or concomitant thrombosis (n = 4). With the use of a vascular snare introduced via the transcubital or transjugular approach, the tip of the central venous catheter could be engaged, and repositioned after deployment of a stent in the innominate or superior vena cava. Results: In all patients it was technically feasible to reposition the central venous catheter and treat the SVCS at the same time. In one patient flipping of the Hickman catheter in its original position provoked dislocation of the released Palmaz stent, which could be positioned in the right common iliac vein. Conclusion: Repositioning of a central venous catheter just before and after stent deployment in SVCS is technically feasible and a better alternative than preprocedural removal of the vascular access

  9. Percutaneous transfermoral embolization of intracerebral arteriovenous malformation by using conventional catheter

    International Nuclear Information System (INIS)

    Choo, In Wook; Park, Soo Sung; Yoon, Jung Sup; Lim, Hyo Keun; Lee, Kyu Ho; Eoh, Whan

    1988-01-01

    Non-surgical transfermoral embolization of centrally located huge intracerebral arteriovenous malformation (AVM) was successfully performed by using conventional 6.5F DAVIS II Catheter in the department of Radiology, Kangdong Sacred Heart Hospital, May 17, 1988. The large A.V.M. was located in left basal ganglia and thalamus on brain C.T. and was supplied by multiple dilated lateral lenticulostriate arteries from left middle cerebral artery and posterior thalamoperforating artery, posterior choroidal artery from left posterior cerebral artery angiographically. The AVM was partially obliterated after embolization of lateral lenticulostriate arteries and thalamoperforating artery with P.V.A. (Polyvinyl Alcohol, ivalon) using conventional 6.5F DAVIS II angiographic catheter. There was no complication which was related to those embolization procedures except transient drowsy consciousness after embolization but it is completely recovered to the level of preembolization state after 10 hours.

  10. Usefulness and Safety of a Guide Catheter Extension System for the Percutaneous Treatment of Complex Coronary Lesions by a Transradial Approach

    OpenAIRE

    García-Blas, Sergio; Núñez, Julio; Mainar, Luis; Miñana, Gema; Bonanad, Clara; Racugno, Paolo; Rodríguez, Juan Carlos; Moyano, Patricia; Sanchis, Juan

    2014-01-01

    Objective The aim of this study was to describe our initial experience with the GuideLiner® catheter (Vascular Solutions Inc.) in the transradial treatment of complex lesions. Materials and Methods The clinical, angiographic and procedural data of percutaneous coronary interventions where GuideLiner was used during 2013 were collected. The transradial approach was used in all cases. The indication for its use, efficacy and periprocedural complications were determined. Sixteen consecutive proc...

  11. A Simplified Technique of Percutaneous Hepatic Artery Port-Catheter Insertion for the Treatment of Advanced Hepatocellular Carcinoma with Portal Vein Invasion

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Sun Young [Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Kim, Ah Hyun; Lee, Do Yun; Lee, Kwang Hun; Won, Jong Yun [Yonsei University College of Medicine, Severance Hospital, Seoul (Korea, Republic of); Kim, Kyung Ah [Inje University Ilsan Paik Hospital, Ilsan (Korea, Republic of)

    2010-12-15

    We assessed the outcomes of a simplified technique for the percutaneous placement of a hepatic artery port-catheter system for chemotherapy infusion in advanced hepatocellular carcinoma with portal vein invasion. From February 2003 to February 2008, percutaneous hepatic artery port-catheter insertion was performed in 122 patients who had hepatocellular carcinoma with portal vein invasion. The arterial access route was the common femoral artery. The tip of the catheter was wedged into the right gastroepiploic artery without an additional fixation device. A side hole was positioned at the distal common hepatic artery to allow the delivery of chemotherapeutic agents into the hepatic arteries. Coil embolization was performed only to redistribute to the hepatic arteries or to prevent the inadvertent delivery of chemotherapeutic agents into extrahepatic arteries. The port chamber was created at either the supra-inguinal or infra-inguinal region. Technical success was achieved in all patients. Proper positioning of the side hole was checked before each scheduled chemotherapy session by port angiography. Catheter-related complications occurred in 19 patients (16%). Revision was achieved in 15 of 18 patients (83%). This simplified method demonstrates excellent technical feasibility, an acceptable range of complications, and is hence recommended for the management of advanced hepatocellular carcinoma with portal vein thrombosis

  12. CT-guided biopsies and drainage

    International Nuclear Information System (INIS)

    Scheppers, I.; Wollschlaeger, D.

    2011-01-01

    Following the implementation of computed tomography (CT) or ultrasound-guided biopsy of solid tumors and the puncture and drainage of liquid processes, the number of surgical open biopsies and curative operations for abscess drainage has declined. Such CT-guided interventions are performed in nearly every organ. Instead of aspiration biopsies, more and more core biopsies are being performed to allow histopathological evaluation and thus allowing targeted therapy. This article is intended to give a general overview of techniques, materials, indications and contraindications. Ultrasound-guided biopsies as well as large bore vacuum biopsies of the breast are not included in this review. (orig.) [de

  13. Efficacy of incision and drainage versus percutaneous catheter drainage in treatment of severe acute pancreatitis complicated by pancreatic abscess

    Directory of Open Access Journals (Sweden)

    YANG Feng

    2016-03-01

    Full Text Available ObjectiveTo investigate the clinical features and treatment of severe acute pancreatitis (SAP complicated by pancreatic abscess (PA. MethodsThe clinical data of 17 SAP patients with PA who were admitted to Affiliated Hospital of Luzhou Medical College from January 1, 2005 to August 25, 2015 were analyzed retrospectively. The clinical manifestations, therapeutic methods, and outcome were summarized. ResultsOf all the 17 patients, 12 patients underwent surgical operation, among whom 9 were cured, 1 experienced postoperative intestinal fistula, and 2 experienced recurrence of abscess and underwent the surgery again (1 died of multiple organ failure, and the mean hospital stay was (108.29±52.37 d; 5 patients underwent percutaneous catheter drainage, among whom 4 were cured, and 1 underwent surgical treatment due to inadequate drainage, and the mean hospital stay was (53.03±6.71 d. ConclusionAdequate drainage should be performed once a confirmed diagnosis of PA is made, and appropriate drainage methods should be selected based on the patient′s actual condition. Minimally invasive treatment has a good effect, a short length of hospital stay, and few complications, and holds promise for clinical application.

  14. Clinical efficacy, safety, and costs of percutaneous occlusive balloon catheter-assisted ureteroscopic lithotripsy for large impacted proximal ureteral calculi: a prospective, randomized study.

    Science.gov (United States)

    Qi, Shiyong; Li, Yanni; Liu, Xu; Zhang, Changwen; Zhang, Hongtuan; Zhang, Zhihong; Xu, Yong

    2014-09-01

    To evaluate the clinical efficacy, safety, and costs of percutaneous occlusive balloon catheter-assisted ureteroscopic lithotripsy (POBC-URSL) for large impacted proximal ureteral calculi. 156 patients with impacted proximal ureteral stones ≥1.5 cm in size were randomized to ureteroscopic lithotripsy (URSL), POBC-URSL, and percutaneous nephrolithotomy (PNL) group between May 2010 and May 2013. For URSL, the calculi were disintegrated with the assistance of anti-retropulsion devices. POBC-URSL was performed with the assistance of an 8F percutaneous occlusive balloon catheter. PNL was finished with the combination of an ultrasonic and a pneumatic lithotripter. A flexible ureteroscope and a 200 μm laser fiber were used to achieve stone-free status to a large extent for each group. Variables studied were mean operative time, auxiliary procedure, postoperative hospital stay, operation-related complications, stone clearance rate, and treatment costs. The mean lithotripsy time for POBC-URSL was shorter than URSL, but longer than PNL (42.6±8.9 minutes vs 66.7±15.3 minutes vs 28.1±6.3 minutes, p=0.014). The auxiliary procedure rate and postoperative fever rate for POBC-URSL were significantly lower than URSL and comparable to PNL (pPNL (98.1% vs 75.0% vs 96.2%, pPNL group and similar to URSL group (p=0.016, pPNL.

  15. CT-guided pericardiocenteses: Clinical profile, practice patterns and clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Eichler, Katrin, E-mail: k.eichler@em.uni-frankfurt.d [Department of Diagnostic and Interventional Radiology, University of Frankfurt, Frankfurt (Germany); Zangos, Stephan; Thalhammer, Axel; Jacobi, Volkmar [Department of Diagnostic and Interventional Radiology, University of Frankfurt, Frankfurt (Germany); Walcher, Felix; Marzi, Ingo [Department of Trauma, Hand and Reconstructive Surgery, University of Frankfurt, Frankfurt (Germany); Moritz, Anton [Department of Thoracic and Cardiovascular Surgery, University of Frankfurt, Frankfurt (Germany); Vogl, Thomas J.; Mack, Martin G. [Department of Diagnostic and Interventional Radiology, University of Frankfurt, Frankfurt (Germany)

    2010-07-15

    Objective: To assess the effectiveness and clinical outcome and technique of CT-guided pericardiocenteses in the treatment of pericardial effusions in adults and children. Methods: 20 drainages were performed in Seldinger-technique under CT-guidance on 20 patients suffering from pericardial effusions and haematomas. In 85%, the etiology of effusion was postoperative. The mean age of the patients was 59 years (minimum 9 years, maximum 86 years).There were 12 male and eight female patients. The inclusion criterion was an echocardiographically relevant proved pericardial effusion. Results: All catheters could be placed successfully (20/20) in the pericardial effusion and allowed for draining of the effusion in all cases under CT-guidance. The overall 30-day mortality rate was 0%. CT-guided pericardiocentesis was successful for withdrawing pericardial fluid and/or relieving tamponade in 100% of all procedures. No major complication was occurred. A total of one minor complication (5%) occurred that required no specific interventions, except for monitoring and appropriate follow-up. We observed one pneumothorax as a minor complication. Conclusions: Pericardial effusions of various causes can be safely, effectively, and quickly managed with CT-guided pericardiocenteses in adults and children. The ventrolateral entry side for the puncture should be preferred to reach the whole effusion and avoid complications, like a pneumothorax.

  16. CT-guided pericardiocenteses: Clinical profile, practice patterns and clinical outcome

    International Nuclear Information System (INIS)

    Eichler, Katrin; Zangos, Stephan; Thalhammer, Axel; Jacobi, Volkmar; Walcher, Felix; Marzi, Ingo; Moritz, Anton; Vogl, Thomas J.; Mack, Martin G.

    2010-01-01

    Objective: To assess the effectiveness and clinical outcome and technique of CT-guided pericardiocenteses in the treatment of pericardial effusions in adults and children. Methods: 20 drainages were performed in Seldinger-technique under CT-guidance on 20 patients suffering from pericardial effusions and haematomas. In 85%, the etiology of effusion was postoperative. The mean age of the patients was 59 years (minimum 9 years, maximum 86 years).There were 12 male and eight female patients. The inclusion criterion was an echocardiographically relevant proved pericardial effusion. Results: All catheters could be placed successfully (20/20) in the pericardial effusion and allowed for draining of the effusion in all cases under CT-guidance. The overall 30-day mortality rate was 0%. CT-guided pericardiocentesis was successful for withdrawing pericardial fluid and/or relieving tamponade in 100% of all procedures. No major complication was occurred. A total of one minor complication (5%) occurred that required no specific interventions, except for monitoring and appropriate follow-up. We observed one pneumothorax as a minor complication. Conclusions: Pericardial effusions of various causes can be safely, effectively, and quickly managed with CT-guided pericardiocenteses in adults and children. The ventrolateral entry side for the puncture should be preferred to reach the whole effusion and avoid complications, like a pneumothorax.

  17. Isolate pulmonary nodule. CT-guided biopsy

    International Nuclear Information System (INIS)

    Bruneton, J.N.; Ettore, F.; Rogopoulos, A.; Geoffray, A.; Balu-Maestro, C.; Le Houcq, M.

    1989-01-01

    Transparietal CT-guided biopsy location can be successfully performed for isolate pulmonary nodules, defined as lesions with a maximal diameter of 3 cm, without any other parenchymal or mediastinal abnormality. A 21 G needle has been used according to an identical protocole in 64 cases (10 benign, 54 malignant). The biopsy was successful in 77.7% of the malignant cases. In relation to the diameter of the nodules, biopsy was successful in 66.7% of the nodules smaller than 2 cm and in 76% of the nodules ranging from 2 to 3 cm. The complications observed were rare (1 case of pneumothorax requiring drainage, 9 cases of pneumothorax without clinical signs and simply followed up, 4 cases of minor hemoptysis requiring no treatment and 5 cases of hematomas smaller than 5 cm on CT) [fr

  18. Transradial percutaneous coronary intervention for left main bifurcation lesions using 7.5-Fr sheathless guide catheter.

    Science.gov (United States)

    Zhao, Huiqiang; Banerjee, Subhash; Chen, Hui; Li, Hongwei

    2018-05-01

    Recent studies have shown sheathless guide catheters (GCs) to be safe and effective during complex lesions such as bifurcations, chronic total occlusion (CTO), and/or calcified lesions. We investigated the feasibility and safety of using 7.5-Fr sheathless GC for transradial percutaneous coronary intervention (PCI) to treat left main bifurcation lesions.A total of 82 patients were consecutively enrolled from March 2013 to February 2016. They underwent transradial PCI for left main bifurcation lesions using the 7.5-Fr sheathless GC.The mean syntax score was 28.1 ± 6.1, and the majority (n = 55, 67.1%) was intermediate scores (23∼32). The unprotected LM disease was present in 67 of 82 patients (81.7%), and true bifurcation (Medina 1, 1, 1) was present in 46 of 82 patients (56.1%). The 2-stent technique was used in 62 of 82 patients (75.6%). The 2-stent technique included 31 cases (37.8%) of "Crush," 18 cases (22.0%) of "Cullote," and 13 (15.8%) cases of "T stent and modified T stent" (T stent). Immediate angiographic success rate was 100% (82/82), and procedural success rate was 97.6% (80/82). The vascular complications occurred in 3 patients (3/82, 3.7%).The use of 7.5-Fr sheathless GC is safe and allows PCI for complex bifurcation lesions located in the distal of left main to be performed transradially with a high success rate.

  19. The value of percutaneous catheter cholangiography in postoperative diagnostics after biliobiliary and biliodigestive anastomoses; Wertigkeit der perkutanen Kathetercholangiographie in der postoperativen Diagnostik biliodigestiver und biliobiliaerer Anastomosen

    Energy Technology Data Exchange (ETDEWEB)

    Barkhausen, J. [Zentralinstitut fuer Roentgendiagnostik, Universitaetsklinikum Essen (Germany); Bidlingmaier, J. [Zentralinstitut fuer Roentgendiagnostik, Universitaetsklinikum Essen (Germany); Mueller, R.D. [Zentralinstitut fuer Roentgendiagnostik, Universitaetsklinikum Essen (Germany); Langer, R. [Zentralinstitut fuer Roentgendiagnostik, Universitaetsklinikum Essen (Germany)

    1996-09-01

    Aim of study: To examine the relative importance of percutaneous catheter cholangiography in postoperative diagnostics after biliary reconstruction. Methods: 55 patients (33 males, 22 females) were subjected to 101 catheter cholangiographies. 30-50 ml of a water-soluble, iodic contrast medium were administered via an infusion system. Initial examinations were performed between the 3nd and 7th day following operation, while follow-up examinations were executed between the 8th and 145th day after surgery. The position of the catheter, the function of the anastomosis, the filling of the biliary ducts and the discharge of the contrast medium were assessed. Results: 45 examinations were inconspicuous. Drainage obstruction of the contrast medium was observed in 24 cases. Filling defects were observed in 8 examinations. A dislocation of the catheter was encountered in 5 cholangiographies while 19 examinations displayed a bile leak. Conclusion: Percutaneous catheter cholangiographies can be used to detect postoperative complications following biliary reconstruction in an easy, reliable, and cost-effective manner that also does not put too much strain on the patient. Indications for the inplementation of catheter cholangiographies are the occurrence of abdominal complaints, the clinical appearance of a peritonitis, or an increase of the serum bilirubin value. Routine examinations are recommended in conditions following liver transplantations. In addition to this, a cholangiography should be carried out prfor to the removal of the catheter. (orig.) [Deutsch] Fragestellung: Geprueft wird der Stellenwert der perkutanen Kathetercholangiographie in der postoperativen Diagnostik nach Anlage biliobiliaerer und biliodigestiver Anastomosen. Material und Methode: Bei 55 Patienten (33 maennlich, 22 weiblich) wurden 101 Kathetercholangiographien durchgefuehrt. Die Erstuntersuchung erfolgte zwischen dem 3. und 7. postoperativen Tag, Kontrolluntersuchungen zwischen dem 8. und 145. Tag

  20. Usefulness of CT-guided automatic needle biopsy of solitary pulmonary nodule smaller than 15 mm

    International Nuclear Information System (INIS)

    Jin, Gong Yong; Lim, Yeong Su

    2004-01-01

    To evaluate the usefulness of the CT-guided percutaneous lung biopsy for the solitary pulmonary nodules smaller than 15 mm in diameter. Between April 2002 and May 2003, we evaluated twenty-five patients (11 men, 14 women, mean ages: 52.5 years) who had solitary pulmonary nodules, which we could not discriminate as being benign or malignant on the CT findings. All the subjects had CT-guided percutaenous cutting needle biopsy (PCNB) performed on them at our institution. A definitive diagnosis of benignity or malignancy was established to retrospectively analyze the patient's records. We evaluated the accuracy, sensitivity, specificity and complications of PCNB for the definitive diagnosis of benignity or malignancy. The sensitivity and specificity of PCNB were determined using the Chi-square test, and the correlations with pneumothorax and emphysema after biopsy were analyzed using Spearman's rank correlation coefficient. In two nodules of the twenty-five nodules, no definitive diagnosis could be established. Of the remaining twenty-three nodules, 7 (30.4%) were malignant and 16 (69.6%) were benign. Twenty (87%) of the twenty-three definitively diagnosed nodules were correctly diagnosed with PCNB. Of the twenty nodules, 6 (30%) were malignant and 14 (70%) were benign. The sensitivity and specificity of the malignant nodules were 85.7% (6/7) and 100% (16/16), respectively. The sensitivity and specificity of the benign nodules were 87.5% (14/16) and 85.7% (6/7), respectively. Post-biopsy complication occurred in nine patients (36%): Hemoptysis (n=4, 16%) and pneumothorax (n=5, 20%). However, there was not a statistical significance between pneumothorax and emphysema after biopsy (r=0.3, p=0.15). When CT-guided percutaneous lung biopsy of the solitary pulmonary nodules smaller than 15 mm in diameter was performed without an on-site cytopathologist, we know that PCNB can yield high diagnostic accuracy and very few complications

  1. CT-guided radiofrequency ablation of spinal osteoid osteomas with concomitant perineural and epidural irrigation for neuroprotection

    International Nuclear Information System (INIS)

    Klass, Darren; Marshall, Tom; Toms, Andoni

    2009-01-01

    Here we report our experience of a neuroprotective adaptation of the technique of CT-guided radiofrequency (RF) ablation of spinal osteoid osteomas. Over 9 years seven patients underwent eight CT-guided RF treatments for osteoid osteoma. CT-guided RF ablation was performed with general anaesthesia. The lesion was heated to 90 C for 2 min for two cycles by using a Cosman SMK TC-10 RF electrode. This was preceded by a bolus of room temperature sterile water (10 ml) injected through a 26G curved spinal needle into the exit foramen and adjacent epidural space for neuroprotection. The age of the patient, sex, lesion location, biopsy results and complications were recorded. All the biopsies (n = 7) demonstrated histological features of osteoid osteoma. All the procedures were technically successful. Clinical success was assessed up to 3 years post procedure. There was an 85% clinical success rate (6 of the 7 patients), with recurrence of a lesion at 6 months, necessitating a repeat procedure (successful). CT-guided percutaneous RF ablation of spinal osteoid osteoma preceded by bolus of sterile water, injected through a spinal needle into the exit foramen and adjacent epidural space for neuroprotection, is a safe and effective procedure. (orig.)

  2. Biopsy system for CT-guided biopsies

    International Nuclear Information System (INIS)

    Onik, G.; Cosman, E.; Wells, T.; Goldberg, H.I.; Moss, A.; Costello, P.; Kane, R.

    1987-01-01

    CT stereotaxic brain biopsies have made brain biopsies safe and minimally invasive. CT-guided biopsies of the body, however, have traditionally used a hand-guidance method. CT biopsy guidance systems for the body have recently become available that have similar capabilities as those of brain biopsy systems. To compare the clinical utility of stereotaxically guided biopsies with hand-guided biopsies, the authors prospectively compared 40 biopsies performed with each method. In the stereotaxic method, a localizor grid was placed on the patient to define a reference point, and a frame was used to guide the needle along the intended path. Computer software programs calculated complex paths from one scan plane to another. Although the results disclosed no significant differences in lesion size or path length between the two groups, the stereotaxically guided biopsies required 75% fewer needle manipulations to hit the intended target. Consequently, the stereotaxically guided biopsies required 40% less time and 80% fewer localization scans to find the biopsy needle than did the hand-guided biopsies

  3. Usefulness and safety of a guide catheter extension system for the percutaneous treatment of complex coronary lesions by a transradial approach.

    Science.gov (United States)

    García-Blas, Sergio; Núñez, Julio; Mainar, Luis; Miñana, Gema; Bonanad, Clara; Racugno, Paolo; Rodríguez, Juan Carlos; Moyano, Patricia; Sanchis, Juan

    2015-01-01

    The aim of this study was to describe our initial experience with the GuideLiner® catheter (Vascular Solutions Inc.) in the transradial treatment of complex lesions. The clinical, angiographic and procedural data of percutaneous coronary interventions where GuideLiner was used during 2013 were collected. The transradial approach was used in all cases. The indication for its use, efficacy and periprocedural complications were determined. Sixteen consecutive procedures (in 15 patients; 12 males and 3 females) were evaluated. The indication for the use of GuideLiner was a difficulty to advance and properly position a stent through a tortuous and/or calcified artery despite using high-support guide catheters or other useful techniques. Of the 16 angiographic procedures, 14 (87.5%) were successful (stent deployment in 13 cases and a drug-eluting balloon in 1 case). Unsuccessful cases were a chronic total occlusion and a diffusely diseased left anterior descendant artery. A type B dissection of a proximal left circumflex artery was the only periprocedural complication. Use of the GuideLiner was an effective and safe technique for the percutaneous treatment of complex coronary lesions in which the adequate progress of angioplasty devices had failed. GuideLiner was particularly helpful when using the transradial approach. Only one minor complication was recorded. © 2014 S. Karger AG, Basel.

  4. Pericardial Tamponade Following CT-Guided Lung Biopsy

    International Nuclear Information System (INIS)

    Mitchell, Michael J.; Montgomery, Mark; Reiter, Charles G.; Culp, William C.

    2008-01-01

    While not free from hazards, CT-guided biopsy of the lung is a safe procedure, with few major complications. Despite its safety record, however, potentially fatal complications do rarely occur. We report a case of pericardial tamponade following CT-guided lung biopsy. Rapid diagnosis and therapy allowed for complete patient recovery. Physicians who perform this procedure should be aware of the known complications and be prepared to treat them appropriately.

  5. A first-in-man study of the Reitan catheter pump for circulatory support in patients undergoing high-risk percutaneous coronary intervention.

    Science.gov (United States)

    Smith, Elliot J; Reitan, Oyvind; Keeble, Thomas; Dixon, Kerry; Rothman, Martin T

    2009-06-01

    To investigate the safety of a novel percutaneous circulatory support device during high-risk percutaneous coronary intervention (PCI). The Reitan catheter pump (RCP) consists of a catheter-mounted pump-head with a foldable propeller and surrounding cage. Positioned in the descending aorta the pump creates a pressure gradient, reducing afterload and enhancing organ perfusion. Ten consecutive patients requiring circulatory support underwent PCI; mean age 71 +/- 9; LVEF 34% +/- 11%; jeopardy score 8 +/- 2.3. The RCP was inserted via the femoral artery. Hemostasis was achieved using Perclose sutures. PCI was performed via the radial artery. Outcomes included in-hospital death, MI, stroke, and vascular injury. Hemoglobin (Hb), free plasma Hb (fHb), platelets, and creatinine (cre) were measured pre PCI and post RCP removal. The pump was inserted and operated successfully in 9/10 cases (median 79 min). Propeller rotation at 10,444 +/- 1,424 rpm maintained an aortic gradient of 9.8 +/- 2 mm Hg. Although fHb increased, there was no significant hemolysis (4.7 +/- 2.4 mg/dl pre vs. 11.9 +/- 10.5 post, P = 0.04, reference 20 mg/dl). Platelets were unchanged (pre 257 +/- 74 x 10(9) vs. 245 +/- 63, P = NS). Renal function improved (cre pre 110 +/- 27 micromol/l vs. 99 +/- 28, P = 0.004). The RCP was not used in one patient following femoral introducer sheath related aortic dissection. All PCI procedures were successful with no deaths or strokes, one MI, and no vascular complications following pump removal. The RCP can be used safely in high-risk PCI patients. This device may be an alternative to other percutaneous systems when substantial cardiac support is needed. (c) 2009 Wiley-Liss, Inc.

  6. Risk Factors of Catheter-related Bloodstream Infection With Percutaneously Inserted Central Venous Catheters in Very Low Birth Weight Infants: A Center's Experience in Taiwan

    Directory of Open Access Journals (Sweden)

    Jen-Fu Hsu

    2010-12-01

    Conclusion: It is important to avoid inserting a PICC at the femoral site. Strict catheter care protocol should also be applied to reduce local site bacterial colonization and removal of PICCs as soon as they are no longer essential for patient care to reduce the incidence of infection.

  7. Successful Percutaneous Coronary Intervention through a Severely Bent Artificial Ascending Aorta Using the DIO Thrombus Aspiration Catheter

    Directory of Open Access Journals (Sweden)

    Akinori Fujikake

    2016-01-01

    Full Text Available A 66-year-old man was admitted to our institute because of chest pain. He had undergone replacement of the ascending aorta due to aortic dissection 9 years previously. We made a diagnosis of acute coronary syndrome, and coronary artery angiography was performed. Although the right coronary artery was successfully cannulated, a severe bend of the artificial aorta made it very difficult to advance the catheter into the left coronary artery. Ultimately, a DIO thrombus aspiration catheter was used to enter the left coronary artery, and a stent was implanted successfully. The DIO catheter is very useful when the selection of a guiding catheter is complicated, such as in the case of severe vessel tortuosity or a bend of the ascending aorta.

  8. CT Guided biopsies of musculoskeletal lesions, radiological and pathologic correlation

    International Nuclear Information System (INIS)

    Hadzihasanovic, B.; Milisic, L.; Zuban, J.; Mujic, E.; Jahic, E.; Gjikolli, B.; Hasanovic, B.; Lincender-Cvijetic, L.; Jaganjac, S.

    2006-01-01

    Full text: The aim of the study is to overview our experiences in taking the CT guided biopsies of musculoskeletal lesions during the period of sixteen months, analysis of validity of samples taken and correlation with pathological findings. CT guided biopsies of musculoskeletal lesions were performed in 32 patients during the period of sixteen months (from December 2004 until March 2006). Age range was from 13 to 78 years. Majorities of the biopsies were performed with coaxial cutting needle system (14 G and 16 G) with introducers size 13 and 15 G. Bone biopsies were performed with Yamsidi needles in purpose of taking the bone cylinder. Majorities of the biopsies were performed under local anaesthesia except a thirteen years old child to whom CT guided biopsy of corpus Th 6 was performed under general anaesthesia. Two samples of tissues were sent in formalin solutions to Pathology Institute for pathological verification. In one case of musculoskeletal lesions CT guided biopsies didn't yield a representative tissue sample. We had high level of congruence between radiological and pathological findings; precise presented in the article. CT guided biopsies of musculoskeletal lesions are method of choice for pathologic verification of musculoskeletal lesions proving incomparable less risk compared to 'open' biopsy which requires operating theatre and general anaesthesia. Coaxial needle systems has shown as suitable for yielding representative tissue samples (two samples for each patient), and samples are also appropriate for immunohistochemical analysis

  9. Extrapleural paravertebral CT guided fine needle biopsy of subcarinal lymph nodes

    International Nuclear Information System (INIS)

    Tantawy, Wahid H.; El-Gemeie, Emad H.; Ibrahim, Ahmed S.; Mohamed, Mona A.

    2012-01-01

    Purpose: To report our experience in CT guided extrapleural paravertebral subcarinal lymph biopsy using a thin 25 gauge (25 G) thin needle without the need of injection of saline to widen the mediastinum. Materials and methods: Biopsy was performed using a 25 G needle which was advanced lateral to the vertebral body between the endothoracic fascia and the parietal pleura to gain access to subcarinal lymph nodes. One hundred and forty one patients were included in the study (74 females, 57 males). No artificial widening of the mediastinum using saline injection was required. The study was performed in the presence of a cytopathologist; sensitivity and specificity rates were calculated. Complications were documented for each case especially for pneumothorax and haemorrhage. Results: Cytopathological diagnosis was reached in all cases. All re-aspirations were done in the same session to reach a primary diagnosis at the time of the biopsy. Imunophenotyping study was done in 94 cases to confirm the primary diagnosis and to classify the malignant lesions. No pneumothorax was encountered. Small haematomas were noted in 5 cases (3.5%). Cytopathology showed a sensitivity of 97.2% and specificity of 100%. By adding immunophenotyping a 100% sensitivity and specificity was achieved. Conclusion: Fine needle aspiration cytology (FNAC) using a 25 gauge needle for subcarinal lymph nodes via a percutaneous extrapleural paravertebral CT guided approach is a safe, minimally invasive, and tolerable procedure yielding a high sensitivity and specificity rates without the need of artificial widening

  10. Prostate biopsy after ano-rectal resection: value of CT-guided trans-gluteal biopsy

    International Nuclear Information System (INIS)

    Cantwell, Colin P.; Hahn, Peter F.; Gervais, Debra A.; Mueller, Peter R.

    2008-01-01

    We describe our single-institutional experience with computed tomography (CT)-guided percutaneous transgluteal biopsy of the prostate in patients in whom transrectal ultrasound-guided biopsy is precluded by prior ano-rectal resection. Between March 1995 and April 2007, 22 patients had 34 prostate biopsies (mean age 68; mean PSA 29 ng/ml; mean follow-up 6.1 years). The charts of patients who had transgluteal biopsy were reviewed for demographic, complications and pathology. Ninety-five percent (21/22) of primary biopsies were diagnostic. Of the 21 diagnostic biopsies, 11 were positive for prostate cancer and ten were definitive benign samples. Seventy-three percent (8/11) of the patients had progressive PSA elevation that mandated 11 further prostate biopsies. Six patients had a second biopsy, one patient had a third and one patient had a fourth biopsy. Among patients who had serial biopsies, 38% (3/8) had prostate cancer. No complications or death occurred. A malignant biopsy was not significantly associated with core number (P = 0.58) or a high PSA level (P 0.15). CT-guided transgluteal biopsy of the prostate is safe and effective. (orig.)

  11. Extrapleural paravertebral CT guided fine needle biopsy of subcarinal lymph nodes

    Energy Technology Data Exchange (ETDEWEB)

    Tantawy, Wahid H., E-mail: tantawyw@yahoo.com [Radiology Department, Faculty of Medicine, Ain Shams University, Egypt Abbassyia square, Cairo (Egypt); El-Gemeie, Emad H. [Pathology Department, National Cancer Institute, Fom El Khalige Faculty of Medicine, Cairo University (Egypt); Ibrahim, Ahmed S., E-mail: asibrahima@gmail.com [Radiology Department, Faculty of Medicine, Ain Shams University, Egypt Abbassyia square, Cairo (Egypt); Mohamed, Mona A. [Radiology Department, Faculty of Medicine, Ain Shams University, Egypt Abbassyia square, Cairo (Egypt)

    2012-10-15

    Purpose: To report our experience in CT guided extrapleural paravertebral subcarinal lymph biopsy using a thin 25 gauge (25 G) thin needle without the need of injection of saline to widen the mediastinum. Materials and methods: Biopsy was performed using a 25 G needle which was advanced lateral to the vertebral body between the endothoracic fascia and the parietal pleura to gain access to subcarinal lymph nodes. One hundred and forty one patients were included in the study (74 females, 57 males). No artificial widening of the mediastinum using saline injection was required. The study was performed in the presence of a cytopathologist; sensitivity and specificity rates were calculated. Complications were documented for each case especially for pneumothorax and haemorrhage. Results: Cytopathological diagnosis was reached in all cases. All re-aspirations were done in the same session to reach a primary diagnosis at the time of the biopsy. Imunophenotyping study was done in 94 cases to confirm the primary diagnosis and to classify the malignant lesions. No pneumothorax was encountered. Small haematomas were noted in 5 cases (3.5%). Cytopathology showed a sensitivity of 97.2% and specificity of 100%. By adding immunophenotyping a 100% sensitivity and specificity was achieved. Conclusion: Fine needle aspiration cytology (FNAC) using a 25 gauge needle for subcarinal lymph nodes via a percutaneous extrapleural paravertebral CT guided approach is a safe, minimally invasive, and tolerable procedure yielding a high sensitivity and specificity rates without the need of artificial widening.

  12. Osteoid osteoma of the spine: CT-guided monopolar radiofrequency ablation

    Energy Technology Data Exchange (ETDEWEB)

    Martel, Jose [Departamento de Diagnostico por Imagen, Fundacion Hospital Alcorcon, Alcorcon, Madrid (Spain)], E-mail: jmartel@fhalcorcon.es; Bueno, Angel [Departamento de Diagnostico por Imagen, Fundacion Hospital Alcorcon, Alcorcon, Madrid (Spain); Nieto-Morales, M Luisa [Servicio de Radiologia, Hospital Universitario de Tenerife (Spain); Ortiz, Eduardo J. [Departamento de Cirugia Ortopedica, Fundacion Hospital Alcorcon, Alcorcon, Madrid (Spain)

    2009-09-15

    CT-guided percutaneous radiofrequency ablation and laser photocoagulation have become the methods of choice for the treatment of all osteoid osteomas except those in contact with neural structures. We report 10 patients with spinal osteoid osteoma adjacent to the neural elements treated with 12 sessions of CT-guided monopolar radiofrequency ablation. The size range of the lesion was 3-14 mm (mean, 7.5 mm) and the distance between the nidus and the adjacent spinal cord or nerve root was 2-12 mm (mean, 5 mm). No intact cortex between the tumor and the spinal cord or nerve roots constituted an exclusion criterion because of a higher risk of undesirable neurotoxic effects. Patients were under general anesthesia. After location of the lesion, a 11G-bone biopsy was introduced into the nidus. The radiofrequency electrode was inserted through the biopsy needle and heated at 90 deg. C for 4 min. Primary success was obtained in eight patients. At follow-up (mean, 19.5 months; range, 6-24 months), pain persisted in two patients after 2 months. Both of them were re-treated. All patients are currently pain-free and complications were not detected. In our opinion, radiofrequency ablation can also be considered the treatment of choice for spinal osteoid osteoma.

  13. Osteoid osteoma of the spine: CT-guided monopolar radiofrequency ablation

    International Nuclear Information System (INIS)

    Martel, Jose; Bueno, Angel; Nieto-Morales, M Luisa; Ortiz, Eduardo J.

    2009-01-01

    CT-guided percutaneous radiofrequency ablation and laser photocoagulation have become the methods of choice for the treatment of all osteoid osteomas except those in contact with neural structures. We report 10 patients with spinal osteoid osteoma adjacent to the neural elements treated with 12 sessions of CT-guided monopolar radiofrequency ablation. The size range of the lesion was 3-14 mm (mean, 7.5 mm) and the distance between the nidus and the adjacent spinal cord or nerve root was 2-12 mm (mean, 5 mm). No intact cortex between the tumor and the spinal cord or nerve roots constituted an exclusion criterion because of a higher risk of undesirable neurotoxic effects. Patients were under general anesthesia. After location of the lesion, a 11G-bone biopsy was introduced into the nidus. The radiofrequency electrode was inserted through the biopsy needle and heated at 90 deg. C for 4 min. Primary success was obtained in eight patients. At follow-up (mean, 19.5 months; range, 6-24 months), pain persisted in two patients after 2 months. Both of them were re-treated. All patients are currently pain-free and complications were not detected. In our opinion, radiofrequency ablation can also be considered the treatment of choice for spinal osteoid osteoma.

  14. Percutaneous catheter drainage of thoracic fluid: the usefulness and safety of bedside trocar placement under ultrasound guidance

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Heon [Seoul Medical Center, Seoul (Korea, Republic of)

    2006-07-15

    The author wanted to evaluate the usefulness and safety of the trocar technique for US-guided bedside catheter placement into thoracic fluid collections, and this technique has generally been reserved for the larger or superficial fluid collections. 42 drainage procedures were performed in 38 patients at the bedside. The patients were positioned supine or semi-upright. A drainage catheter system with a stylet and cannula assembly was used and all of the catheters were inserted using the trocar technique. The procedures consisted of drainage of empyema (n=14), malignant effusion (n=13), lung abscess (n=3), massive transudate (n=8), hemothorax (n=2) and chest wall hematoma (n=2). The clinical results were classified as successful (complete and partially successful), failure or undetermined. The medical records and images were retrospectively reviewed to evaluate the success rate, the complications and the procedure time. Technical success was achieved in all of the 42 procedures. With using the trocar technique, all the catheters were placed into even the small collections without significant complications. Drainage was successful in 36 (85.7%) of the 42 procedures. The average volume of thoracic fluid that was aspirated manually at the time of catheter placement was 420 mL (range: 35 to 1470 mL). The procedure time was less than 10 minutes from US-localization to complete catheter placement in all of the procedures. The trocar technique under US guidance can be an efficient and safe alternative to the Seldinger or guide-wire exchange technique for bedside catheter placement in the critically ill or hemodynamically unstable patients.

  15. Value of CT-guided biopsy in malignant lymphoma; Wertigkeit der CT-gesteuerten Biopsie maligner Lymphome

    Energy Technology Data Exchange (ETDEWEB)

    Libicher, M.; Noeldge, G.; Radeleff, B.; Gholipur, F.; Richter, G.M. [Abteilung Radiodiagnostik, Universitaetsklinikum Heidelberg (Germany)

    2002-12-01

    Management of diagnosing malignant lymphomas has changed with development of CT-guided techniques and reliable biopsy tools.Pathologists can use representative tissue samples for sub classification in more than 90%.Evaluation of residual lymphoma or relapse can be nearly as effective. Therefore percutaneous biopsy can be considered as primary diagnostic tool in the absence of peripheral lymphadenopathy. CT-guided biopsies can be performed on an outpatient basis under conscious sedation considering contraindications as well as regional complications. Acceptance of percutaneous biopsy by the pathologist and oncologist is based on diagnostic effectiveness that is significantly improved if more than 3{dagger}solid tissue samples are taken. This article reviews the value of CT-guided biopsy in comparison to surgical procedures in patients with malignant lymphoma. Essential aspects that lead to a diagnostic percutaneous biopsy are discussed on grounds of the current literature. (orig.) [German] Mit der Entwicklung CT-gesteuerter Biopsieverfahren sowie zuverlaessiger Biopsiesysteme hat sich die Vorgehensweise bei der Diagnostik maligner Lymphome geaendert. Repraesentative Stanzzylinder mit hoher Praeparatequalitaet ermoeglichen dem Pathologen eine Subklassifikation der Lymphome in ueber 90%. Eine aehnlich hohe Treffsicherheit ist auch bei der Rezidivdiagnostik moeglich. Deshalb sind perkutane Biopsien bei fehlender peripherer Lymphadenopathie als primaere diagnostische Methode geeignet. Unter Beachtung der Kontraindikationen sowie der regional unterschiedlichen Komplikationsmoeglichkeiten koennen die meisten CT-gesteuerten Biopsien ambulant unter Analgosedierung durchgefuehrt werden. Die Akzeptanz perkutaner Biopsien durch Pathologen und Onkologen ist an die diagnostische Genauigkeit gekoppelt. Diese wird durch Gewinnung von mindestens 3 repraesentativen Biopsiezylindern aus den soliden Anteilen eines Lymphoms signifikant erhoeht. Die vorliegende Uebersichtsarbeit

  16. CT-guided fixation of sacral fractures and sacrolilac joint disruptions

    International Nuclear Information System (INIS)

    Nelson, D.W.; Duwelius, P.

    1990-01-01

    Placement of sacral fixation screws at surgery is performed blindly (ie, by palpation). The authors of this paper employed CT to localize the screw between the neutral foramina and anterior sacral cortex and to decrease the morbidity associated with general anesthesia and surgery. Six patients underwent CT-guided sacral fixation performed by means of the 7.0 mm A0 cannulated screw system. All patients had reducible vertical sacral fractures or sacroiliac joint disruptions. Following placement of an epidural catheter for anesthesia, patients were scanned in the prone or decubitus position. Measurements for placement of the guide pin were made from the preliminary scans. Following CT confirmation of satisfactory guide pin placement across the fracture, the screw track was drilled, the screw length was determined, and the fixation screw was placed in position. A CT scan was obtained to evaluate the final position of the screw

  17. The Place of Computed Tomography as a Guidance Modality in Percutaneous Nephrostomy: Analysis of a 10-Year Single-Center Experience

    International Nuclear Information System (INIS)

    Egilmez, H.; Oztoprak, I.; Atalar, M.; Cetin, A.; Gumus, C.; Gultekin, Y.; Bulut, S.; Arslan, M.; Solak, O.

    2007-01-01

    Background: Percutaneous nephrostomy (PCN) has been established as an effective technique for urinary decompression or diversion. This procedure may be performed with the guidance of fluoroscopy, ultrasonography, a combination of fluoroscopy and ultrasonography, computed tomography (CT), or magnetic resonance imaging. Purpose: To retrospectively review experience with CT-guided PCN over a 10-year period in a single center. Material and Methods: All CT-guided PCN procedures performed in adults at our institution between 1995 and 2005 were evaluated. In 882 patients, 1113 nephrostomy catheters were inserted. Interventional radiologists or radiology residents under direct attending supervision inserted all catheters. During the PCN procedure, bleeding, sepsis, and injuries to adjacent organs were regarded as major complications. Clinical events requiring nominal therapy with no sequelae were regarded as minor complications. Results: PCN procedures were performed via 1-3 punctures in patients with grades 0-1 and 2 hydronephrosis, and via 1-2 punctures in patients with grade 3 hydronephrosis. They were carried out with a procedure time ranging from 9 to 26 min. All PCNs were considered as technically successful, and no major complications were observed. There were minor complications including transient macroscopic hematuria (28.6%, 19.9%, and 4.9% in patients with hydronephrosis grades 0-1, 2, and 3, respectively) and perirenal hematomas in a total of eight patients. No patient required additional intervention secondary to complications of the PCN procedure. Conclusion: CT-guided PCN is an efficient and safe procedure with major and minor complication rates below the accepted thresholds. It can be used for the management of patients requiring nephrostomy insertion in inpatient settings, and might be a preferable procedure in patients with minimal or no dilatation of the renal pelvis. Keywords: Computed tomography; percutaneous nephrostomy; urinary obstruction

  18. The Place of Computed Tomography as a Guidance Modality in Percutaneous Nephrostomy: Analysis of a 10-Year Single-Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Egilmez, H.; Oztoprak, I.; Atalar, M.; Cetin, A.; Gumus, C.; Gultekin, Y.; Bulut, S.; Arslan, M.; Solak, O. [Depts. of Radiology, Obstetrics and Gynecology, and Urology, Cumhuriyet Univ. School of Medicine, Sivas (Turkey)

    2007-09-15

    Background: Percutaneous nephrostomy (PCN) has been established as an effective technique for urinary decompression or diversion. This procedure may be performed with the guidance of fluoroscopy, ultrasonography, a combination of fluoroscopy and ultrasonography, computed tomography (CT), or magnetic resonance imaging. Purpose: To retrospectively review experience with CT-guided PCN over a 10-year period in a single center. Material and Methods: All CT-guided PCN procedures performed in adults at our institution between 1995 and 2005 were evaluated. In 882 patients, 1113 nephrostomy catheters were inserted. Interventional radiologists or radiology residents under direct attending supervision inserted all catheters. During the PCN procedure, bleeding, sepsis, and injuries to adjacent organs were regarded as major complications. Clinical events requiring nominal therapy with no sequelae were regarded as minor complications. Results: PCN procedures were performed via 1-3 punctures in patients with grades 0-1 and 2 hydronephrosis, and via 1-2 punctures in patients with grade 3 hydronephrosis. They were carried out with a procedure time ranging from 9 to 26 min. All PCNs were considered as technically successful, and no major complications were observed. There were minor complications including transient macroscopic hematuria (28.6%, 19.9%, and 4.9% in patients with hydronephrosis grades 0-1, 2, and 3, respectively) and perirenal hematomas in a total of eight patients. No patient required additional intervention secondary to complications of the PCN procedure. Conclusion: CT-guided PCN is an efficient and safe procedure with major and minor complication rates below the accepted thresholds. It can be used for the management of patients requiring nephrostomy insertion in inpatient settings, and might be a preferable procedure in patients with minimal or no dilatation of the renal pelvis. Keywords: Computed tomography; percutaneous nephrostomy; urinary obstruction.

  19. [Clinical value of CT-guided high frequency-induced thermotherapy as a treatment for intrahepatic cholangiocarcinoma].

    Science.gov (United States)

    Fan, Wei-Jun; Zhang, Liang; Gu, Yang-Kui; Wang, Li-Gang; Ouyang, Yu-Shu

    2008-07-01

    To evaluate the therapeutic effect of CT-guided high frequency-induced thermotherapy (HiTT) for intrahepatic cholangiocarcinoma. Seventeen patients of intrahepatic cholangiocarcinoma with 21 lesions underwent comprehensive treatment with HiTT as the principle approach. As to the patients with obstructive jaundice, percutaneous trans-hepatic cholangial drainage (PTCD) or bile duct endoprosthesis placement was performed first to improve the liver function, then HiTT was performed; and patients without obstructive jaundice underwent CT-guided HiTT directly, 1-2 weeks later, chemotherapy was given for 4 - 6 courses. CT scan 1 week after HiTT showed a short-term achievement rate of 100% (17/17), and the single puncture in situ ablation rate was 76.1% (16/21). The average life span in the near future was 13.5 months. The adverse effects included topo-bleeding, pain after procedure, liver function damage, defervescence, etc. All the patients recovered after symptomatic treatment. The clinical value of CT-guided HiTT for intrahepatic cholangiocarcinoma is obvious.

  20. Sacral-neuromodulation CT-guided

    International Nuclear Information System (INIS)

    Amoroso, Lamberto; Ricci, Stefano; Pelliccioni, Giuseppe; Scarpino, Osvaldo; Ghiselli, Roberto; Saba, Vittorio

    2005-01-01

    Purpose: Sacral neuromodulation is a new treatment for refractory voiding disorders such as urge incontinence, urinary retention, frequency-urgency syndromes and faecal incontinence. The current approach to sacral nerve stimulation consists of a two-stage procedure. The first is a PNE test (Percutaneous Nerve Evaluation) by a provisional electrically stimulated spinal needle, placed percutaneously in the S3 foramina for four of ten days. If successful, the second stage, permanent implantation, is carried out. The PNE test is performed under fluoroscopic control using the palpable bony sacral foramina as referral points. This technique can show some limitations, such as operator Rx exposure, poor visualization of sacral foramina because of bowel gas artefacts or sacral malformation. In order to reduce these inconveniences and to improve efficiency of the test we tried an alternative technique. The purpose of our study was to test the use of CT as an alternative technique in order to evaluate its advantages and possible routine use. Materials and methods: We tested 30 patients with the PNE test under CT guidance (16 males and 14 females) suffering from serious pelvic disorders and not responding to the normal therapeutic regime. Twenty-seven patient showed relative anatomical integrity of the pelvis and the sacrum, the remaining 3 patients presented morphological anormalities of the sacral foramina. With the patient in the prone position the sacral foramina were identified with CT volumetric scanning using a spiral CT scanner equipped with a second console for the three-dimensional reconstructions. Having identified the location of the S3 foramina, a sterile field was prepared and the spiral needle introduced checking correct positioning with a CT control scan. An electrode was inserted after having checked correct muscular contractile response and the precise position with a further CT scan. Results: Thirty patients were subjected to PNE under CT guidance for a

  1. Simple and inexpensive method for CT-guided stereotaxy

    Energy Technology Data Exchange (ETDEWEB)

    Wester, K; Sortland, O; Hauglie-Hanssen, E

    1981-01-01

    A simple and inexpensive method for CT-guided stereotaxy is described. The method requires neither sophisticated computer programs nor additional stereotactic equipment, such as special head holders for the CT, and can be easily obtained without technical assistance. The method is designed to yield the vertical coordinates.

  2. Percutaneous Placement of Central Venous Catheters: Comparing the Anatomical Landmark Method with the Radiologically Guided Technique for Central Venous Catheterization Through the Internal Jugular Vein in Emergent Hemodialysis Patients

    Energy Technology Data Exchange (ETDEWEB)

    Koroglu, M.; Demir, M.; Koroglu, B.K.; Sezer, M.T.; Akhan, O.; Yildiz, H.; Yavuz, L.; Baykal, B.; Oyar, O. [Suleyman Demirel Univ., Isparta (Turkey). Depts. of Radiology, Internal Medicine and Anesthesiology

    2006-02-15

    Purpose: To compare the success and immediate complication rates of the anatomical landmark method (group 1) and the radiologically (combined real-time ultrasound and fluoroscopy) guided technique (group 2) in the placement of central venous catheters in emergent hemodialysis patients. Material and Methods: The study was performed prospectively in a randomized manner. The success and immediate complication rates of radiologically guided placement of central venous access catheters through the internal jugular vein (n = 40) were compared with those of the anatomical landmark method (n 40). The success of placement, the complications, the number of passes required, and whether a single or double-wall puncture occurred were also noted and compared. Results: The groups were comparable in age and sex. The indication for catheter placement was hemodialysis access in all patients. Catheter placement was successful in all patients in group 2 and unsuccessful in 1 (2.5%) patient in group 1. All catheters functioned adequately and immediately after the placement (0% initial failure rate) in group 2, but 3 catheters (7.5% initial failure rate) were non-functional just after placement in group 1. The total number of needle passes, double venous wall puncture, and complication rate were significantly lower in group 2. Conclusion: Percutaneous central venous catheterization via the internal jugular vein can be performed by interventional radiologists with better technical success rates and lower immediate complications. In conclusion, central venous catheterization for emergent dialysis should be performed under both real-time ultrasound and fluoroscopic guidance.

  3. Temperature Measurements of the Low-Attenuation Radiographic Ice Ball During CT-Guided Renal Cryoablation

    International Nuclear Information System (INIS)

    Permpongkosol, Sompol; Link, Richard E.; Kavoussi, Louis R.; Solomon, Stephen B.

    2008-01-01

    During renal cryoablation a low-attenuation area on CT develops around the cryoprobe. Knowledge of the temperature of the growing low-attenuation area can guide therapy and ensure lethal temperatures. Herein, we report thermocouple results and correlating CT images during the development of the low-attenuation 'radiographic ice ball.' Five patients who underwent percutaneous CT-guided renal cryoablation were identified who had thermocouples inserted and serial intraprocedural CT images that included images with thermocouple measurements of 0 o and sub-0 o C. Thermocouples had been percutaneously placed just beyond the edge of the tumors either to ensure adequate cooling or to ensure safety to adjacent critical structures. Renal cryotherapy under CT guidance produced a growing low-attenuation area corresponding to the radiographic ice ball. When the thermocouple measured 0 o C, CT images showed the thermocouple tip at the edge of the low-attenuation ice ball. At lower temperatures the tip was within the low-attenuation ice ball. We conclude that knowledge of the temperature at the ice ball edge during cryoablation can be used to predict the extent of tissue necrosis and thus provide an estimate of cryotherapy effectiveness during the procedure. Further work is necessary to establish a firm relationship between the thermal conditions and the zone of damage

  4. Efficacy of an opposite position aspiration on resolution of pneumothorax following CT-guided lung biopsy

    Science.gov (United States)

    Zeng, L-C; Du, Y; Yang, H-F; Xie, M-G; Liao, H-Q; Zhang, Y-D; Li, L; Wang, Q; Hu, L

    2015-01-01

    Objective: To evaluate the efficacy of aspiration in an opposite position to deal with pneumothorax after CT-guided lung biopsy. Methods: A retrospective study was developed involving 210 patients with pneumothorax who had undergone CT-guided percutaneous core biopsies from January 2012 to March 2014 for various pulmonary lesions. Asymptomatic patients with minimal pneumothorax were treated conservatively. Simple manual aspiration was performed for symptomatic patients with minimal pneumothorax and for all patients with moderate to large pneumothorax. An opposite position aspiration was performed when simple manual aspiration failed. The efficacy of simple manual aspiration and the opposite position aspiration was observed. Results: Among 210 patients with pneumothorax, 128 (61.0%) asymptomatic patients with minimal pneumothorax were treated conservatively. The remaining 82 were treated with attempted simple manual aspiration. Out of these 82 patients, simple manual aspiration was successful in 58 (70.7%, 58/82) cases. The complete and partial regression rates were 17.2% (10/58) and 82.8% (48/58), respectively. In the other 24 patients (29.3%, 24/82), simple aspiration technique was ineffective. An opposite position (from prone to supine or vice versa) was applied, and a new biopsy puncture site was chosen for reaspiration. This procedure was successful in 22 patients but not in 2 patients who had to have a chest tube insertion. The complete and partial regression rates were 25.0% (6/24) and 66.7% (16/24), respectively. Applying the new method, the total effective rate of aspiration improved significantly from 70.7% (58/82) to 97.6% (80/82). Conclusion: The opposite position aspiration can be safe, effective and minimally invasive treatment for CT-guided lung biopsy-induced pneumothorax thus reducing the use of chest tube significantly. Advances in knowledge: (1) Opposite position aspiration can elevate the success rate of aspiration significantly (from 70.7% to 97

  5. Closed reduction with CT-guided screw fixation for unstable sacroiliac joint fracture-dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Baskin, Kevin M.; Cahill, Ann Marie; Kaye, Robin D. [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Born, Christopher T. [Temple University Hospital/Temple Children' s Hospital, Temple Sports Medicine, Marlton, NJ (United States); Grudziak, Jan S. [Children' s Hospital of Pittsburgh, Department of Orthopedic Surgery, Pittsburgh, PA (United States); Towbin, Richard B.

    2004-12-01

    Unstable posterior pelvic ring fractures and dislocations are uncommon but potentially life-threatening injuries in children. Early definitive management reduces risk of immediate complications as well as chronic pain and gait dysfunction. Conventional operative therapy carries substantial risk of extensive blood loss and iatrogenic neurological and vascular injury. Minimally invasive image-guided intervention may further reduce immediate risk and improve long-term outcome. To describe CT-guided closed reduction and internal fixation (CRIF) and review outcomes of unstable fracture-dislocation of the sacroiliac (SI) joint in children. Between 2000 and 2003, three children (two girls, one boy) age 8-14 years were referred to interventional radiology for treatment of unstable SI joint fracture-dislocation not adequately treated with anterior external fixation alone. The three affected SI joints (two left, one right) were treated in a combined approach by pediatric interventional radiologists and orthopedic surgeons, using a percutaneous approach under CT guidance. Over a threaded guiding pin, 7.3 mm cannulated screws were used to achieve stable reduction of the affected SI joints. One screw was removed after slight (2 mm) migration. No neurovascular or other complications occurred. All patients had satisfactory healing with near-anatomic reduction, although recovery of the youngest was delayed by associated spinal injury. Compared to open surgical alternatives, CRIF under CT guidance reduces operating time, decreases blood loss, and allows early definitive fixation and immediate non-weight-bearing mobilization with a low rate of complication for unstable posterior pelvic ring fractures. In addition, CT-guided placement of the guide pin may allow safer screw positioning and may minimize the total number of screws needed to achieve pelvic stability. (orig.)

  6. Results and complications of CT-guided transthoracic fine-needle aspiration biopsy of pulmonary lesions

    Energy Technology Data Exchange (ETDEWEB)

    Lima, Cristiano Dias de; Nunes, Rodolfo Acatauassu; Saito, Eduardo Haruo; Higa, Claudio; Cardona, Zanier Jose Fernando; Santos, Denise Barbosa dos, E-mail: cristianodiaslima@gmail.co [Hospital Universitario Pedro Ernesto (HUPE/UERJ), Rio de Janeiro, RJ (Brazil). Dept. Cirurgia Toracica

    2011-03-15

    Objective: to analyze the cytological findings of CT-guided percutaneous fine-needle aspiration biopsies of the lung, to demonstrate the diagnostic feasibility of the method in the investigation of pulmonary lesions, and to determine the complications of the procedure, evaluating its safety. Methods: a retrospective analysis of 89 patients with various types of pulmonary lesions who underwent 97 procedures over a period of five years. The patients were divided into groups regarding the indication for the procedure: suspicion of primary lung cancer (stages IIIB or IV); suspicion of lung cancer (stages I, II, or IIIA) and clinical contraindications for surgery; suspicion of pulmonary metastasis from other organs; and pulmonary lesions with benign radiological aspect. All of the procedures were performed with 25-gauge needles and were guided by spiral CT. The final diagnosis was confirmed by surgical biopsy and clinical/oncological follow-up. For the analysis of complications, the total number of procedures was considered. Results: the main indication for the procedure was suspicion of advanced stage primary lung cancer. The accuracy of the method for malignant lesions was 91.5%. The lesion was confirmed as cancer in 73% of the patients. The major complication was pneumothorax (27.8%), which required chest tube drainage in 12.4% of the procedures. Conclusions: the principal indication for CT-guided fine-needle biopsy was suspicion of primary lung cancer in patients who were not surgical candidates. The procedure has high diagnostic feasibility for malignant pulmonary diseases. The most prevalent complication was pneumothorax. However, in most cases, chest tube drainage was unnecessary. No deaths were related to the procedure. (author)

  7. Closed reduction with CT-guided screw fixation for unstable sacroiliac joint fracture-dislocation

    International Nuclear Information System (INIS)

    Baskin, Kevin M.; Cahill, Ann Marie; Kaye, Robin D.; Born, Christopher T.; Grudziak, Jan S.; Towbin, Richard B.

    2004-01-01

    Unstable posterior pelvic ring fractures and dislocations are uncommon but potentially life-threatening injuries in children. Early definitive management reduces risk of immediate complications as well as chronic pain and gait dysfunction. Conventional operative therapy carries substantial risk of extensive blood loss and iatrogenic neurological and vascular injury. Minimally invasive image-guided intervention may further reduce immediate risk and improve long-term outcome. To describe CT-guided closed reduction and internal fixation (CRIF) and review outcomes of unstable fracture-dislocation of the sacroiliac (SI) joint in children. Between 2000 and 2003, three children (two girls, one boy) age 8-14 years were referred to interventional radiology for treatment of unstable SI joint fracture-dislocation not adequately treated with anterior external fixation alone. The three affected SI joints (two left, one right) were treated in a combined approach by pediatric interventional radiologists and orthopedic surgeons, using a percutaneous approach under CT guidance. Over a threaded guiding pin, 7.3 mm cannulated screws were used to achieve stable reduction of the affected SI joints. One screw was removed after slight (2 mm) migration. No neurovascular or other complications occurred. All patients had satisfactory healing with near-anatomic reduction, although recovery of the youngest was delayed by associated spinal injury. Compared to open surgical alternatives, CRIF under CT guidance reduces operating time, decreases blood loss, and allows early definitive fixation and immediate non-weight-bearing mobilization with a low rate of complication for unstable posterior pelvic ring fractures. In addition, CT-guided placement of the guide pin may allow safer screw positioning and may minimize the total number of screws needed to achieve pelvic stability. (orig.)

  8. PET/CT-guided Interventions: Personnel Radiation Dose

    International Nuclear Information System (INIS)

    Ryan, E. Ronan; Thornton, Raymond; Sofocleous, Constantinos T.; Erinjeri, Joseph P.; Hsu, Meier; Quinn, Brian; Dauer, Lawrence T.; Solomon, Stephen B.

    2013-01-01

    PurposeTo quantify radiation exposure to the primary operator and staff during PET/CT-guided interventional procedures.MethodsIn this prospective study, 12 patients underwent PET/CT-guided interventions over a 6 month period. Radiation exposure was measured for the primary operator, the radiology technologist, and the nurse anesthetist by means of optically stimulated luminescence dosimeters. Radiation exposure was correlated with the procedure time and the use of in-room image guidance (CT fluoroscopy or ultrasound).ResultsThe median effective dose was 0.02 (range 0–0.13) mSv for the primary operator, 0.01 (range 0–0.05) mSv for the nurse anesthetist, and 0.02 (range 0–0.05) mSv for the radiology technologist. The median extremity dose equivalent for the operator was 0.05 (range 0–0.62) mSv. Radiation exposure correlated with procedure duration and with the use of in-room image guidance. The median operator effective dose for the procedure was 0.015 mSv when conventional biopsy mode CT was used, compared to 0.06 mSv for in-room image guidance, although this did not achieve statistical significance as a result of the small sample size (p = 0.06).ConclusionThe operator dose from PET/CT-guided procedures is not significantly different than typical doses from fluoroscopically guided procedures. The major determinant of radiation exposure to the operator from PET/CT-guided interventional procedures is time spent in close proximity to the patient

  9. PET/CT-guided Interventions: Personnel Radiation Dose

    Energy Technology Data Exchange (ETDEWEB)

    Ryan, E. Ronan, E-mail: ronan@ronanryan.com; Thornton, Raymond; Sofocleous, Constantinos T.; Erinjeri, Joseph P. [Memorial Sloan-Kettering Cancer Center, Department of Radiology (United States); Hsu, Meier [Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics (United States); Quinn, Brian; Dauer, Lawrence T. [Memorial Sloan-Kettering Cancer Center, Department of Medical Physics (United States); Solomon, Stephen B. [Memorial Sloan-Kettering Cancer Center, Department of Radiology (United States)

    2013-08-01

    PurposeTo quantify radiation exposure to the primary operator and staff during PET/CT-guided interventional procedures.MethodsIn this prospective study, 12 patients underwent PET/CT-guided interventions over a 6 month period. Radiation exposure was measured for the primary operator, the radiology technologist, and the nurse anesthetist by means of optically stimulated luminescence dosimeters. Radiation exposure was correlated with the procedure time and the use of in-room image guidance (CT fluoroscopy or ultrasound).ResultsThe median effective dose was 0.02 (range 0-0.13) mSv for the primary operator, 0.01 (range 0-0.05) mSv for the nurse anesthetist, and 0.02 (range 0-0.05) mSv for the radiology technologist. The median extremity dose equivalent for the operator was 0.05 (range 0-0.62) mSv. Radiation exposure correlated with procedure duration and with the use of in-room image guidance. The median operator effective dose for the procedure was 0.015 mSv when conventional biopsy mode CT was used, compared to 0.06 mSv for in-room image guidance, although this did not achieve statistical significance as a result of the small sample size (p = 0.06).ConclusionThe operator dose from PET/CT-guided procedures is not significantly different than typical doses from fluoroscopically guided procedures. The major determinant of radiation exposure to the operator from PET/CT-guided interventional procedures is time spent in close proximity to the patient.

  10. Risk Factors for the Need of Surgical Necrosectomy After Percutaneous Catheter Drainage in the Management of Infection Secondary to Necrotizing Pancreatitis.

    Science.gov (United States)

    Ji, Liang; Wang, Gang; Li, Le; Li, Yi-Long; Hu, Ji-Sheng; Zhang, Guang-Quan; Chen, Hong-Ze; Chen, Hua; Kong, Rui; Bai, Xue-Wei; Sun, Bei

    2018-04-01

    This study aimed to assess the need of surgical necrosectomy after percutaneous catheter drainage (PCD) for infected necrotizing pancreatitis. The clinical data of documented/suspected patients who were treated with a step-up approach were extracted and analyzed. Of the 329 patients enrolled, the initial PCD was performed at 12 (interquartile range, 9-15) days since onset and 35.3% were cured by PCD alone. In the pre-PCD model, mean computed tomographic (CT) density of necrotic fluid collection (NFC; P the initial PCD were independent risk factors, and a combination of the previously mentioned 2 factors produced an area under the curve of 0.775. In the post-PCD model, mean CT density of NFC (P = 0.041), MOF (P = 0.002), and serum procalcitonin level (P = 0.035) 3 days after the initial PCD were independent risk factors, and a combination of these previously mentioned factors produced an area under the curve of 0.642. Both mean CT density of NFC and MOF are independent pre- and post-PCD risk factors for the need of necrosectomy after PCD. Post-PCD serum procalcitonin level might be a respondent factor that is correlated with the necessity of necrosectomy.

  11. Predictors of Percutaneous Catheter Drainage (PCD) after Abdominal Paracentesis Drainage (APD) in Patients with Moderately Severe or Severe Acute Pancreatitis along with Fluid Collections

    Science.gov (United States)

    Liu, Wei-hui; Wang, Tao; Yan, Hong-tao; Chen, Tao; Xu, Chuan; Ye, Ping; Zhang, Ning; Liu, Zheng-cai; Tang, Li-jun

    2015-01-01

    Aims Although we previously demonstrated abdominal paracentesis drainage (APD) preceding percutaneous catheter drainage (PCD) as the central step for treating patients with moderately severe (MSAP) or severe acute pancreatitis (SAP), the predictors leading to PCD after APD have not been studied. Methods Consecutive patients with MSAP or SAP were recruited between June 2011 and June 2013. As a step-up approach, all patients initially received medical management, later underwent ultrasound-guided APD before PCD, if necessary, followed by endoscopic necrosectomy through the path formed by PCD. APD primarily targeted fluid in the abdominal or pelvic cavities, whereas PCD aimed at (peri)pancreatic fluid. Results Of the 92 enrolled patients, 40 were managed with APD alone and 52 received PCD after APD (14 required necrosectomy after initial PCD). The overall mortality was 6.5%. Univariate analysis showed that among the 20 selected parameters, 13 factors significantly affected PCD intervention after APD. Multivariate analysis revealed that infected (peri)pancreatic collections (P = -0.001), maximum extent of necrosis of more than 30% of the pancreas (P = -0.024), size of the largest necrotic peri(pancreatic) collection (P = -0.007), and reduction of (peri)pancreatic fluid collections by collections, a largest necrotic peri(pancreatic) collection of more than 100 ml, and reduction of (peri)pancreatic fluid collections by <50% after APD could effectively predict the need for PCD in the early course of the disease. PMID:25659143

  12. Spinal CT-guided injections. Clinical applications-limitations

    International Nuclear Information System (INIS)

    Stamatakis, V.; Vlachou, I.; Petrocheilou, G.; Safarika, V.; Geroukis, I.; Petinelli, A.; Stathopoulou, S.; Kokkinis, C.

    2012-01-01

    Full text: Introduction: Chronic spinal pain is an important health issue with serious social and financial consequences. Thus, application of minimal invasive procedures is a popular technique for immediate relief of pain. Objectives and tasks: Our purpose is to present CT guided intraspinal injection of pharmaceutical agents for the relief of persistent pain. Material and methods: Chronic localized or radicular spinal pain may be treated safely and efficiently with injection of various pharmaceutical agents (local anesthetic, opioid analgesic and steroids or combination of these). The possible sites of infiltration include: a) intervertebral joints (facets), b) sacroiliac joints, c)perineural infiltration of the affected nerve roots and d) the epidural space. We will mention the patients choice criteria (combination of clinical symptoms and specific pain evaluation questionnaire) as they are reported in the international bibliography. Finally, we will discuss the repeatability criteria of the method as well as its limitations. Results: CT-guided pharmaceutical agents injection for the relief of persistent spinal pain have an advantage against other methods because of the precision and safety that they offer to the localization and diagnosis of the pain cause. Conclusion: Small complications percentage and satisfactory results have made CT-guided spinal injections a popular technique for chronic back pain relief. In order to apply these techniques the good knowledge of the method, its possibilities and limitations is necessary

  13. Systemic Air Embolism After CT-guided Lung Biopsy

    Science.gov (United States)

    2017-11-27

    Patients Who Underwent Percutaneous Lung Biopsy Under CT Guidance; Patients Who Presented Systemic Air Embolism After Percutaneous Lung Biopsy Under CT Guidance Depicted at the Time of the Procedure on a Whole Thoracic CT

  14. Radiologic placement of Hickman catheters

    International Nuclear Information System (INIS)

    Robertson, L.J.; Mauro, M.A.; Jaques, P.F.

    1988-01-01

    Hickman catheter inserter has previously been predominantly accomplished surgically by means of venous cutdown or percutaneous placement in the operating room. The authors describe their method and results for 55 consecutive percutaneous placements of Hickman catheters in the interventional radiology suite. Complication rates were comparable to those for surgical techniques. Radiologic placement resulted in increased convenience, decreased time and cost of insertion, and super fluoroscopic control of catheter placement and any special manipulations. Modern angiographic materials provide safer access to the subclavian vein than traditional methods. The authors conclude that radiologic placement of Hickman catheters offers significant advantages over traditional surgical placement

  15. Ultrasound-Guided Percutaneous Catheter Drainage of Large Breast Abscesses in Lactating Women: How to Preserve Breastfeeding Safely.

    Science.gov (United States)

    Falco, Giuseppe; Foroni, Monica; Castagnetti, Fabio; Marano, Luigi; Bordoni, Daniele; Rocco, Nicola; Marchesi, Vanessa; Iotti, Valentina; Vacondio, Rita; Ferrari, Guglielmo

    2016-12-01

    Management of breast abscess in lactating women remains controversial. During pregnancy, women may develop different kinds of benign breast lesions that could require a surgical incision performed under general anesthesia with consequent breastfeeding interruption. The purpose of this study was to prospectively evaluate the management of large breast abscesses with ultrasound-assisted drainage aiming at breastfeeding preservation. 34 lactating women with a diagnosis of unilateral breast abscess have been treated with an ultrasound (US)-assisted drainage of the abscess. A pigtail catheter was inserted into the fluid collection using the Seldinger technique under US guide and connected to a three stop way to allow drainage and irrigation of the cavity until its resolution. All procedures have been found safe and well tolerated. No recurrence was observed and breastfeeding was never interrupted. The described technique allows to avoid surgery and to preserve breastfeeding in well-selected patients with a safe, well-tolerated and cost-effective procedure.

  16. Urinary catheters

    Science.gov (United States)

    Catheter - urine; Foley catheter; Indwelling catheter; Suprapubic catheters ... stones Blood infections ( septicemia ) Blood in the urine (hematuria) Kidney damage (usually only with long-term, indwelling ...

  17. CT-guided core needle biopsy of mediastinal nodes through a transpulmonary approach: retrospective analysis of the procedures conducted over six years.

    Science.gov (United States)

    Yin, Zhongyuan; Liang, Zhiwen; Li, Pengcheng; Wang, Qiong

    2017-08-01

    To retrospectively evaluate the diagnostic performance and complications of a CT-guided core needle cutting biopsy of mediastinal nodes through a transpulmonary approach. From January 2009 to December 2014, we used a coaxial positioning system and an 18G cutting-type biopsy device to perform CT-guided percutaneous transpulmonary needle biopsies of mediastinal nodes for 127 patients. The diagnostic performance, complication rate, influencing factors, distribution of mediastinal nodes and pathological diagnoses were investigated. Among 127 patients, pathologic analyses showed that all of the biopsies were technically successful. The sensitivity, specificity, positive predictive value, and negative predictive value were all 100%. As for complications, the ratios for pneumothorax and hemoptysis were 33.9% and 4.7%, respectively. Multivariate analyses revealed that the distance from the pleura to the target lesion (P = 0.008) and the numbers of visceral pleura injuries (P = 0.006) were the two most significant risk factors for pneumothorax, and that the distance from the pleura to the target lesion (P = 0.004) was the most significant risk factor for hemoptysis. CT-guided core needle cutting biopsy of mediastinal nodes through a transpulmonary approach is a safe and efficient diagnostic method. • CT-guided core needle biopsy is an accurate technique for diagnosing mediastinal nodes. • The rates of complications are similar to those for pulmonary lesion biopsy. • Pneumothorax risk factors include distance from pleura to target lesion and number of visceral pleura. • Distance from pleura to target lesion is the risk factor for hemoptysis. • CT-guided core needle biopsy is an important diagnostic method for mediastinal nodes.

  18. Percutaneous cholecystostomy

    International Nuclear Information System (INIS)

    Akhan, Okan; Akinci, Devrim; Oezmen, Mustafa N.

    2002-01-01

    Percutaneous cholecystostomy (PC), a technique that consists of percutaneous catheter placement in the gallbladder lumen under imaging guidance, has become an alternative to surgical cholecystostomy in recent years. Indications of PC include calculous or acalculous cholecystitis, cholangitis, biliary obstruction and opacification of biliary ducts. It also provides a potential route for stone dissolution therapy and stone extraction. Under aseptic conditions and ultrasound guidance, using local anesthesia, the procedure is carried out by using either modified Seldinger technique or trocar technique. Transhepatic or transperitoneal puncture can be performed as an access route. Several days after the procedure transcatheter cholangiography is performed to assess the patency of cystic duct, presence of gallstones and catheter position. The tract is considered mature in the absence of leakage to the peritoneal cavity, subhepatic, subcapsular, or subdiaphragmatic spaces. Response rates to PC in the literature are between the range of 56-100% as the variation of different patient population. Complications associated with PC usually occur immediately or within days and include haemorrhage, vagal reactions, sepsis, bile peritonitis, pneumothorax, perforation of the intestinal loop, secondary infection or colonisation of the gallbladder and catheter dislodgment. Late complications have been reported as catheter dislodgment and recurrent cholecystitis. PC under ultrasonographic guidance is a cost-effective, easy to perform and reliable procedure with low complication and high success rates for critically ill patients with acute cholecystitis. It is generally followed by elective cholecystectomy, if possible. However, it may be definitive treatment, especially in acalculous cholecystitis

  19. Percutaneous cholecystostomy

    Energy Technology Data Exchange (ETDEWEB)

    Akhan, Okan E-mail: akhano@tr.net; Akinci, Devrim; Oezmen, Mustafa N

    2002-09-01

    Percutaneous cholecystostomy (PC), a technique that consists of percutaneous catheter placement in the gallbladder lumen under imaging guidance, has become an alternative to surgical cholecystostomy in recent years. Indications of PC include calculous or acalculous cholecystitis, cholangitis, biliary obstruction and opacification of biliary ducts. It also provides a potential route for stone dissolution therapy and stone extraction. Under aseptic conditions and ultrasound guidance, using local anesthesia, the procedure is carried out by using either modified Seldinger technique or trocar technique. Transhepatic or transperitoneal puncture can be performed as an access route. Several days after the procedure transcatheter cholangiography is performed to assess the patency of cystic duct, presence of gallstones and catheter position. The tract is considered mature in the absence of leakage to the peritoneal cavity, subhepatic, subcapsular, or subdiaphragmatic spaces. Response rates to PC in the literature are between the range of 56-100% as the variation of different patient population. Complications associated with PC usually occur immediately or within days and include haemorrhage, vagal reactions, sepsis, bile peritonitis, pneumothorax, perforation of the intestinal loop, secondary infection or colonisation of the gallbladder and catheter dislodgment. Late complications have been reported as catheter dislodgment and recurrent cholecystitis. PC under ultrasonographic guidance is a cost-effective, easy to perform and reliable procedure with low complication and high success rates for critically ill patients with acute cholecystitis. It is generally followed by elective cholecystectomy, if possible. However, it may be definitive treatment, especially in acalculous cholecystitis.

  20. Pulmonary emphysema is a predictor of pneumothorax after CT-guided transthoracic pulmonary biopsies of pulmonary nodules.

    Science.gov (United States)

    Lendeckel, Derik; Kromrey, Marie-Luise; Ittermann, Till; Schäfer, Sophia; Mensel, Birger; Kühn, Jens-Peter

    2017-01-01

    Pneumothoraces are the most frequently occurring complications of CT-guided percutaneous transthoracic pulmonary biopsies (PTPB). The aim of this study was to evaluate the influence of pre-diagnostic lung emphysema on the incidence and extent of pneumothoraces and to establish a risk stratification for the evaluation of the pre-procedure complication probability. CT-guided PTPB of 100 pre-selected patients (mean age 67.1±12.8 years) were retrospectively enrolled from a single center database of 235 PTPB performed between 2012-2014. Patients were grouped according to pneumothorax appearance directly after PTPB (group I: without pneumothorax, n = 50; group II: with pneumothorax, n = 50). Group II was further divided according to post-interventional treatment (group IIa: chest tube placement, n = 24; group IIb: conservative therapy, n = 26). For each patient pre-diagnostic percentage of emphysema was quantified using CT density analysis. Emphysema stages were compared between groups using bivariate analyses and multinomial logistic regression analyses. Emphysema percentage was significantly associated with the occurrence of post-interventional pneumothorax (p = 0.006). Adjusted for potential confounders (age, gender, lesion size and length of interventional pathway) the study yielded an OR of 1.07 (p = 0.042). Absolute risk of pneumothorax increased from 43.4% at an emphysema rate of 5% to 73.8% at 25%. No differences could be seen in patients with pneumothorax between percentage of emphysema and mode of therapy (p = 0.721). The rate of lung emphysema is proportionally related to the incidence of pneumothorax after CT-guided PTPB and allows pre-interventional risk stratification. There is no association between stage of emphysema and post-interventional requirement of chest tube placement.

  1. CT guided stereotaxy based on scout view imaging

    Energy Technology Data Exchange (ETDEWEB)

    Wester, K; Kjartansson, O; Bakke, S J

    1987-05-01

    A simple and inexpensive method for CT guided sterotaxy is described. The method requires no extra equipment in the interface between the computer tomograph and the stereotaxic frame, and could therefore easily be adopted in most neurosurgical units. With this method, information from the transaxial CT sections is transferred manually via the scout view image to the operation theater skull X-rays, and thereby to the stereotaxic frame. The method has proved to be sufficiently accurate for all current non-functional stereotaxic procedures in our department during 30 months of testing.

  2. CT guided stereotaxy based on scout view imaging

    International Nuclear Information System (INIS)

    Wester, K.; Kjartansson, O.; Bakke, S.J.; Rikshospitalet, Oslo

    1987-01-01

    A simple and inexpensive method for CT guided sterotaxy is described. The method requires no extra equipment in the interface between the computer tomograph and the stereotaxic frame, and could therefore easily be adopted in most neurosurgical units. With this method, information from the transaxial CT sections is transferred manually via the scout view image to the operation theater skull X-rays, and thereby to the stereotaxic frame. The method has proved to be sufficiently accurate for all current non-functional stereotaxic procedures in our department during 30 months of testing. (orig.)

  3. Evaluation of efficacy of amikacin for attenuation of catheter-related bladder discomfort in patients undergoing percutaneous nephrolithotomy: A prospective, randomized, placebo-controlled, double-blind study.

    Science.gov (United States)

    Verma, Ruchi; Agarwal, Anil; Singh, Prabhat Kumar; Gupta, Devendra; Shamim, Rafat

    2016-01-01

    Catheter-related bladder discomfort (CRBD) is the most distressing symptom in patients due to intraoperative urinary catheterization. Amikacin significantly inhibits detrusor contraction evoked by prejunctional stimulation. The aim of this study is to evaluate the efficacy of amikacin in prevention of CRBD in patients undergoing percutaneous nephrolithotomy. Study areas were operation theater and postanesthesia care unit of the Department of Anesthesiology, SGPGIMS, Lucknow. One hundred adult patients of either sex were randomly assigned into two groups of fifty each. Patients in control group received normal saline whereas patients in amikacin group received amikacin 10 mg/kg just before induction. Grading of CRBD was done as none, mild, moderate, and severe by a blinded observer at 0, 1, 6, 12, and 24 h after surgery. Data were analyzed using Student's t -test and Chi-square test among groups. Incidence of CRBD was compared with Chi-square test whereas severity was analyzed by the test of proportions (Z-test). Visual analog score was compared using Mann-Whitney U-test for surgical site pain. Incidence of CRBD in control group was 66% as compared to 44% observed in amikacin group ( P < 0.05). During intergroup comparison at different time points, incidence of CRBD was reduced at 1 and 6 h in the amikacin group ( P < 0.05). Significant reduction in the severity of CRBD (moderate) was also observed at 1 h in the amikacin group ( P < 0.05). At rest of the time points, there was no significant difference. Amikacin can significantly reduce the incidence and severity of CRBD in the first few hours after surgery.

  4. Renal Sympathetic Denervation by CT-Guided Ethanol Injection: A Phase II Pilot Trial of a Novel Technique

    International Nuclear Information System (INIS)

    Ricke, J.; Seidensticker, M.; Becker, S.; Schiefer, J.; Adamchic, I.; Lohfink, K.; Kandulski, M.; Heller, A.; Mertens, P. R.

    2016-01-01

    ObjectivesCT-guided ethanol-mediated renal sympathetic denervation in treatment of therapy-resistant hypertension was performed to assess patient safety and collect preliminary data on treatment efficacy.Materials and MethodsEleven patients with therapy-resistant hypertension (blood pressure of >160 mmHg despite three different antihypertensive drugs including a diuretic) and following screening for secondary causes were enrolled in a phase II single arm open label pilot trial of CT-guided neurolysis of sympathetic renal innervation. Primary endpoint was safety, and secondary endpoint was a decrease of the mean office as well as 24-h systolic blood pressure in follow-up. Follow-up visits at 4 weeks, 3, and 6 months included 24-h blood pressure assessments, office blood pressure, laboratory values, as well as full clinical and quality of life assessments.ResultsNo toxicities ≥3° occurred. Three patients exhibited worsened kidney function in follow-up analyses. When accounting all patients, office systolic blood pressure decreased significantly at all follow-up visits (maximal mean decrease −41.2 mmHg at 3 months). The mean 24-h systolic blood pressure values decreased significantly at 3 months, but not at 6 months (mean: −9.7 and −6.3 mmHg, respectively). Exclusion of five patients who had failed catheter-based endovascular denervation and/or were incompliant for antihypertensive drug intake revealed a more pronounced decrease of 24-h systolic blood pressure (mean: −18.3 and −15.2 mmHg at 3 and 6 months, p = 0.03 and 0.06).ConclusionCT-guided sympathetic denervation proved to be safe and applicable under various anatomical conditions with more renal arteries and such of small diameter

  5. Renal Sympathetic Denervation by CT-Guided Ethanol Injection: A Phase II Pilot Trial of a Novel Technique

    Energy Technology Data Exchange (ETDEWEB)

    Ricke, J., E-mail: jens.ricke@med.ovgu.de; Seidensticker, M.; Becker, S. [Otto-von-Guericke University Magdeburg, Department of Radiology and Nuclear Medicine, Universitätsklinikum Magdeburg AöR (Germany); Schiefer, J. [Universitätsklinikum Magdeburg AöR, Department of Nephrology and Hypertension, Diabetes and Endocrinology (Germany); Adamchic, I.; Lohfink, K. [Otto-von-Guericke University Magdeburg, Department of Radiology and Nuclear Medicine, Universitätsklinikum Magdeburg AöR (Germany); Kandulski, M.; Heller, A.; Mertens, P. R. [Universitätsklinikum Magdeburg AöR, Department of Nephrology and Hypertension, Diabetes and Endocrinology (Germany)

    2016-02-15

    ObjectivesCT-guided ethanol-mediated renal sympathetic denervation in treatment of therapy-resistant hypertension was performed to assess patient safety and collect preliminary data on treatment efficacy.Materials and MethodsEleven patients with therapy-resistant hypertension (blood pressure of >160 mmHg despite three different antihypertensive drugs including a diuretic) and following screening for secondary causes were enrolled in a phase II single arm open label pilot trial of CT-guided neurolysis of sympathetic renal innervation. Primary endpoint was safety, and secondary endpoint was a decrease of the mean office as well as 24-h systolic blood pressure in follow-up. Follow-up visits at 4 weeks, 3, and 6 months included 24-h blood pressure assessments, office blood pressure, laboratory values, as well as full clinical and quality of life assessments.ResultsNo toxicities ≥3° occurred. Three patients exhibited worsened kidney function in follow-up analyses. When accounting all patients, office systolic blood pressure decreased significantly at all follow-up visits (maximal mean decrease −41.2 mmHg at 3 months). The mean 24-h systolic blood pressure values decreased significantly at 3 months, but not at 6 months (mean: −9.7 and −6.3 mmHg, respectively). Exclusion of five patients who had failed catheter-based endovascular denervation and/or were incompliant for antihypertensive drug intake revealed a more pronounced decrease of 24-h systolic blood pressure (mean: −18.3 and −15.2 mmHg at 3 and 6 months, p = 0.03 and 0.06).ConclusionCT-guided sympathetic denervation proved to be safe and applicable under various anatomical conditions with more renal arteries and such of small diameter.

  6. Catheter Angiography

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Catheter Angiography Catheter angiography uses a catheter, x-ray ... are the limitations of Catheter Angiography? What is Catheter Angiography? Angiography is a minimally invasive medical test ...

  7. CT-guided localization of small pulmonary nodules using adjacent microcoil implantation prior to video-assisted thoracoscopic surgical resection

    Energy Technology Data Exchange (ETDEWEB)

    Su, Tian-Hao; Jin, Long; He, Wen [Capital Medical University, Department of Radiology, Beijing Friendship Hospital, Beijing (China); Fan, Yue-Feng [Xiamen University, Department of Interventional Therapy, The First Affiliated Hospital, Xiamen, Fujian (China); Hu, Li-Bao [Peking University People' s Hospital, Department of Radiology, Beijing (China)

    2015-09-15

    To describe and assess the localization of small peripheral pulmonary nodules prior to video-assisted thoracoscopic surgical (VATS) resection using the implantation of microcoils. Ninety-two patients with 101 pulmonary nodules underwent computed tomography (CT)-guided implantation of microcoils proximal to each nodule. Patients were randomly assigned to undergo entire microcoil or leaving-microcoil-end implantations. The complications and efficacy of the two implantation methods were evaluated. VATS resection of lung tissue containing each pulmonary lesion and microcoil were performed in the direction of the microcoil marker. Histopathological analysis was performed for the resected pulmonary lesions. CT-guided microcoil implantation was successful in 99/101 cases, and the placement of microcoils within 1 cm of the nodules was not disruptive. There was no difference in the complications and efficacy associated with the entire implantation method (performed for 51/99 nodules) versus the leaving-microcoil-end implantation method (performed for 48/99 nodules). All nodules were successfully removed using VATS resection. Asymptomatic pneumothorax occurred in 16 patients and mild pulmonary haemorrhage occurred in nine patients. However, none of these patients required further surgical treatment. Preoperative localization of small pulmonary nodules using a refined percutaneous microcoil implantation method was found to be safe and useful prior to VATS resection. (orig.)

  8. Time-dependent analysis of incidence, risk factors and clinical significance of pneumothorax after percutaneous lung biopsy.

    Science.gov (United States)

    Lim, Woo Hyeon; Park, Chang Min; Yoon, Soon Ho; Lim, Hyun-Ju; Hwang, Eui Jin; Lee, Jong Hyuk; Goo, Jin Mo

    2018-03-01

    To evaluate the time-dependent incidence, risk factors and clinical significance of percutaneous lung biopsy (PLB)-related pneumothorax. From January 2012-November 2015, 3,251 patients underwent 3,354 cone-beam CT-guided PLBs for lung lesions. Cox, logistic and linear regression analyses were performed to identify time-dependent risk factors of PLB-related pneumothorax, risk factors of drainage catheter insertion and those of prolonged catheter placement, respectively. Pneumothorax occurred in 915/3,354 PLBs (27.3 %), with 230/915 (25.1 %) occurring during follow-ups. Risk factors for earlier occurrence of PLB-related pneumothorax include emphysema (HR=1.624), smaller target (HR=0.922), deeper location (HR=1.175) and longer puncture time (HR=1.036), while haemoptysis (HR=0.503) showed a protective effect against earlier development of pneumothorax. Seventy-five cases (8.2 %) underwent chest catheter placement. Mean duration of catheter placement was 3.2±2.0 days. Emphysema (odds ratio [OR]=2.400) and longer puncture time (OR=1.053) were assessed as significant risk factors for catheter insertion, and older age (parameter estimate=1.014) was a predictive factor for prolonged catheter placement. PLB-related pneumothorax occurred in 27.3 %, of which 25.1 % developed during follow-ups. Smaller target size, emphysema, deeply-located lesions were significant risk factors of PLB-related pneumothorax. Emphysema and older age were related to drainage catheter insertion and prolonged catheter placement, respectively. • One-fourth of percutaneous lung biopsy (PLB)-related pneumothorax occurs during follow-up. • Smaller, deeply-located target and emphysema lead to early occurrence of pneumothorax. • Emphysema is related to drainage catheter insertion for PLB-related pneumothorax. • Older age may lead to prolonged catheter placement for PLB-related pneumothorax. • Tailored management can be possible with time-dependent information of PLB-related pneumothorax.

  9. Percutaneous retrieval of centrally embolized fragments of central venous access devices or knotted Swan-Ganz catheters. Clinical report of 14 retrievals with detailed angiographic analysis and review of procedural aspects

    Directory of Open Access Journals (Sweden)

    Łukasz Kalińczuk

    2016-05-01

    Full Text Available Introduction: Totally implantable venous access systems (TIVAS, Swan-Ganz (SG and central venous catheters (CVC allow easy and repetitive entry to the central cardiovascular system. Fragments of them may be released inadvertently into the cardiovascular system during their insertion or as a result of mechanical complications encountered during long-term utilization. Aim : To present results of percutaneous retrieval of embolized fragments of central venous devices or knotted SG and review the procedural aspects with a series of detailed angiographies. Material and methods : Between January 2003 and December 2012 there were 14 (~0.025% successful retrievals in 13 patients (44 ±16 years, 15% females of embolized fragments of TIVAS (n = 10 or CVC (n = 1 or of dislodged guide-wires (n = 2 or knotted SG (n = 1. Results : Foreign bodies with the forward end located in the right ventricle (RV, as well as those found in the pulmonary artery (PA, often required repositioning with a pigtail catheter as compared to those catheter fragments which were located in the right atrium (RA and/or great vein and possessed an accessible free end allowing their direct ensnarement with the loop snare (57.0% (4/7 vs. 66.7% (2/3 vs. 0.0% (0/3; p = 0.074 respectively. Procedure duration was 2–3 times longer among catheters retrieved from the PA than among those with the forward edge located in the RV or RA (30 (18–68 vs. 13.5 (11–37 vs. 8 min (8–13; p = 0.054 respectively. The SG catheter knotted in the vena cava superior (VCS was encircled with the loop snare introduced transfemorally, subsequently cut at its skin entrance and then pulled down inside the 14 Fr vascular sheath. Conclusions : By using the pigtail catheter and the loop snare, it is feasible to retrieve centrally embolized fragments or knotted central venous access devices.

  10. CT-guided radiofrequency tumor ablation in children

    International Nuclear Information System (INIS)

    Botsa, Evanthia; Poulou, Loukia S.; Koundouraki, Antonia; Thanos, Loukas; Koutsogiannis, Ioannis; Ziakas, Panayiotis D.; Alexopoulou, Efthimia

    2014-01-01

    Image-guided radiofrequency ablation is a well-accepted technique of interventional oncology in adults. To evaluate the efficacy and safety of CT-guided radiofrequency ablation as a minimally invasive treatment for metastatic neoplasms in children. A total of 15 radiofrequency ablation sessions were performed in 12 children and young adults (median age 9.5; range 5-18 years) with metastatic malignancies. Seven children and young adults had secondary hepatic lesions, three had pulmonary and two had bone lesions. Radiofrequency ablation was performed under conscious sedation. The median lesion size was 1.7 cm (range 1.3-2.8 cm). The median time for ablation was 8 min (range 7-10 min). Radiofrequency procedures were technically successful in all tumors. Postablation imaging immediately after, and 1 month and 3 months after radiofrequency ablation showed total necrosis in all patients. At 6-month follow-up, three patients (all with lesion size >2 cm) had local recurrence and underwent a second radiofrequency ablation session. At 2-year follow-up no patient had recurrence of the treated tumor. Post-ablation syndrome occurred in four children. No major complication occurred. CT-guided radiofrequency tumor ablation was safe and efficient for palliative treatment in our cohort of patients. (orig.)

  11. CT-guided suprascapular nerve blocks: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Schneider-Kolsky, M.E.; Pike, J.; Connell, D.A. [Department of Medical Imaging, Victoria House Private Hospital, 316 Malvern Road, Prahran 3181, Melbourne, Victoria (Australia)

    2004-05-01

    The objective of this study was to describe the suprascapular nerve block using CT guidance and to evaluate the short- and medium-term efficacy in a range of shoulder pathologies. CT-guided infiltration around the suprascapular nerve was performed with bupivacaine and Celestone Chronodose on 40 consecutive patients presenting with chronic shoulder pathologies unresponsive to conventional treatment. Patients were interviewed using the Shoulder Pain and Disability Index (SPADI) before the procedure, 30 min after the procedure and at 3 days, 3 weeks and 6 weeks afterwards. Within 30 min of the block overall pain scores decreased from a mean ({+-}SEM) pain score of 7.0 ({+-}0.4) to 3.5 ({+-}0.5) (n=39, P<0.001). At 3 days after the procedure, the mean overall improvement of the pain and disability scores were 20.4% ({+-}4.9, P<0.001) and 16.8% ({+-}4.8, P=0.004) respectively. Sustained pain relief and reduced disability were achieved in 10 of 35 (29%) patients at 3 weeks and longer. Patients suffering from soft tissue pathologies were the most likely patients to benefit from the injection. No serious side effects were noted. In some patients with chronic soft tissue pathologies who do not respond to conventional treatment, a CT-guided suprascapular nerve block can provide safe short- and medium-term relief from pain and disability. (orig.)

  12. The results of CT-guided periradicular pain control

    International Nuclear Information System (INIS)

    Uhlenbrock, D.; Arlinghaus, J.

    1997-01-01

    The effectiveness of CT-guided periradicular pain therapy was studied. Material and method: 55 patients with lumbar and/or radicular pain were treated by periradicular injections of 40 ml triamcinolon, in some cases combined with injection of the facets of the lumbar vertebrae. 36 patients had chronic symptoms; in 7, these were acute, and 12 patients complained of renewed disc symptoms following previous disc surgery. Approximately 4 months after the conclusion of treatment, the patients were requested to complete a questionnaire giving information on the course and after-effects of treatment. The questionnaire was repeated after 5 months. Results: 55% of patients were free of symptoms or had had some improvement at the time of the questionnaire; 30% reported temporary improvement, and in 15% there was no change compared with the pre-treatment symptoms. At the time of the second questionnaire, the proportion of patients who had derived benefit from the treatment was somewhat lower. 49% reported that they were pain-free or improved, while temporary improvement was reported by 36% of patients. Conclusion: CT-guided periradicular pain therapy is a valuable procedure in patients in whom conservative measures prove ineffective, and when surgery is not indicated. However, only about half the treated patients maintain permanent improvement. (orig.) [de

  13. CT-guided suprascapular nerve blocks: a pilot study

    International Nuclear Information System (INIS)

    Schneider-Kolsky, M.E.; Pike, J.; Connell, D.A.

    2004-01-01

    The objective of this study was to describe the suprascapular nerve block using CT guidance and to evaluate the short- and medium-term efficacy in a range of shoulder pathologies. CT-guided infiltration around the suprascapular nerve was performed with bupivacaine and Celestone Chronodose on 40 consecutive patients presenting with chronic shoulder pathologies unresponsive to conventional treatment. Patients were interviewed using the Shoulder Pain and Disability Index (SPADI) before the procedure, 30 min after the procedure and at 3 days, 3 weeks and 6 weeks afterwards. Within 30 min of the block overall pain scores decreased from a mean (±SEM) pain score of 7.0 (±0.4) to 3.5 (±0.5) (n=39, P<0.001). At 3 days after the procedure, the mean overall improvement of the pain and disability scores were 20.4% (±4.9, P<0.001) and 16.8% (±4.8, P=0.004) respectively. Sustained pain relief and reduced disability were achieved in 10 of 35 (29%) patients at 3 weeks and longer. Patients suffering from soft tissue pathologies were the most likely patients to benefit from the injection. No serious side effects were noted. In some patients with chronic soft tissue pathologies who do not respond to conventional treatment, a CT-guided suprascapular nerve block can provide safe short- and medium-term relief from pain and disability. (orig.)

  14. CT-guided radiofrequency tumor ablation in children

    Energy Technology Data Exchange (ETDEWEB)

    Botsa, Evanthia [National and Kapodistrian University of Athens, First Pediatric Clinic, Agia Sofia Children' s Hospital, Athens (Greece); Poulou, Loukia S.; Koundouraki, Antonia; Thanos, Loukas [Sotiria General Hospital for Chest Diseases, Department of Medical Imaging and Interventional Radiology, Athens (Greece); Koutsogiannis, Ioannis [General Military Hospital NIMTS, Department of Medical Imaging, Athens (Greece); Ziakas, Panayiotis D. [Warren Alpert Medical School of Brown University Rhode Island Hospital, Division of Infectious Diseases, Providence, RI (United States); Alexopoulou, Efthimia [Attikon University Hospital, Second Department of Radiology, Athens University School of Medicine, Athens (Greece)

    2014-11-15

    Image-guided radiofrequency ablation is a well-accepted technique of interventional oncology in adults. To evaluate the efficacy and safety of CT-guided radiofrequency ablation as a minimally invasive treatment for metastatic neoplasms in children. A total of 15 radiofrequency ablation sessions were performed in 12 children and young adults (median age 9.5; range 5-18 years) with metastatic malignancies. Seven children and young adults had secondary hepatic lesions, three had pulmonary and two had bone lesions. Radiofrequency ablation was performed under conscious sedation. The median lesion size was 1.7 cm (range 1.3-2.8 cm). The median time for ablation was 8 min (range 7-10 min). Radiofrequency procedures were technically successful in all tumors. Postablation imaging immediately after, and 1 month and 3 months after radiofrequency ablation showed total necrosis in all patients. At 6-month follow-up, three patients (all with lesion size >2 cm) had local recurrence and underwent a second radiofrequency ablation session. At 2-year follow-up no patient had recurrence of the treated tumor. Post-ablation syndrome occurred in four children. No major complication occurred. CT-guided radiofrequency tumor ablation was safe and efficient for palliative treatment in our cohort of patients. (orig.)

  15. CT-Guided Drainage of Pericardial Effusion after Open Cardiac Surgery.

    Science.gov (United States)

    Nour-Eldin, Nour-Eldin Abdelrehim; Alsubhi, Mohammed; Gruber-Rouh, Tatjana; Vogl, Thomas J; Kaltenbach, Benjamin; Soliman, Hazem Hamed; Hassan, Wael Eman; Abolyazid, Sherif Maher; Naguib, Nagy N

    2017-08-01

    This study was designed to evaluate the safety and efficacy of CT-guided drainage of the pericardial effusion in patients after cardiac surgery. The study included 128 consecutive patients (82 males, 46 females; mean age 66.6 years, SD: 4.2) complicated by pericardial effusion or hemopericardium after cardiac surgeries between June 2008 and June 2016. The medical indication for therapeutic pericardiocentesis in all patients was hemodynamic instability caused by pericardial effusion. The treatment criteria for intervention were evidence of pericardial tamponade with ejection fraction (EF) effusion was 260 ml (range 80-900 ml; standard deviation [SD]: ±70). Directly after pericardiocentesis, there was a significant improvement of the ejection fraction to 40-55% (mean: 45%; SD: ±5; p effusion drainage was 10%. The drainage was applied anteriorly (preventricular) in 39 of 128 (30.5%), retroventricularly in 33 of 128 (25.8%), and infracardiac in 56 of 128 (43.8%). Recurrence rate of pericardial effusion after removal of drains was 4.7% (67/128). Complete drainage was achieved in retroventricular and infracardiac positioning of the catheter (p effusion is a minimally invasive technique for the release of the tamponade effect of the effusion and improvement of cardiac output.

  16. CT-guided core needle biopsy of mediastinal nodes through a transpulmonary approach: retrospective analysis of the procedures conducted over six years

    Energy Technology Data Exchange (ETDEWEB)

    Yin, Zhongyuan; Liang, Zhiwen; Li, Pengcheng; Wang, Qiong [Huazhong University of Science and Technology, Cancer Center, Union Hospital, Tongji Medical College, Wuhan (China)

    2017-08-15

    To retrospectively evaluate the diagnostic performance and complications of a CT-guided core needle cutting biopsy of mediastinal nodes through a transpulmonary approach. From January 2009 to December 2014, we used a coaxial positioning system and an 18G cutting-type biopsy device to perform CT-guided percutaneous transpulmonary needle biopsies of mediastinal nodes for 127 patients. The diagnostic performance, complication rate, influencing factors, distribution of mediastinal nodes and pathological diagnoses were investigated. Among 127 patients, pathologic analyses showed that all of the biopsies were technically successful. The sensitivity, specificity, positive predictive value, and negative predictive value were all 100%. As for complications, the ratios for pneumothorax and hemoptysis were 33.9% and 4.7%, respectively. Multivariate analyses revealed that the distance from the pleura to the target lesion (P = 0.008) and the numbers of visceral pleura injuries (P = 0.006) were the two most significant risk factors for pneumothorax, and that the distance from the pleura to the target lesion (P = 0.004) was the most significant risk factor for hemoptysis. CT-guided core needle cutting biopsy of mediastinal nodes through a transpulmonary approach is a safe and efficient diagnostic method. (orig.)

  17. CT-guided puncture for direct MR-arthrography of the shoulder: Description of possible techniques

    Directory of Open Access Journals (Sweden)

    Hauth E

    2016-07-01

    Full Text Available The following report describes the possible techniques of CT-guided puncture for direct magnetic resonance (MR arthrography of the shoulder. CT-guided puncture can be regarded as an alternative technique to fluoroscopic- or ultrasound-guided puncture for MR-arthrography of the shoulder with high efficiency, low dose and extremely low complication rate.

  18. Computed tomography-guided percutaneous core needle biopsy of deep seated bone lesions in two dogs

    International Nuclear Information System (INIS)

    Mori, T.; Sakaida, M.; Yamada, M.; Akiyama, H.; Takai, Y.; Sakai, H.; Maruo, K.

    2006-01-01

    Computed Tomography (CT)-guided percutaneous core needle biopsies were undertaken for the diagnosis of osteosarcoma in the pelvis (case 1) and myeloma (case 2) in the seventh lumber vertebra which were difficult to targeted by palpation, ultrasound or fluoroscopy. In both cases, enough tissue for pathological diagnosis were obtained without any complication. CT-guided biopsy was thought to be a safe, easy and effective technique for the evaluation of the deep seated bone lesion

  19. CT-guided stereotactic evacuation of hypertensive intracerebral hematomas

    International Nuclear Information System (INIS)

    Hondo, Hideki

    1983-01-01

    Computerized tomography (CT) is now effective not only for definite diagnosis and location of intracerebral hematomas but also for coordination of the center of a hematoma. CT-guided stereotactic evacuation of hypertensive intracerebral hematoma was performed in 51 cases: 34 of basal ganglionic hematoma with or without ventricular perforation, 11 of subcortical hematoma, 3 of thalamic hematoma and 3 of cerebellar hematoma. Three dimensional CT images or biplane CT images were taken to determine the coordinates of the target point, which was the center of the hematoma. Then, a silicon tube (O.D. 3.5 phi, I.D. 2.1 phi) was inserted into the center of the hematoma through a burr-hole under local anesthesia, and the liquid or solid hematoma was aspirated as completely as possible with a syringe. Urokinase (6,000 I.U./5 ml saline) was administered through this silicon tube every 6 or 12 hours for several days until the hematoma had drained out competely. The silicon tube was taken out when repeated CT scanning revealed no hematoma. The results of clinical follow-ups indicated that this procedure is as good as, or rather better than conventional microsurgery with evacuation of hematoma under direct vision. Moreover this CT-guided stereotactic approach for evacuation of the hematoma has the following advantages: 1) the procedure is simple and safe, 2) operation can be performed under local anesthesia, and 3) the hematoma is drained out completely with the aid of urokinase. This surgery seems indicated as an emergency treatment for high-age or high risk patients and also as a routine surgery for intracerebral hematomas in patients showing no herination signs. (author)

  20. Percutaneous gastroenterostomy

    Energy Technology Data Exchange (ETDEWEB)

    Wittich, G.R.; Van Sonnenberg, E.; Casola, G.; Jantsch, H.; Walter, R.; Lechner, G.

    1987-05-01

    Percutaneous gastrostomies or gastroenterostomies serve for temporary or permanent enteric feeding in patients with obstruction or functional derangement of the esophagus or hypopharynx. In addition, this radiological procedure may be indicated for small bowel decompression. The authors present their experience in 71 patients. Insufflation of air through a nasogastric tube or catheter is the preferred method for gastric distension. The inferior margin of the left lobe of the liver and the transverse colon are localized sonographically and fluoroscopically prior to puncture. Either Seldinger or Trocartechniques have proven effective in establishing access to the stomach. The feeding tube is advanced into the proximal jejunum to reduce the likelyhood of gastroesophageal reflux and possible aspiration. Complications were encountered in four patients and included catheter dislocation in three and respiratory distress in one patient.

  1. Technical note: subclavian artery misplacement of a 12F Shaldon catheter: percutaneous repair with a local closure device under temporary balloon tamponade; Technische Mitteilung: Entfernung eines fehlplatzierten 12F Shaldon Katheters aus der A. subclavia und Abdichtung mittels Verschlusssystem bei temporaerer Ballonblockade

    Energy Technology Data Exchange (ETDEWEB)

    Wildberger, J.E.; Katoh, M.; Guenther, R.W. [Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany); Fussen, R. [Anaesthesiologische Klinik, Medizinisches Zentrum Kreis Aachen GmbH (Germany)

    2006-06-15

    A case of subsequent percutaneous repair using a local closure device with a collagen block (VasoSeal {sup registered}) and temporary balloon tamponade after inadvertent subclavian artery misplacement of a 12F Shaldon catheter is reported. Balloon occlusion safely prevented displacement of collagen into the vascular lumen by occluding the 12F entry site. Furthermore, collagen-induced coagulation was facilitated. (orig.)

  2. Transthoracic CT-guided biopsy with multiplanar reconstruction image improves diagnostic accuracy of solitary pulmonary nodules

    International Nuclear Information System (INIS)

    Ohno, Yoshiharu; Hatabu, Hiroto; Takenaka, Daisuke; Imai, Masatake; Ohbayashi, Chiho; Sugimura, Kazuro

    2004-01-01

    Objective: To evaluate the utility of multiplanar reconstruction (MPR) image for CT-guided biopsy and determine factors of influencing diagnostic accuracy and the pneumothorax rate. Materials and methods: 390 patients with 396 pulmonary nodules underwent transthoracic CT-guided aspiration biopsy (TNAB) and transthoracic CT-guided cutting needle core biopsy (TCNB) as follows: 250 solitary pulmonary nodules (SPNs) underwent conventional CT-guided biopsy (conventional method), 81 underwent CT-fluoroscopic biopsy (CT-fluoroscopic method) and 65 underwent conventional CT-guided biopsy in combination with MPR image (MPR method). Success rate, overall diagnostic accuracy, pneumothorax rate and total procedure time were compared in each method. Factors affecting diagnostic accuracy and pneumothorax rate of CT-guided biopsy were statistically evaluated. Results: Success rates (TNAB: 100.0%, TCNB: 100.0%) and overall diagnostic accuracies (TNAB: 96.9%, TCNB: 97.0%) of MPR were significantly higher than those using the conventional method (TNAB: 87.6 and 82.4%, TCNB: 86.3 and 81.3%) (P<0.05). Diagnostic accuracy were influenced by biopsy method, lesion size, and needle path length (P<0.05). Pneumothorax rate was influenced by pathological diagnostic method, lesion size, number of punctures and FEV1.0% (P<0.05). Conclusion: The use of MPR for CT-guided lung biopsy is useful for improving diagnostic accuracy with no significant increase in pneumothorax rate or total procedure time

  3. CT-guided radiofrequency ablation of osteoid osteoma using a multi-tined expandable electrode system.

    Science.gov (United States)

    Costanzo, Alessandro; Sandri, Andrea; Regis, Dario; Trivellin, Giacomo; Pierantoni, Silvia; Samaila, Elena; Magnan, Bruno

    2017-10-18

    Radiofrequency ablation (RFA) is the gold standard for the treatment of symptomatic osteoid osteoma (OO) as RFA yields both a high success and low complication rate. It has been widely utilized over the years, but recurrences of OO after this treatment have been documented. These recurrences may be the result of various factors, including incomplete tumor ablation, and are significantly higher in lesions greater than 10 mm. Thus, the need to induce thermal ablation in a wider area led us to use a Multi-Tined Expandable Electrode System (MTEES). In this study we examined the efficacy and safety of RFA using a MTEES in symptomatic OO. Between January 2005 and June 2007, 16 patients with symptomatic OO were treated by CT-guided percutaneous RFA using a MTEES. The diameter of OO ranged from 6 to 15 mm (mean 10±2.6 mm). Patients were evaluated for clinical outcomes, complications and recurrence. Pain evaluation was assessed preoperatively, 2 weeks postoperatively and at last follow-up. Clinical follow-up was available for all patients at a mean of 84.3 months (range 73-96 months). Mean preoperative VAS score was 7.4 (range 5-9), two weeks after the procedure mean VAS score was 0.3 (range 0-1) with a mean change of -7.06 points (p<0.0001). At the last follow-up a complete relief from pain has been observed in all patients. No major and minor complications were observed nor recurrences. RFA using a MTEES has been effective, safe and reliable for the treatment of OOs. This system, by increasing the size of the necrosis, could be a viable alternative to the single needle electrode in lesions larger than 10 mm, reducing the risk of recurrence.

  4. Study of CT-guided iodine-125 implantation in the treatment of rabbit VX2 tumor

    International Nuclear Information System (INIS)

    He Kewu; Gao Bin; Li Jiajia

    2008-01-01

    Objective: To evaluate the effect of CT-guided iodine-125 seed( 125 I) implantation to rabbit model VX2 tumor cell apoptosis. Methods: VX2 tumor cells were implanted into muscle of 40 rabbits legs, 3 weeks later, as the diameter of tumor reached 2 cm available for test. Randomly selected the sampling tumor on one leg of rabbit as for the test team and tumor on the contralateral leg as for control team. Under CT guidance, 125 I seeds were implanted into 20 tumor lesions of the test team, and hollow seeds were implanted into 20 tumor lesions of the control team. Instantly, 72 h, 1, 2, 3 w after operation, percutaneous tumor tissue sampling was done 0.5-1.0 cm and 1.0-1.5 cm away from seed implanted site under CT guidance; and apoptosis was investigated by FCM. Results: Instantly, 72 h, 1, 2, 3 w after treatment with iodine-125 ( 125 I) implantation, the tissue sampling away from seed 0.5-1.0 cm showed the apoptosis rates of control team and test team were respectively as follows: (5.43±0.67)% and (5.48±0.66)%, (P>0.05), (5.45±0.58)% and (11.60±0.87)%, (P O.05)of the control team and test team. Conclusions: 125 I seeds implantation can induce tumor cell apoptosis, beginning at 72 h and reached peak at 2 w and kept the high level here afterword. The apoptosis rate descended rapidly along with the increase of distance away from the 125 I seedling. (authors)

  5. Effectiveness of combined use of imprint cytological and histological examination in CT-guided tissue-core biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Yamagami, Takuji; Yoshimatsu, Rika; Kajiwara, Kenji; Ishikawa, Masaki; Awai, Kazuo [Hiroshima University, Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences, Minami-Ku, Hiroshima (Japan); Matsumoto, Tomohiro; Hasebe, Terumitsu [Tokai University Hachioji Hospital, Tokai University School of Medicine, Department of Radiology, Hachioji, Tokyo (Japan); Kakizawa, Hideaki [Hiroshima University, Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences, Minami-Ku, Hiroshima (Japan); Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Department of Diagnostic Radiology, Naka-Ku, Hiroshima (Japan); Toyoda, Naoyuki [Hiroshima University, Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences, Minami-Ku, Hiroshima (Japan); National Hospital Organisation Kure Medical Centre, Department of Diagnostic Radiology, Kure, Hiroshima (Japan)

    2014-05-15

    This study evaluated the efficacy of the combination of imprint cytology and histology in tissue-core percutaneous biopsy under real-time computed tomography (CT) fluoroscopic guidance. Between October 2009 and June 2013, 156 percutaneous needle biopsies were performed in our institution. Those obtained by tissue-core biopsy underwent both imprint cytological and histological examinations routinely after touch imprint cytology was performed on site to evaluate the samples' sufficiency for cytological and pathological examination. Final diagnosis was confirmed by independent surgical pathology, independent culture results or clinical follow-up. Rates of adequate specimens and precise diagnosis, by combined cytological and histological examination were 100 % (156/156) and 96.2 % (150/156), by cytology 94.4 % (152/156) and 83.3 % (130/156) and by histology 99.3 % (155/156) and 92.3 % (144/156). Precise diagnosis was achieved by combined examinations in 94.7 % (89/94) of thoracic lesions, 97.6 % (40/41) of musculoskeletal lesions, and 100 % (21/21) of abdominal, pelvic and retroperitoneal lesions. In all 104 lesions diagnosed as malignant by CT-guided biopsy and in 30 of 52 diagnosed as benign, specific cell types could be proved by combined examinations. Combined imprint cytology and histology performed after on-site touch imprint cytological evaluation improved the diagnostic ability of CT fluoroscopically guided biopsy. (orig.)

  6. Effectiveness of combined use of imprint cytological and histological examination in CT-guided tissue-core biopsy

    International Nuclear Information System (INIS)

    Yamagami, Takuji; Yoshimatsu, Rika; Kajiwara, Kenji; Ishikawa, Masaki; Awai, Kazuo; Matsumoto, Tomohiro; Hasebe, Terumitsu; Kakizawa, Hideaki; Toyoda, Naoyuki

    2014-01-01

    This study evaluated the efficacy of the combination of imprint cytology and histology in tissue-core percutaneous biopsy under real-time computed tomography (CT) fluoroscopic guidance. Between October 2009 and June 2013, 156 percutaneous needle biopsies were performed in our institution. Those obtained by tissue-core biopsy underwent both imprint cytological and histological examinations routinely after touch imprint cytology was performed on site to evaluate the samples' sufficiency for cytological and pathological examination. Final diagnosis was confirmed by independent surgical pathology, independent culture results or clinical follow-up. Rates of adequate specimens and precise diagnosis, by combined cytological and histological examination were 100 % (156/156) and 96.2 % (150/156), by cytology 94.4 % (152/156) and 83.3 % (130/156) and by histology 99.3 % (155/156) and 92.3 % (144/156). Precise diagnosis was achieved by combined examinations in 94.7 % (89/94) of thoracic lesions, 97.6 % (40/41) of musculoskeletal lesions, and 100 % (21/21) of abdominal, pelvic and retroperitoneal lesions. In all 104 lesions diagnosed as malignant by CT-guided biopsy and in 30 of 52 diagnosed as benign, specific cell types could be proved by combined examinations. Combined imprint cytology and histology performed after on-site touch imprint cytological evaluation improved the diagnostic ability of CT fluoroscopically guided biopsy. (orig.)

  7. [Predictive factors of complications during CT-guided transthoracic biopsy].

    Science.gov (United States)

    Fontaine-Delaruelle, C; Souquet, P-J; Gamondes, D; Pradat, E; de Leusse, A; Ferretti, G R; Couraud, S

    2017-04-01

    CT-guided transthoracic core-needle biopsy (TTNB) is frequently used for the diagnosis of lung nodules. The aim of this study is to describe TTNBs' complications and to investigate predictive factors of complications. All consecutive TTNBs performed in three centers between 2006 and 2012 were included. Binary logistic regression was used for multivariate analysis. Overall, 970 TTNBs were performed in 929 patients. The complication rate was 34% (life-threatening complication in 6%). The most frequent complications were pneumothorax (29% included 4% which required chest-tube) and hemoptysis (5%). The mortality rate was 0.1% (n=1). In multivariate analysis, predictive factor for a complication was small target size (AOR=0.984; 95% CI [0.976-0.992]; P<0.001). This predictive factor was also found for occurrence of life-threatening complication (AOR=0.982; [0.965-0.999]; P=0.037), of pneumothorax (AOR=0.987; [0.978-0.995]; P=0.002) and of hemoptysis (AOR=0.973; [0.951-0.997]; P=0.024). One complication occurred in one-third of TTNBs. The proportion of life-threatening complication was 6%. A small lesion size was predictive of complication occurrence. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  8. CT guided interventional therapy for hypertensive cerebral hemorrhage

    International Nuclear Information System (INIS)

    Lin Bo; Duan Bing

    2009-01-01

    Objective: To discuss the curative effect of CT-guided puncture and drainage in treating hypertensive cerebral hemorrhage. Methods: Adjusting the suitable point and direction of puncture according to the form and size of the haematoma and patient's status, the haematoma was eliminated by minimally invasive puncture and drainage guided under CT layer image in 40 cases of hypertensive cerebral hemorrhage. Results: Modality rate of treatment group was 12.5% (5/40), and is much lower than control group, which was 45% (13/30) (P<0.01). When asscess the Activities of Daily Living (ADL) after 6 months follow-up, the ADL1-ADL3 scale in treatment group was 27 cases (70%), and was much higher than that in control group, which was 29.4% (5/17), (P < 0.05). Conclusion: Minimal invasive therapy of cerebral hemorrhage has great superiority in elimination most part of the hematoma such as simple, accurate location, low cost, safe and effective, and is worthy of recommendation clinically. (authors)

  9. CT-guided stereotactic operation for hypertensive intracerebral hematoma

    International Nuclear Information System (INIS)

    Takahashi, Shinichiro; Sonobe, Makoto; Koshu, Keiji; Kusunose, Mutsuo; Tsumura, Kotaro

    1989-01-01

    CT-guided stereotactic operation was performed in 55 patients with hypertensive intracerebral hematoma. Location of the hematoma was putamen in 28 cases, thalamus in 14 cases, subcortical area in 9 cases, cerebellum in 3 cases and pons in one case. Ages ranged from 36 to 85 years (mean 59.5). The mean timing of the surgery after bleeding was 4.2 days. The estimated volume of the hematoma on CT was 8 ml to 57 ml in putaminal, 9 ml to 40 ml in thalamic, 18 ml to 77 ml in subcortical, 17 ml to 26 ml in cerebellar and 5 ml in pontine hemorrhage. Aspiration rate at surgery was 60.4% in putaminal, 37.9% in thalamic, 41.7% in subcortical, 45.2% in cerebellar and 30% in pontine hemorrhage. In addition, we evaluated ADL at 6 months postoperatively in patients with putaminal and thalamic hamorrhage. It is concluded that stereotactic operation is advisable in those cases with 10 to 50 ml hematoma volumes in putamen or thalamus. On the other hand, in cases with over 50ml volume, hematoma should be evacuated by craniotomy. (author)

  10. CT guided stereotactic evacuation of hypertensive and traumatic intracerebral hematomas

    International Nuclear Information System (INIS)

    Hondo, Hideki; Matsumoto, Keizo

    1983-01-01

    Recent advancement of CT system provides not only definite diagnosis and location of intracerebral hematoma but also coordinates of the center of the hematoma. Trials of stereotactic evacuation of the hematoma have been reported by some authors in the cases of subacute or chronic stages of hypertensive intracerebral hemorrhage. In this series, similar surgery has been performed in 33 cases of hypertensive intracerebral hematoma including 22 cases in acute stage, and 2 cases of traumatic hematoma. Clinical outcomes were investigated and the results were considered to be equivalent or rather better in the conventional microsurgery with evacuation of hematoma under direct vision. However, there still remained controversial problems in the cases of threatened herniation signs, because in these cases regular surgery with total evacuation of the hematoma at one time might have been preferable. The benefits of this CT guided stereotactic approach for the evacuation of the hematoma were thought to be as follow: 1) the procedure is simple and safe, 2) operation is readily performed under local anesthesia, and 3) the hematoma was drained out totally by means of urokinase activity. It is our impression that this surgery not only is indicated as emergency treatment for the patients of high-age or in high risk, but also can institute as a routine surgery for the intracerebral hematomas in patients showing no herniation sign. (J.P.N.)

  11. Utility of CT-guided abdominal aspiration procedures

    International Nuclear Information System (INIS)

    Sundaram, M.; Wolverson, M.K.; Heiberg, E.; Pilla, T.; Vas, W.G.; Shields, J.B.

    1982-01-01

    Over 200 consecutive diagnostic needle aspiration procedures of the abdomen were performed under computed tomographic (CT) guidance. Biopsies were done of the liver in 88 patients, the pancreas in 28, the kidney in 20, and the retroperitoneum in 32; 30 underwent an aspiration procedure for characterization of an intraabdominal fluid collection. Accuracy of diagnosis was very high for hepatic (99%) and renal (100%) biopsies and in characterization of fluid collections (100%). Accuracy for retroperitoneal biopsy was 87.5% and for pancreatic biopsy 82%. Overall accuracy for all sites was 95%. There were one false-negative diagnosis for the liver and five false-negative diagnoses for the pancreas. Insufficient material was obtained for diagnosis in four instances of retroperitoneal biopsy. There were no false positives. The technique is facilitated by rapid CT scan time, large aperture gantry, and rapid CT image reconstruction. Twenty gauge needles were used more frequently than 22 gauge needles because of their greater rigidity and ease of control. CT-guided diagnostic aspiration procedures are particularly useful for diagnosis of small, deep-seated lesions and in evaluation of lesions found in severely ill patients. An experienced cytologist is essential to the success of the technique

  12. Clinical investigation of CT-guided ozone-blowing and fumigation ...

    African Journals Online (AJOL)

    Clinical investigation of CT-guided ozone-blowing and fumigation therapy for the chronic ... African Journal of Biotechnology ... In control group, seven patients were completely cured in 45 days after being treated by traditional surgery.

  13. A self-retaining looped catheder for percutaneous biliary drainage

    International Nuclear Information System (INIS)

    Guenther, R.; Klose, K.; Daehnert, W.

    1983-01-01

    A percutaneous catheter which can be looped by means of a nylon thread was used in 32 patients for percutaneous biliary drainage. The catheter can be fixed in this way and is thereby prevented from migrating from the biliary system. The catheter is not suitable for proximal obstructions. Problems may arise during the removal of the nylon thread and loss of looping of the point of catheter. (orig.) [de

  14. CT guided stereotactic evacuation for hypertensive intracerebral hematoma

    International Nuclear Information System (INIS)

    Nakajima, Hideo

    1990-01-01

    Sixty-one cases of hypertensive intracerebral hematoma were evacuated by CT guided stereotactic method. The operation was performed in the CT room under general anesthesia using the KOMAI-NAKAJIMA STEREOTACTIC DEVICE. This instrument has a micromanipulater that can be used for various kinds of stereotactic procedures. Three dimensional position of the target point (aspiration point of the hematoma) was determined on the film obtained from CT scanning of the patient in the stereotactic system. If the hematoma was small, the target point was enough to be one point at the center of the hematoma, but in case of the large hematoma, several target points were given according to the shape of hematoma. The probe, ordinarily a steel tube 4 mm in outer diameter, was inserted through brain to the target point and the hematoma was aspirated through a silicon tube connected to a vacuum system. Among 61 cases examined, 30 cases of thalamic hemorrhage were operated upon and 36 cases were not operated. They were classified according to the volume of hematoma into 3 groups as follows: A=less than 10 ml, B=11-25 ml, C=more than 25 ml. The operated cases were compared with the non operated cases on the improvement of consciousness in each group. In the A group, the operated patients in the level I recovered more slowly than the non operated patients, but in the level II patients, this was reversed. In the B group, the operated patients improved more quickly except the level I patients. In the C group, almost all of non operated patients died. Thus, this operation was very useful in improving consciousness of level II or III patients independent of hematoma volume. It accelerated the recovery of motor function in the level I. This non inversive technique is considered effective for the removal of deep intracerebral hematoma. (author)

  15. Enabling image fusion for a CT guided needle placement robot

    Science.gov (United States)

    Seifabadi, Reza; Xu, Sheng; Aalamifar, Fereshteh; Velusamy, Gnanasekar; Puhazhendi, Kaliyappan; Wood, Bradford J.

    2017-03-01

    Purpose: This study presents development and integration of hardware and software that enables ultrasound (US) and computer tomography (CT) fusion for a FDA-approved CT-guided needle placement robot. Having real-time US image registered to a priori-taken intraoperative CT image provides more anatomic information during needle insertion, in order to target hard-to-see lesions or avoid critical structures invisible to CT, track target motion, and to better monitor ablation treatment zone in relation to the tumor location. Method: A passive encoded mechanical arm is developed for the robot in order to hold and track an abdominal US transducer. This 4 degrees of freedom (DOF) arm is designed to attach to the robot end-effector. The arm is locked by default and is released by a press of button. The arm is designed such that the needle is always in plane with US image. The articulated arm is calibrated to improve its accuracy. Custom designed software (OncoNav, NIH) was developed to fuse real-time US image to a priori-taken CT. Results: The accuracy of the end effector before and after passive arm calibration was 7.07mm +/- 4.14mm and 1.74mm +/-1.60mm, respectively. The accuracy of the US image to the arm calibration was 5mm. The feasibility of US-CT fusion using the proposed hardware and software was demonstrated in an abdominal commercial phantom. Conclusions: Calibration significantly improved the accuracy of the arm in US image tracking. Fusion of US to CT using the proposed hardware and software was feasible.

  16. Asymptomatic acute ischemic stroke after primary percutaneous coronary intervention in patients with acute coronary syndrome might be caused mainly by manipulating catheters or devices in the ascending aorta, regardless of the approach to the coronary artery

    International Nuclear Information System (INIS)

    Murai, Motonobu; Hazui, Hiroshi; Sugie, Akira

    2007-01-01

    Asymptomatic acute ischemic stroke (aAIS) following primary percutaneous coronary intervention (p-PCI) in patients with acute coronary syndrome (ACS) has not been studied in detail. Of 75 patients who underwent p-PCI, 26 (34.7%) developed aAIS as determined by diffusion-weighted magnetic resonance imaging (MRI). Including the approach to the coronary artery (via lower limb or right upper limb), 23 factors were compared between patients with (n=26) and without (n=49) aAIS. Age, hypertension, smoking, plasma glucose levels, Killip grade, right coronary artery (RCA) as culprit vessel, percutaneous coronary intervention (PCI) time, and the frequency of device insertion into the coronary artery differed in a statistically significant manner. However, multivariate analysis showed that the RCA (odds ratio 3.477) and the frequency of device insertion (1.375) were independent factors linked to the incidence of aAIS. Moreover, anterior or posterior location and left or right cerebral circulation of aAIS were equivalent in both approaches. Cranial MRI images following emergency PCI revealed that 34.7% of the patients with ACS had aAIS that might be caused by manipulating the catheter or devices in the ascending aorta, micro-air bubble embolism during injection, or micro-thrombus embolism derived from the ACS lesions during the PCI procedure. (author)

  17. Catheter Angiography

    Medline Plus

    Full Text Available ... of a catheter makes it possible to combine diagnosis and treatment in a single procedure. Catheter angiography ... of a catheter makes it possible to combine diagnosis and treatment in a single procedure. An example ...

  18. Catheter Angiography

    Medline Plus

    Full Text Available ... few millimeters) in the skin where the catheter can be inserted into an artery. The catheter is ... need for surgery. If surgery remains necessary, it can be performed more accurately. Catheter angiography presents a ...

  19. Catheter Angiography

    Medline Plus

    Full Text Available ... resonance imaging (MRI) In catheter angiography, a thin plastic tube, called a catheter , is inserted into an ... The catheter used in angiography is a long plastic tube about as thick as a strand of ...

  20. Catheter Angiography

    Medline Plus

    Full Text Available ... using: x-rays with catheters computed tomography (CT) magnetic resonance imaging (MRI) In catheter angiography, a thin plastic ... called superselective angiography. Unlike computed tomography (CT) or magnetic resonance (MR) angiography , use of a catheter makes it ...

  1. Catheter Angiography

    Medline Plus

    Full Text Available ... Z Catheter Angiography Catheter angiography uses a catheter, x-ray imaging guidance and an injection of contrast material ... vessels in the body. Angiography is performed using: x-rays with catheters computed tomography (CT) magnetic resonance imaging ( ...

  2. The contribution of CT-guided transthoracic lung biopsy to the diagnosis of organising pneumonia.

    Science.gov (United States)

    Metzger, F; Pernet, D; Manzoni, P; Ranfaing, E; Dalphin, J-C

    2010-09-01

    Organising pneumonia is a pulmonary disease with variable clinical and radiological features and with many differential diagnoses. Diagnosis is based on histology obtained by either transbronchial or surgical lung biopsy but these techniques have several disadvantages. The aim of this study was to evaluate the diagnostic yield of CT-guided transthoracic lung biopsy in organising pneumonia and to compare it to the usual diagnostic tools. Six cases of organising pneumonia diagnosed with CT-guided lung biopsy are reported and discussed. The role of CT-guided lung biopsy in the diagnosis of organising pneumonia was also reviewed in the literature. CT-guided transthoracic lung biopsies provided a higher rate of adequate samples than transbronchial biopsies (92-100% versus 77-86%). The samples were larger, which reduced the risks of misdiagnosis and increased the diagnostic yield (88-97% versus 26-55% in pulmonary nodules and 42-100% versus 66-75% in diffuse pulmonary disease). Complications were rare and generally not serious. CT-guided transthoracic lung biopsy may be considered in place of transbronchial biopsy in the diagnosis of organising pneumonia. Surgical lung biopsy remains the gold standard method for diagnosis. Copyright © 2010 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  3. A study on CT-guided stereotactic technique for functional neurosurgery

    International Nuclear Information System (INIS)

    Uetsuhara, Koichi; Asakura, Tetsuhiko; Hirahara, Kazuho; Gondo, Masazumi; Oda, Hiroshige

    1987-01-01

    Recently, CT-guided stereotactic surgery has become of major interest, and some authors have discussed its potential in functional neurosurgery. The following is a comparative study of the CT-guided stereotactic technique and the conventional roentogenographic stereotactic technique. The Brown-Roberts-Wells apparatus was used for both types of procedures. 37 stereotactic procedures were performed on 35 patients under local anesthesia; 16 for stereotactic biopsy and 21 for stereotactic functional neurosurgery. Target points for stereotactic biopsy were determined by the CT-guided technique and target points for functional neurosurgery were determined by the conventional roentogenographic technique. The correlation with the position of target point determined by both techniques was investigated in the 21 functional neurosurgical procedures. On these occasions the authors used the reformatted horizontal and sagittal CT through the anterior and posterior commissure to determine the position of target point by the CT-guided technique. Results: It was found that the AC-PC line crossed with Reid's base line at angle of 11 ± 1 deg, and therefore it is important to obtain a CT images including AC-PC line at this angle. When applying the CT guided stereotactic procedure for functional surgery, it should be known that there could be a discrepancy within 2 mm from the conventional target determination. (author)

  4. Location of pulmonary modules prior to video thoracoscopic surgery by CT-guided hook wire placement: Preliminary study

    International Nuclear Information System (INIS)

    Ferreiras, J.; Salmeron, I.; Bustos Garcia de Castro, A.; Hernando, F.; Gomez, A.; Torres, A.

    1996-01-01

    Despite the efficacy of computerized tomography (CT) or radiologically-guided percutaneous biopsy and that offluoroscopically-guided trans bronchial biopsy in characterizing pulmonary nodules, it is not always possible to determine the etiology using these techniques, making it necessary to resort to thoracotomy. Recent developments in endoscopicsurgery equipment and the availability of advance video imaging technology have extended the indications for both diagnostic and therapeutic thoracoscopy. Thus, a number of procedures that previously could only be performed bymeans of thoracotomy, such as resection of peripheral pulmonary nodules, can nowbe carried out by means of video thoracoscopic (VT) surgery. Palpation orvisual location of pulmonary nodules by thoracoscopy is essential but is not always possible when the nodules measure less than 20 mm or when their location is not subpleural. In such cases, a procedure for their prior location is useful. In eight patients with pulmonary nodules who were to undergo subsequent VT surgery, the attempt was made to locate the nodules by CT-guided placementof a hook wire, similar to that employed in breast, and methylene blue injection. The hook wire was correctly introduced without significant complications in all eight cases. The eight nodules were successfully resected during the thoracoscopic procedure, in which the hook wire and methylene blue staining were of great assistance. In certain cases, the location of pulmonary nodules by means of CT-guidehook wire placement and methylene blue injection allows the video thoracoscopic resection of lesions of difficult access. (Author)

  5. Percutaneous transluminal rotational atherectomy in the treatment of peripheral vascular disease using a transluminal endatherectomy catheter (TEC): Initial results and angiographic follow-up

    International Nuclear Information System (INIS)

    Rilinger, Norbert; Goerich, Johannes; Scharrer-Pamler, Reinhard; Vogel, Jochen; Tomczak, Reinhard; Merkle, Elmar; Sokiranski, Roman; Brambs, Hans-Juergen

    1997-01-01

    Purpose. To evaluate the clinical results of percutaneous transluminal rotational atherectomy in the treatment of peripheral vascular disease. Methods. Rotational atherectomy was performed in 39 patients aged 39-87 years (mean 66.6 years). A total of 71 lesions (43 stenoses and 28 occlusions) were treated in 40 limbs. Additional balloon angioplasty was required in 54% of lesions. Fifteen patients (37.5%) presented in Fontaine stage II, 10 patients (25%) in Fontaine stage III and 15 patients (37.5%) in Fontaine stage IV. Rotational atherectomy at 750 rpm was carried out over a 0.014-inch guidewire with continuous aspiration into a vacuum, bottle. Follow-up angiography and color flow Doppler examinations were performed in 22 patients (23 limbs) after a mean period of 6 months (range 2-14 months). Results. There was one primary technical failure. In 36 of 40 lesions there was a good angiographic result with residual stenoses in less than 30%. In 70 lesions treated by rotational atherectomy, however, 54% showed residual stenoses of 30%-50% and these cases required additional balloon angioplasty. The mean ankle-brachial index improved significantly (p<0.001), from 0.49 before the procedure to 1.01 after the procedure. A single distal embolus, related to primary recanalization, occurred and there were two large inguinal hematomas. Cumulative clinical patency after 6 months was 83.8% and cumulative angiographic patency after 6 months was 79.1%. Conclusion. Percutaneous rotational atherectomy is a promising approach for the treatment of chronic peripheral vascular disease. Further prospective, randomized studies are necessary to compare percutaneous transluminal angioplasty with this new technical approach

  6. CT guided celiac plexus and splanchnic nerve neurolysis : the modified anterior approach

    International Nuclear Information System (INIS)

    Lee, Jeong Min; Lee, Mi Suk; Ym, Seong Hee; Lee, Jin Hee

    1997-01-01

    Since it was first described by Kappis, celiac plexus neurolysis (CPN) has been performed under fluoroscopic guidance by anesthetists or surgeons for the relief of intractable pain caused by upper abdominal malignancy. Recently, however, several groups have reported a computed tomography (CT)-guided technique that increased the safety of the blocking procedure and improved its results. The authors present a new technique CT-guided celiac plexus and splanchic nerve block, to be used simultaneously with a modified anterior approach. Using CT to guide needle tip placement, an anterior approach that permitted direct neurolysis of the celiac ganglia and splanchnic nerve was developed

  7. Self-retaining small-looped catheter for narrow bile ducts in high common bile duct obstruction

    International Nuclear Information System (INIS)

    Guenther, R.W.; Daehnert, W.

    1985-01-01

    A new self-retaining catheter was devised for percutaneous drainage of small bile ducts. The device allows safe external drainage without the risk of catheter dislocation even in high bile duct obstruction. The catheter is also suitable for percutaneous nephrostomy in non-dilated pyelocaliceal system. (orig.)

  8. CT-guided radiofrequency ablation of T1a renal cell carcinma in Korea; Mid-erm outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hae Jin; Park, Byung Kwan; Park, Jung Jae; Kim, Chan Kyo [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2016-09-15

    To evaluate the mid-term outcomes of percutaneous radiofrequency ablation (RFA) treatment in patients with small (< 4 cm) renal cell carcinoma (RCC) in Korea. Between 2010 and 2015, 51 patients (40 men and 11 women; median age, 57 years) with biopsyproven 51 RCC were treated using CT-guided RFA. All patients were clinically staged T1aN0M0 prior to RFA. The median tumor size and follow-up period were 2.1 cm (range, 1.0–3.9 cm) and 26 months (4–60 months), respectively. Local tumor progression, distant metastasis, primary and secondary effectiveness rates, and major complication rates were recorded. Estimated glomerular filtration rates (GFRs) between pre-RFA and last follow-up were compared using paired t tests. The 2-year recurrence-free survival rate was calculated using Kaplan-Meier survival analysis. Of the 51 patients, 2 (3.9%) experienced local tumor progression, and 1 (2.0%) had lymph node metastasis after the first RFA session. Primary and secondary effectiveness rates were 96.1% (49/51) and 100% (1/1), respectively. Only 1 patient experienced a major complication (uretero-pelvic stricture) after the second RFA session for treating a local tumor progression, and the major complication rate was 1.9% (1/52). The median pre-RFA and last follow-up GFRs were 87.1 mL/ min/1.73 m{sup 2} (14.2–142.7 mL/min/1.73 m{sup 2}) and 72.0 mL/min/1.73 m{sup 2} (7.2–112.6 mL/min/1.73 m{sup 2}), respectively (p < 0.0001). The 2-year recurrence-free survival rate was 96.0%. CT-guided RFA is a safe and effective treatment in Korean patients with T1a RCC because of excellent mid-term outcomes.

  9. CT-Guided Radiofrequency Ablation of T1a Renal Cell Carcinoma in Korea: Mid-Term Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hae Jin; Park, Byung Kwan; Park, Jung Jae; Kim, Chan Kyo [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351 (Korea, Republic of)

    2016-11-01

    To evaluate the mid-term outcomes of percutaneous radiofrequency ablation (RFA) treatment in patients with small (< 4 cm) renal cell carcinoma (RCC) in Korea. Between 2010 and 2015, 51 patients (40 men and 11 women; median age, 57 years) with biopsyproven 51 RCC were treated using CT-guided RFA. All patients were clinically staged T1aN0M0 prior to RFA. The median tumor size and follow-up period were 2.1 cm (range, 1.0–3.9 cm) and 26 months (4–60 months), respectively. Local tumor progression, distant metastasis, primary and secondary effectiveness rates, and major complication rates were recorded. Estimated glomerular filtration rates (GFRs) between pre-RFA and last follow-up were compared using paired t tests. The 2-year recurrence-free survival rate was calculated using Kaplan-Meier survival analysis. Of the 51 patients, 2 (3.9%) experienced local tumor progression, and 1 (2.0%) had lymph node metastasis after the first RFA session. Primary and secondary effectiveness rates were 96.1% (49/51) and 100% (1/1), respectively. Only 1 patient experienced a major complication (uretero-pelvic stricture) after the second RFA session for treating a local tumor progression, and the major complication rate was 1.9% (1/52). The median pre-RFA and last follow-up GFRs were 87.1 mL/ min/1.73 m{sup 2} (14.2–142.7 mL/min/1.73 m{sup 2}) and 72.0 mL/min/1.73 m{sup 2} (7.2–112.6 mL/min/1.73 m{sup 2}), respectively (p < 0.0001). The 2-year recurrence-free survival rate was 96.0%. CT-guided RFA is a safe and effective treatment in Korean patients with T1a RCC because of excellent mid-term outcomes.

  10. CT-Guided Radiofrequency Ablation of T1a Renal Cell Carcinoma in Korea: Mid-Term Outcomes

    International Nuclear Information System (INIS)

    Kim, Hae Jin; Park, Byung Kwan; Park, Jung Jae; Kim, Chan Kyo

    2016-01-01

    To evaluate the mid-term outcomes of percutaneous radiofrequency ablation (RFA) treatment in patients with small (< 4 cm) renal cell carcinoma (RCC) in Korea. Between 2010 and 2015, 51 patients (40 men and 11 women; median age, 57 years) with biopsyproven 51 RCC were treated using CT-guided RFA. All patients were clinically staged T1aN0M0 prior to RFA. The median tumor size and follow-up period were 2.1 cm (range, 1.0–3.9 cm) and 26 months (4–60 months), respectively. Local tumor progression, distant metastasis, primary and secondary effectiveness rates, and major complication rates were recorded. Estimated glomerular filtration rates (GFRs) between pre-RFA and last follow-up were compared using paired t tests. The 2-year recurrence-free survival rate was calculated using Kaplan-Meier survival analysis. Of the 51 patients, 2 (3.9%) experienced local tumor progression, and 1 (2.0%) had lymph node metastasis after the first RFA session. Primary and secondary effectiveness rates were 96.1% (49/51) and 100% (1/1), respectively. Only 1 patient experienced a major complication (uretero-pelvic stricture) after the second RFA session for treating a local tumor progression, and the major complication rate was 1.9% (1/52). The median pre-RFA and last follow-up GFRs were 87.1 mL/ min/1.73 m 2 (14.2–142.7 mL/min/1.73 m 2 ) and 72.0 mL/min/1.73 m 2 (7.2–112.6 mL/min/1.73 m 2 ), respectively (p < 0.0001). The 2-year recurrence-free survival rate was 96.0%. CT-guided RFA is a safe and effective treatment in Korean patients with T1a RCC because of excellent mid-term outcomes

  11. Catheter Angiography

    Medline Plus

    Full Text Available ... incision in the skin. Once the catheter is guided to the area being examined, a contrast material ... inserted into an artery. The catheter is then guided through the arteries to the area to be ...

  12. Catheter Angiography

    Medline Plus

    Full Text Available ... it will make the rest of the procedure pain-free. You will not feel the catheter in ... nurse if you notice any bleeding, swelling or pain at the site where the catheter entered the ...

  13. Catheter Angiography

    Medline Plus

    Full Text Available ... an artery through a small incision in the skin. Once the catheter is guided to the area ... small incision (usually a few millimeters) in the skin where the catheter can be inserted into an ...

  14. Catheter Angiography

    Medline Plus

    Full Text Available ... should inform the nurse if you notice any bleeding, swelling or pain at the site where the ... Rarely, the catheter punctures the artery, causing internal bleeding. It also is possible that the catheter tip ...

  15. Catheter Angiography

    Medline Plus

    Full Text Available ... catheter , is inserted into an artery through a small incision in the skin. Once the catheter is ... the tube and images are captured using a small dose of ionizing radiation ( x-rays ). top of ...

  16. Catheter Angiography

    Medline Plus

    Full Text Available ... imaging (MRI) In catheter angiography, a thin plastic tube, called a catheter , is inserted into an artery ... examined, a contrast material is injected through the tube and images are captured using a small dose ...

  17. Catheter Angiography

    Medline Plus

    Full Text Available ... or other procedures such as chemoembolization or selective internal radiation therapy. identify dissection or splitting in the ... days. Rarely, the catheter punctures the artery, causing internal bleeding. It also is possible that the catheter ...

  18. Catheter Angiography

    Medline Plus

    Full Text Available ... is performed using: x-rays with catheters computed tomography (CT) magnetic resonance imaging (MRI) In catheter angiography, ... tumor; this is called superselective angiography. Unlike computed tomography (CT) or magnetic resonance (MR) angiography , use of ...

  19. Catheter Angiography

    Medline Plus

    Full Text Available ... is performed using: x-rays with catheters computed tomography (CT) magnetic resonance imaging (MRI) In catheter angiography, a ... tumor; this is called superselective angiography. Unlike computed tomography (CT) or magnetic resonance (MR) angiography , use of a ...

  20. Catheter Angiography

    Medline Plus

    Full Text Available ... Catheter angiography uses a catheter, x-ray imaging guidance and an injection of contrast material to examine ... removable dental appliances, eye glasses and any metal objects or clothing that might interfere with the x- ...

  1. Catheter Angiography

    Medline Plus

    Full Text Available ... most cases, the kidneys will regain their normal function within five to seven days. Rarely, the catheter ... limitations of Catheter Angiography? Patients with impaired kidney function, especially those who also have diabetes, are not ...

  2. Catheter Angiography

    Medline Plus

    Full Text Available ... lies. The catheter used in angiography is a long plastic tube about as thick as a strand of spaghetti. top of page How does the procedure work? Catheter angiography works much the same as a ...

  3. Catheter Angiography

    Medline Plus

    Full Text Available ... lessen your anxiety during the procedure. The area of the groin or arm where the catheter will be inserted is shaved, ... contrast material is injected through the catheter and reaches the blood vessels being studied, several sets of x-rays are taken. Then the catheter is ...

  4. Technical note: CT-guided biopsy of lung masses using an automated guiding apparatus

    International Nuclear Information System (INIS)

    Chellathurai, Amarnath; Kanhirat, Saneej; Chokkappan, Kabilan; Swaminathan, Thiruchendur S; Kulasekaran, Nadhamuni

    2009-01-01

    Automated guiding apparatuses for CT-guided biopsies are now available. We report our experience with an indigenous system to guide lung biopsies. This system gave results similar to those with the manual technique. Automated planning also appears to be technically easier, it requires fewer number of needle passes, consumes less time, and requires fewer number of check scans

  5. Stress-induced osteolysis of distal clavicle: imaging patterns and treatment using CT-guided injection

    Energy Technology Data Exchange (ETDEWEB)

    Sopov, V.; Groshar, D. [Dept. of Nuclear Medicine, Technion-Israel Inst. of Technology, Haifa (Israel); Fuchs, D. [Dept. of Orthopaedics, Technion-Israel Inst. of Technology, Haifa (Israel); Bar-Meir, E. [Dept. of Radiology, Technion-Israel Inst. of Technology, Haifa (Israel)

    2001-02-01

    Osteolysis of distal clavicle (ODC) may occur in patients who experience repeated stress or microtrauma to the shoulder. This entity has clinical and radiological findings similar to post-traumatic ODC. We describe a case of successful treatment of stress-induced ODC with CT-guided injection of corticosteroid and anesthetic drug into the acromioclavicular joint. (orig.)

  6. Stress-induced osteolysis of distal clavicle: imaging patterns and treatment using CT-guided injection

    International Nuclear Information System (INIS)

    Sopov, V.; Groshar, D.; Fuchs, D.; Bar-Meir, E.

    2001-01-01

    Osteolysis of distal clavicle (ODC) may occur in patients who experience repeated stress or microtrauma to the shoulder. This entity has clinical and radiological findings similar to post-traumatic ODC. We describe a case of successful treatment of stress-induced ODC with CT-guided injection of corticosteroid and anesthetic drug into the acromioclavicular joint. (orig.)

  7. Impact of delineation uncertainties on dose to organs at risk in CT-guided intracavitary brachytherapy.

    LENUS (Irish Health Repository)

    Duane, Frances K

    2014-08-07

    This study quantifies the inter- and intraobserver variations in contouring the organs at risk (OARs) in CT-guided brachytherapy (BT) for the treatment of cervical carcinoma. The dosimetric consequences are reported in accordance with the current Gynecological Groupe Européen de Curiethérapie\\/European Society for Therapeutic Radiology and Oncology guidelines.

  8. The cost-effectiveness of CT-guided sacroiliac joint injections: a measure of QALY gained.

    Science.gov (United States)

    Bydon, Mohamad; Macki, Mohamed; De la Garza-Ramos, Rafael; Youssef, Mina; Gokaslan, Ziya L; Meleka, Sherif; Bydon, Ali

    2014-10-01

    The purpose of this study is to estimate the total cost and the quality of life years (QALY) gained for computer tomography (CT)-guided sacroiliac joint (SIJ) injections. The cost per QALY gained for the procedure is the primary end-point of this study. In our 1-year prospective institutional study, we gathered 30 patients undergoing CT-guided SIJ injections for degenerative changes at the SIJ space. Patient-reported outcomes included both the US population-based EQ-5D (EuroQol) index score and the EQ-visual analog scale (VAS). The EQ-5D is based on mobility, self-care, usual activities, pain/discomfort, and anxiety depression. Utility expenditures were based on hospital charges at our institution. All 30 patients had one pre-injection physician visit followed by 43 initial injections (13 bilateral). Each patient underwent one CT scan, and three patients required additional plain films. In the 1 year following the injections, 26 physician visits were documented. Five patients required repeat CT-guided injections. Total 1-year cost for all 30 patients was $34 874·00. Mean decrease in EQ-VAS was 0·60 (P  =  0·187). The mean 1-year gain of 0·58 EQ-5D QALY reached statistical significance (P sacroiliac injections was $2004·29. In one of the first cost analyses of CT-guided sacroiliac injections, we found that the procedure improves pain and activities of daily living. The cost per QALY gained by CT-guided sacroiliac injections falls well below the threshold cost of 1 QALY, suggesting that the procedure is strongly cost-effective.

  9. MRI-guided and CT-guided cervical nerve root infiltration therapy. A cost comparison

    Energy Technology Data Exchange (ETDEWEB)

    Maurer, M.H.; Froeling, V.; Roettgen, R.; Bucourt, M. de; Hamm, B.; Streitparth, F. [Charite University Medicine Berlin (Germany). Dept. of Diagnostic and Interventional Radiology; Bretschneider, T. [Magdeburg Univ. (Germany). Dept. of Radiology and Nuclear Medicine; Hartwig, T.; Disch, A.C. [Charite University Medicine Berlin (Germany). Center for Musculoskeletal Surgery

    2014-06-15

    Purpose: To evaluate and compare the costs of MRI-guided and CT-guided cervical nerve root infiltration for the minimally invasive treatment of radicular neck pain. Materials and Methods: Between September 2009 and April 2012, 22 patients (9 men, 13 women; mean age: 48.2 years) underwent MRI-guided (1.0 Tesla, Panorama HFO, Philips) single-site periradicular cervical nerve root infiltration with 40 mg triamcinolone acetonide. A further 64 patients (34 men, 30 women; mean age: 50.3 years) were treated under CT fluoroscopic guidance (Somatom Definition 64, Siemens). The mean overall costs were calculated as the sum of the prorated costs of equipment use (purchase, depreciation, maintenance, and energy costs), personnel costs and expenditure for disposables that were identified for MRI- and CT-guided procedures. Additionally, the cost of ultrasound guidance was calculated. Results: The mean intervention time was 24.9 min. (range: 12-36 min.) for MRI-guided infiltration and 19.7 min. (range: 5-54 min.) for CT-guided infiltration. The average total costs per patient were EUR 240 for MRI-guided interventions and EUR 124 for CT-guided interventions. These were (MRI/CT guidance) EUR 150/60 for equipment use, EUR 46/40 for personnel, and EUR 44/25 for disposables. The mean overall cost of ultrasound guidance was EUR 76. Conclusion: Cervical nerve root infiltration using MRI guidance is still about twice as expensive as infiltration using CT guidance. However, since it does not involve radiation exposure for patients and personnel, MRI-guided nerve root infiltration may become a promising alternative to the CT-guided procedure, especially since a further price decrease is expected for MRI devices and MR-compatible disposables. In contrast, ultrasound remains the less expensive method for nerve root infiltration guidance. (orig.)

  10. CT-guided core needle biopsy of pleural lesions: Evaluating diagnostic yield and associated complications

    International Nuclear Information System (INIS)

    Niu, Xiang Ke; Bhetuwal, Anup; Yang, Han Feng

    2015-01-01

    The purpose of this study was to retrospectively evaluate the diagnostic accuracy and complications of CT-guided core needle biopsy (CT-guided CNB) of pleural lesion and the possible effects of influencing factors. From September 2007 to June 2013, 88 consecutive patients (60 men and 28 women; mean [+/- standard deviation] age, 51.1 +/- 14.4 years; range, 19-78 years) underwent CT-guided CNB, which was performed by two experienced chest radiologists in our medical center. Out of 88 cases, 56 (63%) were diagnosed as malignant, 28 (31%) as benign and 4 (5%) as indeterminate for CNB of pleural lesions. The final diagnosis was confirmed by either histopathological diagnosis or clinical follow-up. The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and complication rates were statistically evaluated. Influencing factors (patient age, sex, lesion size, pleural-puncture angle, patient position, pleural effusion, and number of pleural punctures) were assessed for their effect on accuracy of CT-guided CNB using univariate and subsequent multivariate analysis. Diagnostic accuracy, sensitivity, specificity, PPV, and NPV were 89.2%, 86.1%, 100%, 100%, and 67.8%, respectively. The influencing factors had no significant effect in altering diagnostic accuracy. As far as complications were concerned, occurrence of pneumothorax was observed in 14 (16%) out of 88 patients. Multivariate analysis revealed lesion size/pleural thickening as a significant risk factor (odds ratio [OR]: 8.744, p = 0.005) for occurrence of pneumothorax. Moreover, presence of pleural effusion was noted as a significant protective factor (OR: 0.171, p = 0.037) for pneumothorax. CT-guided CNB of pleural lesion is a safe procedure with high diagnostic yield and low risk of significant complications.

  11. CT-guided core needle biopsy of pleural lesions: Evaluating diagnostic yield and associated complications

    Energy Technology Data Exchange (ETDEWEB)

    Niu, Xiang Ke [Dept. of Radiology, Affiliated Hospital of Chengdu University, Chengdu (China); Bhetuwal, Anup; Yang, Han Feng [Dept. of Radiology, Sichuan Key Laboratory of Medical Imaging, Affiliated Hospital of North Sichuan Medical College, Nanchong (China)

    2015-02-15

    The purpose of this study was to retrospectively evaluate the diagnostic accuracy and complications of CT-guided core needle biopsy (CT-guided CNB) of pleural lesion and the possible effects of influencing factors. From September 2007 to June 2013, 88 consecutive patients (60 men and 28 women; mean [+/- standard deviation] age, 51.1 +/- 14.4 years; range, 19-78 years) underwent CT-guided CNB, which was performed by two experienced chest radiologists in our medical center. Out of 88 cases, 56 (63%) were diagnosed as malignant, 28 (31%) as benign and 4 (5%) as indeterminate for CNB of pleural lesions. The final diagnosis was confirmed by either histopathological diagnosis or clinical follow-up. The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and complication rates were statistically evaluated. Influencing factors (patient age, sex, lesion size, pleural-puncture angle, patient position, pleural effusion, and number of pleural punctures) were assessed for their effect on accuracy of CT-guided CNB using univariate and subsequent multivariate analysis. Diagnostic accuracy, sensitivity, specificity, PPV, and NPV were 89.2%, 86.1%, 100%, 100%, and 67.8%, respectively. The influencing factors had no significant effect in altering diagnostic accuracy. As far as complications were concerned, occurrence of pneumothorax was observed in 14 (16%) out of 88 patients. Multivariate analysis revealed lesion size/pleural thickening as a significant risk factor (odds ratio [OR]: 8.744, p = 0.005) for occurrence of pneumothorax. Moreover, presence of pleural effusion was noted as a significant protective factor (OR: 0.171, p = 0.037) for pneumothorax. CT-guided CNB of pleural lesion is a safe procedure with high diagnostic yield and low risk of significant complications.

  12. MRI-guided and CT-guided cervical nerve root infiltration therapy. A cost comparison

    International Nuclear Information System (INIS)

    Maurer, M.H.; Froeling, V.; Roettgen, R.; Bucourt, M. de; Hamm, B.; Streitparth, F.; Bretschneider, T.; Hartwig, T.; Disch, A.C.

    2014-01-01

    Purpose: To evaluate and compare the costs of MRI-guided and CT-guided cervical nerve root infiltration for the minimally invasive treatment of radicular neck pain. Materials and Methods: Between September 2009 and April 2012, 22 patients (9 men, 13 women; mean age: 48.2 years) underwent MRI-guided (1.0 Tesla, Panorama HFO, Philips) single-site periradicular cervical nerve root infiltration with 40 mg triamcinolone acetonide. A further 64 patients (34 men, 30 women; mean age: 50.3 years) were treated under CT fluoroscopic guidance (Somatom Definition 64, Siemens). The mean overall costs were calculated as the sum of the prorated costs of equipment use (purchase, depreciation, maintenance, and energy costs), personnel costs and expenditure for disposables that were identified for MRI- and CT-guided procedures. Additionally, the cost of ultrasound guidance was calculated. Results: The mean intervention time was 24.9 min. (range: 12-36 min.) for MRI-guided infiltration and 19.7 min. (range: 5-54 min.) for CT-guided infiltration. The average total costs per patient were EUR 240 for MRI-guided interventions and EUR 124 for CT-guided interventions. These were (MRI/CT guidance) EUR 150/60 for equipment use, EUR 46/40 for personnel, and EUR 44/25 for disposables. The mean overall cost of ultrasound guidance was EUR 76. Conclusion: Cervical nerve root infiltration using MRI guidance is still about twice as expensive as infiltration using CT guidance. However, since it does not involve radiation exposure for patients and personnel, MRI-guided nerve root infiltration may become a promising alternative to the CT-guided procedure, especially since a further price decrease is expected for MRI devices and MR-compatible disposables. In contrast, ultrasound remains the less expensive method for nerve root infiltration guidance. (orig.)

  13. Intravascular (catheter) MR imaging

    International Nuclear Information System (INIS)

    Cohen, A.M.; Hurst, G.C.; Katz, D.E.; Dverk, J.L.; Wiesen, E.J.; Czerski, L.W.; Malaya, R.; Bellon, E.M.

    1989-01-01

    Intravascular MR probes allow excellent spatial resolution and have the potential to detect arterial wall microstructure. Ultrasonic intravascular probes suggest that detailed morphologic information can assist clinical decision making. Catheter MR probes of 2--7 mm outside diameter (OD) were built of copper wire, Teflon, and parts from standard commercial catheters. The probes were connected to the surface coil receiver input of our Picker VISTA 2055HP 1.5-T imaging system. The extant (linear) body coil was used for transmit. Phantoms were constructed of coaxial glass MR tubes, filled with doped water. Watanabe rabbit aorta and human autopsy iliac artery specimens were examined within 4 hours of excision or stored by freezing. In vivo iliac arteries in dogs under general anesthesia were imaged, with percutaneous placement of the probe. Results are presented

  14. Pressure-wire-guided percutaneous transluminal pulmonary angioplasty: a breakthrough in catheter-interventional therapy for chronic thromboembolic pulmonary hypertension.

    Science.gov (United States)

    Inami, Takumi; Kataoka, Masaharu; Shimura, Nobuhiko; Ishiguro, Haruhisa; Yanagisawa, Ryoji; Fukuda, Keiichi; Yoshino, Hideaki; Satoh, Toru

    2014-11-01

    This study sought to prove the safety and effectiveness of pressure-wire-guided percutaneous transluminal pulmonary angioplasty (PTPA). PTPA has been demonstrated to be effective for treatment of chronic thromboembolic pulmonary hypertension. However, a major and occasionally fatal complication after PTPA is reperfusion pulmonary edema. To avoid this, we developed the PEPSI (Pulmonary Edema Predictive Scoring Index). The pressure wire has been used to detect insufficiency of flow in a vessel. We included 350 consecutive PTPA sessions in 103 patients with chronic thromboembolic pulmonary hypertension from January 1, 2009 to December 31, 2013. During these 5 years, 140 PTPA sessions were performed without guidance, 65 with guidance of PEPSI alone, and 145 with both PEPSI and pressure-wire guidance. Each PTPA session was finished after achieving PEPSI scores of PEPSI guidance and each target lesion achieving distal mean pulmonary arterial pressure PEPSI (0% and 6.9%, respectively). Furthermore, the group guided by pressure wire and PEPSI accomplished the same hemodynamic improvements with fewer numbers of target lesions treated and sessions performed. The combined approach using pressure wire and PEPSI produced more efficient clinical results and greatly reduced reperfusion pulmonary edema and vessel complications. This is further evidence that PTPA is an alternative strategy for treating chronic thromboembolic pulmonary hypertension. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  15. Computed tomography-guided percutaneous biopsy of bone lesions: rate of diagnostic success and complications

    International Nuclear Information System (INIS)

    Maciel, Macello Jose Sampaio; Tyng, Chiang Jeng; Barbosa, Paula Nicole Vieira Pinto; Bitencourt, Almir Galvao Vieira; Matushita Junior, Joao Paulo Kawaoka; Zurstrassen, Charles Edouard; Chung, Wu Tu; Chojniak, Rubens

    2014-01-01

    Objective: To determine the rates of diagnostic success and complications of computed tomography (CT)-guided percutaneous biopsy of bone lesions suspected for malignancy. Materials and Methods: Retrospective study including 186 cases of CT-guided percutaneous biopsies of bone lesions in the period from January, 2010 to December, 2012. All the specimens were obtained with 8-10 gauge needles. The following data were collected: demographics, previous history of malignancy, data related to the lesion, to the procedure, and to histological results. Results: Most patients were women (57%), and the mean age was 53.0 ± 16.4 years. In 139 cases (74.6%), there was diagnostic suspicion of metastasis and the most common primary tumors were breast (32.1%) and prostate (11.8%). The bones most commonly involved were spine (36.0%), hip (32.8%) and long bones (18.3%). Complications occurred in only three cases (1.6%) including bone fracture, paraesthesia with functional impairment, and needle breakage requiring surgical removal. The specimens collected from 183 lesions (98.4%) were considered appropriate for diagnosis. Malignant results were more frequently found in patients who had a suspected secondary lesion and history of known malignancy (p < 0.001), and in patients who underwent PET/CT-guided procedures (p = 0.011). Conclusion: CT-guided percutaneous biopsy is a safe and effective procedure for the diagnosis of suspicious bone lesions. (author)

  16. Computed tomography-guided percutaneous biopsy of bone lesions: rate of diagnostic success and complications

    Energy Technology Data Exchange (ETDEWEB)

    Maciel, Macello Jose Sampaio; Tyng, Chiang Jeng; Barbosa, Paula Nicole Vieira Pinto; Bitencourt, Almir Galvao Vieira; Matushita Junior, Joao Paulo Kawaoka; Zurstrassen, Charles Edouard; Chung, Wu Tu; Chojniak, Rubens, E-mail: macellomaciel@me.com [A.C.Camargo Cancer Center, Sao Paulo, SP (Brazil)

    2014-09-15

    Objective: To determine the rates of diagnostic success and complications of computed tomography (CT)-guided percutaneous biopsy of bone lesions suspected for malignancy. Materials and Methods: Retrospective study including 186 cases of CT-guided percutaneous biopsies of bone lesions in the period from January, 2010 to December, 2012. All the specimens were obtained with 8-10 gauge needles. The following data were collected: demographics, previous history of malignancy, data related to the lesion, to the procedure, and to histological results. Results: Most patients were women (57%), and the mean age was 53.0 ± 16.4 years. In 139 cases (74.6%), there was diagnostic suspicion of metastasis and the most common primary tumors were breast (32.1%) and prostate (11.8%). The bones most commonly involved were spine (36.0%), hip (32.8%) and long bones (18.3%). Complications occurred in only three cases (1.6%) including bone fracture, paraesthesia with functional impairment, and needle breakage requiring surgical removal. The specimens collected from 183 lesions (98.4%) were considered appropriate for diagnosis. Malignant results were more frequently found in patients who had a suspected secondary lesion and history of known malignancy (p < 0.001), and in patients who underwent PET/CT-guided procedures (p = 0.011). Conclusion: CT-guided percutaneous biopsy is a safe and effective procedure for the diagnosis of suspicious bone lesions. (author)

  17. Usefulness of CT-guided trans-bronchial needle aspiration biopsy for mediastinal lymph nodes

    International Nuclear Information System (INIS)

    Cui Bing; Rong Fu

    2001-01-01

    Objective: To determine the nature of enlarged mediastinal lymph nodes, the study of CT-guided trans-bronchial needle aspiration biopsy (CT-TBNA) was conducted. Methods: According to classification and locating standard of mediastinal lymph nodes, CT-TBNA was performed in 158 mediastinal lymph nodes of 73 patients, including 54 primary lung cancer with enlarged mediastinal lymph nodes, 5 malignant lymphoma, 3 mediastinal abscess and 11 mediastinal inflammatory adenopathy. Results: CT confirmed that the needles were inside all 158 lymph nodes. Adequate aspirates for histologic and/or cytologic diagnosis were obtained in 136 of 158(86%) lymph node biopsies. No serious complications occurred. Conclusion: Locating standard of CT-guided TBNA was reliable. Puncture was safe and cost-effective. CT-TBNA was important for ascertaining the nature of mediastinal adenopathy and staging of neoplasms

  18. Clinical experience of quantex coordinate software for CT guided stereotactic surgery

    International Nuclear Information System (INIS)

    Yabashi, Toshitake; Ichikawa, Hideo; Yasuda, Eisuke; Tsuruta, Hatsuo; Ishikawa, Yoshihisa; Kimura, Tokuji; Kanamori, Isao

    1991-01-01

    Recently, Quantex Coordinate Software was newly developed for CT-guided stereotactic surgery. We have the opportunity of using this software in 6 cases with intracerebral hematoma for evacuation and 2 cases with brain tumor for needle biopsy by using CT-guided stereotactic surgery. The followings are the features with a little clinical experience. One of the biggest features is that this software can simulate the best expected route of the puncture needle from burr hole to target point before inserting. Also compared with CT 9000 series Software, it has many new functions for more advanced hardware as well as advance standard software. Two cases of intracerebral hematoma for evacuation and 1 case of a brain tumor for a biopsy were carried out using this software mainly as a simulation. In all cases, this software proved to be very useful. (author)

  19. CT-guided preoperative needle localization of MRI-detected breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Giagounidis, Elektra M. E-mail: giagounjdis@online.de; Markus, Ruwe; Josef, Luetzeler; Wemer, Audretsch; Mahdi, Rezai; Bernward, Kurtz

    2001-08-01

    To assess the value of accurate preoperative CT-guided needle localization of occult breast lesions, we reviewed a total of 39 needle-directed biopsies of breast tumors in 24 women. The average age was 52.9 years (range 31-67). All lesions were nonpalpable and mammographically, as well as sonographically occult. They were solely seen on MR-images. After demonstrating the suspicious region on CT scans, a hookwire was inserted. The correct position was confirmed by a control scan. The subsequent histopathological examination showed that 28 of the lesions (71.8%) were benign, among them mastopathy, fibrosis, fibroadenoma, papilloma, intramammary lymph node, liponecrosis and epitheliosis. Eleven lesions (28%) were malignant and showed either lobular, ductal or tubular cancer. Our results endorse that CT guided needle localization is a helpful method that allows a precise surgical excision of the suspect area with the removal of a minimal amount of breast tissue.

  20. Complications of CT guided lumbar sympathicolysis: own experience and review of literature

    International Nuclear Information System (INIS)

    Ernst, S.; Heindel, W.; Fischbach, R.; Langen, H.J.; Krahe, T.; Gawenda, M.; Neubauer, S.

    1998-01-01

    Aim: To review the complications of CT guided lumbar sympathicolysis (CTLS) on the basis of our own experience and the available literature. Methods: 241 CTLS were performed by a standard technique according to Haaga's method. Clinical follow-up revealed 4 serious complications; these were analysed and compared with published cases. Results: Amongst our patients there were three fibrotic ureter stenoses and one retroperitoneal abscess. Analysis of the serious complications described in the literature indicates that introduction of CT guided lumbar sympathicolysis has reduced the severity and frequency of complications as compared with surgical and 'blind' procedures. With CTLS, no deaths due to the procedure have been reported in the literature. The results indicate that damage to the ureters can be caused by substances used for the neurolysis. (orig./MG) [de

  1. Radiation exposure of the radiologist's eye lens during CT-guided interventions.

    Science.gov (United States)

    Heusch, Philipp; Kröpil, Patric; Buchbender, Christian; Aissa, Joel; Lanzman, Rotem S; Heusner, Till A; Ewen, Klaus; Antoch, Gerald; Fürst, Günther

    2014-02-01

    In the past decade the number of computed tomography (CT)-guided procedures performed by interventional radiologists have increased, leading to a significantly higher radiation exposure of the interventionalist's eye lens. Because of growing concern that there is a stochastic effect for the development of lens opacification, eye lens dose reduction for operators and patients should be of maximal interest. To determine the interventionalist's equivalent eye lens dose during CT-guided interventions and to relate the results to the maximum of the recommended equivalent dose limit. During 89 CT-guided interventions (e.g. biopsies, drainage procedures, etc.) measurements of eye lens' radiation doses were obtained from a dedicated dosimeter system for scattered radiation. The sensor of the personal dosimeter system was clipped onto the side of the lead glasses which was located nearest to the CT gantry. After the procedure, radiation dose (µSv), dose rate (µSv/min) and the total exposure time (s) were recorded. For all 89 interventions, the median total exposure lens dose was 3.3 µSv (range, 0.03-218.9 µSv) for a median exposure time of 26.2 s (range, 1.1-94.0 s). The median dose rate was 13.9 µSv/min (range, 1.1-335.5 µSv/min). Estimating 50-200 CT-guided interventions per year performed by one interventionalist, the median dose of the eye lens of the interventional radiologist does not exceed the maximum of the ICRP-recommended equivalent eye lens dose limit of 20 mSv per year.

  2. CT-guided procedures: evaluation of a phantom system to teach accurate needle placement

    International Nuclear Information System (INIS)

    Dimmick, S.; Jones, M.; Challen, J.; Iedema, J.; Wattuhewa, U.; Coucher, J.

    2007-01-01

    Aim: To evaluate the use of a phantom system to help teach the basic techniques of accurate CT-guided needle placement, thereby avoiding the risks associated with teaching on patients. Materials and Methods: Gelatine phantoms with five, 1.9 cm embedded spherical wooden targets were constructed. Four trainee operators performed 15 simulated biopsy procedures on the targets (series one) and repeated identical procedures 2 weeks later (series two). Statistical analysis of accuracy of needle placement and subject confidence were performed. Results: Significant sequential improvement in axial plane angular error was noted with the average error decreasing by 0.33 degrees after every five procedures performed (95% CI: -0.58 to -0.08, p = 0.01). Operator confidence indicated significant improvement both within each series and from series one to series two (95% CI: 0.08 to 1.17, p = 0.025 and 95% CI: 0.00 to 0.58, p = 0.05) respectively. However, variability in operator performance made statistically significant improvement in other variables unproven. Conclusion: Despite the study comprising a relatively small number of participants and procedures, it clearly demonstrated the effectiveness of teaching operators to perform CT-guided procedures using a phantom system. Needle placement accuracy significantly improved, with a reduction in axial angular error, and improved operator confidence without the risks associated with training on patients. Three of the operators in this study had never performed a CT-guided procedure previously, and their proficiency, after a relatively short but intense period of training, was impressive. The use of phantoms should be considered routinely for basic training of CT-guided needle placement

  3. Clinical Value of CT-Guided Needle Biopsy for Retroperitoneal Lesions

    International Nuclear Information System (INIS)

    Tomozawa, Yuki; Inaba, Yoshitaka; Yamaura, Hidekazu; Sato, Yozo; Kato, Mina; Kanamoto, Takaaki; Sakane, Makoto

    2011-01-01

    The purpose of this study was to investigate retrospectively the clinical procedural performance of CT-guided needle biopsy for retroperitoneal lesions. CT-guided needle biopsy was performed in 74 consecutive patients (M:F = 44:30; mean age, 59.7 years) with retroperitoneal lesions between April 1998 and June 2009. The target lesion ranged from 1.5 to 12.5 cm in size. The biopsy access path ranged from 3.5 to 11.5 cm in depth. A biopsy specimen was obtained using an 18-gauge core needle under a CT or CT-fluoroscopy guidance and with the patient under local anesthesia. The histopathological diagnoses from the biopsies were obtained. The diagnostic confirmation of the subtype of lymphoma was evaluated. Satisfactory biopsy samples were obtained in 73 (99%) of 74 patients and a pathological diagnosis was made in 70 (95%) of 74 patients. Sixty three lesions were malignant (45 lymphomas, nine primary tumors, nine lymph node metastases) and seven were benign. The subtype of lymphoma was specified in 43 (96%) of 45 patients who were diagnosed with lymphoma. Analysis of the value of CT-guided biopsy in this series indicated 63 true positives, zero false positive, six true negatives and five false negatives. This test had a sensitivity of 93%, a specificity of 100% and an accuracy of 93%. No major complications were seen and minor complications were noted in seven patients (five with local hematomas, two with transient pain at the puncture site). CT-guided needle biopsy for retroperitoneal lesions is highly practical and useful, and particularly for determining the subtypes in patients with lymphoma.

  4. Prospective evaluation of the radiologist's hand dose in CT-guided interventions

    International Nuclear Information System (INIS)

    Rogits, B.; Jungnickel, K.; Loewenthal, D.; Dudeck, O.; Pech, M.; Ricke, J.; Kropf, S.; Nekolla, E.A.; Wieners, G.

    2013-01-01

    Purpose: Assessment of radiologist's hand dose in CT-guided interventions and determination of influencing factors. Materials and Methods: The following CT-guided interventions were included: Core biopsy, drainage, periradicular therapy, and celiac plexus neurolysis. The hand dose was measured with an immediately readable dosimeter, the EDD-30 (Unfors, Sweden). The default parameters for CT fluoroscopy were 120 kV, 90 mA and a 4 mm slice thickness. All interventions were performed on a 16-slice CT unit (Aquilion 16 Toshiba, Japan). The tumor size, degree of difficulty (1 - 3), level of experience and device parameters (mAs, dose-length product, scan time) were documented. Results: 138 CT-guided interventions (biopsy n = 99, drainage n = 23, pain therapy n = 16) at different locations (lung n = 41, retroperitoneum n = 53, liver n = 25, spine n = 19) were included. The lesion size was 4 - 240 mm (median: 23 mm). The fluoroscopy time per intervention was 4.6 - 140.2 s (median: 24.2 s). The measured hand dose ranged from 0.001 - 3.02 mSv (median: 0.22 mSv). The median hand dose for lung puncture (n = 41) was slightly higher (median: 0.32 mSv, p = 0.01) compared to that for the liver, retroperitoneum and other. Besides physical influencing factors, the degree of difficulty (p = 0.001) and summed puncture depth (p = 0.004) correlated significantly with the hand dose. Conclusion: The median hand dose for different CT-guided interventions was 0.22 mSv. Therefore, the annual hand dose limit would normally only be reached with about 2000 interventions. (orig.)

  5. Diagnostic accuracy and safety of CT-guided fine needle aspiration biopsy in cavitary pulmonary lesions

    Energy Technology Data Exchange (ETDEWEB)

    Zhuang, Yi-Ping, E-mail: yipingzhuang2010@sina.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Wang, Hai-Yan, E-mail: mycherishgirl@sohu.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Zhang, Jin, E-mail: yari_zj@hotmail.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Feng, Yong, E-mail: fengyong119@sohu.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Zhang, Lei, E-mail: motozl163@163.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China)

    2013-01-15

    Objective: CT-guided transthoracic biopsy is a well-established method in the cytologic or histologic diagnosis of pulmonary lesions. The knowledge of its diagnostic performance and complications for cavitary pulmonary lesions is limited. The purpose of this study was to determine the diagnostic accuracy and safety of CT-guided fine needle aspiration biopsy (FNAB) in cavitary pulmonary lesions. Materials and methods: 102 consecutive patients with pulmonary cavitary lesions received CT-guided FNAB with use of an 18-gauge (n = 35) or 20-gauge (n = 67) Chiba for histology diagnosis. The sensitivity, specificity, and diagnostic accuracy of FNAB were calculated as compared with the final diagnosis. Complications associated with FNAB were observed. The diagnostic accuracy and complications were compared between patients with different lesion sizes and different cavity wall thickness. Results: The overall sensitivity, specificity, and accuracy of FNAB were 96.3%, 98.0%, and 96.1%, respectively. The sensitivity, specificity, and diagnosis accuracy in different lesion size (<2 cm vs ≥2 cm), or different cavity wall thickness (<5 mm vs ≥5 mm) were not different (P > 0.05; 0.235). More nondiagnostic sample was found in wall thickness <5 mm lesions (P = 0.017). Associated complications included pneumothorax in 9 (8.8%) patients and alveolar hemorrhage in 14 patients (13.7%) and hemoptysis in 1 patient (1%). No different rate of complications was found with regard to lesion size, wall thickness, length of the needle path and needle size (P > 0.05). Conclusion: CT-guided FNAB can be effectively ad safely used for patients with pulmonary cavitary lesions.

  6. Usefulness of normal saline for sealing the needle track after CT-guided lung biopsy

    International Nuclear Information System (INIS)

    Li, Y.; Du, Y.; Luo, T.Y.; Yang, H.F.; Yu, J.H.; Xu, X.X.; Zheng, H.J.; Li, B.

    2015-01-01

    Aim: To determine whether the use of normal saline for sealing the needle track can reduce the incidence of pneumothorax and chest tube placement after computed tomography (CT)-guided lung biopsy. Materials and methods: A prospective, randomised, controlled trial enrolling 322 patients was conducted. All patients were randomly assigned to one of two groups: those in whom the needle track was not sealed with normal saline (n=161, Group A) and those who did receive normal saline (n=161, Group B). CT-guided biopsy was performed with coaxial technique. Normal saline, which ranged from 1–3 ml, was injected while the trocar needle was being withdrawn. Patient characteristics, lesion, and procedure variables were analysed as potential risk variables for occurrence of pneumothorax and chest tube placement. Results: The incidence of pneumothorax was 26.1% in Group A and 6.2% in Group B (p<0.001). Nine patients in Group A and one patient in Group B required chest tube placement (p=0.010). Using multiple logistic regression analysis, smaller lesion size, greater needle–pleural angle, longer lesion–pleural distance, presence of emphysema, and no sealing the needle track with normal saline were significantly associated with an increased risk of pneumothorax, and that the latter three factors were also associated with an increased risk of pneumothorax requiring chest tube placement. Conlusion: Normal saline for sealing the needle track significantly reduces the incidence of pneumothorax and prevents subsequent chest tube placement after CT-guided lung biopsy. - Highlights: • Normal saline is an effective sealant for use in lung biopsy. • This technique reduced the incidence of pneumothorax and chest tube placement. • This technique should be recommended for CT-guided lung biopsy.

  7. Therapeutic outcome of CT-guided radiofrequency ablation in patients with osteoid osteoma

    Energy Technology Data Exchange (ETDEWEB)

    Lassalle, Louis; Campagna, R.; Corcos, G.; Feydy, A. [Hopital Cochin-APHP Paris Universite Paris Descartes, Service de Radiologie Osteo-Articulaire, Paris (France); Babinet, A. [Hopital Cochin-APHP Paris Universite Paris Descartes, Service de Chirurgie Orthopedique, Paris (France); Larousserie, F. [Hopital Cochin-APHP Paris Universite Paris Descartes, Service d' Anatomo-Pathologie, Paris (France); Stephanazzi, J. [Hopital Cochin-APHP Paris Universite Paris Descartes, Service d' Anesthesie, Paris (France)

    2017-07-15

    To assess the long-term outcome of computed tomography-guided radiofrequency ablation (CT-guided RFA) in patients with suspected osteoid osteoma (OO). Single-center retrospective study. Patients with clinical suspicion and imaging diagnosis of osteoid osteoma were treated by CT-guided RFA using the same device with either a 7- or 10-mm active tip electrode. Specific precautions were applied in case of articular or spinal OO. Patients were contacted by phone to evaluate the long-term outcome in terms of pain, ability to perform daily activities (including sports), and long-term complications. Success was defined as the absence of residual pain and ability to perform daily activities normally. From 2008 to 2015, 126 patients were treated by CT-guided RFA for OO in our institution. Mean patient age was 26.1 years (SD = 11, range 1-53); mean delay to diagnosis was 16.9 months (SD = 15.2, range 1-120). Among patients who answered the follow-up call (n = 88), the overall success rate was 94.3%: 79/88 (89.8%) had primary success of the procedure, and 4/88 (4.5%) had a secondary success (repeat-RFA after pain recurrence). Mean follow-up time was 34.6 months (SD = 24.7, range 3-90). Few complications occurred: two mild reversible peripheral nerve injuries, one brachial plexus neuropathy, one broken electrode tip fragment, and one muscular hematoma. Osteoid osteoma can be effectively and safely treated by CT-guided RFA using the presented ablation protocol. Beneficial effects of the treatment persist at long-term follow-up. (orig.)

  8. Therapeutic outcome of CT-guided radiofrequency ablation in patients with osteoid osteoma

    International Nuclear Information System (INIS)

    Lassalle, Louis; Campagna, R.; Corcos, G.; Feydy, A.; Babinet, A.; Larousserie, F.; Stephanazzi, J.

    2017-01-01

    To assess the long-term outcome of computed tomography-guided radiofrequency ablation (CT-guided RFA) in patients with suspected osteoid osteoma (OO). Single-center retrospective study. Patients with clinical suspicion and imaging diagnosis of osteoid osteoma were treated by CT-guided RFA using the same device with either a 7- or 10-mm active tip electrode. Specific precautions were applied in case of articular or spinal OO. Patients were contacted by phone to evaluate the long-term outcome in terms of pain, ability to perform daily activities (including sports), and long-term complications. Success was defined as the absence of residual pain and ability to perform daily activities normally. From 2008 to 2015, 126 patients were treated by CT-guided RFA for OO in our institution. Mean patient age was 26.1 years (SD = 11, range 1-53); mean delay to diagnosis was 16.9 months (SD = 15.2, range 1-120). Among patients who answered the follow-up call (n = 88), the overall success rate was 94.3%: 79/88 (89.8%) had primary success of the procedure, and 4/88 (4.5%) had a secondary success (repeat-RFA after pain recurrence). Mean follow-up time was 34.6 months (SD = 24.7, range 3-90). Few complications occurred: two mild reversible peripheral nerve injuries, one brachial plexus neuropathy, one broken electrode tip fragment, and one muscular hematoma. Osteoid osteoma can be effectively and safely treated by CT-guided RFA using the presented ablation protocol. Beneficial effects of the treatment persist at long-term follow-up. (orig.)

  9. Therapeutic outcome of CT-guided radiofrequency ablation in patients with osteoid osteoma.

    Science.gov (United States)

    Lassalle, Louis; Campagna, R; Corcos, G; Babinet, A; Larousserie, F; Stephanazzi, J; Feydy, A

    2017-07-01

    To assess the long-term outcome of computed tomography-guided radiofrequency ablation (CT-guided RFA) in patients with suspected osteoid osteoma (OO). Single-center retrospective study. Patients with clinical suspicion and imaging diagnosis of osteoid osteoma were treated by CT-guided RFA using the same device with either a 7- or 10-mm active tip electrode. Specific precautions were applied in case of articular or spinal OO. Patients were contacted by phone to evaluate the long-term outcome in terms of pain, ability to perform daily activities (including sports), and long-term complications. Success was defined as the absence of residual pain and ability to perform daily activities normally. From 2008 to 2015, 126 patients were treated by CT-guided RFA for OO in our institution. Mean patient age was 26.1 years (SD = 11, range 1-53); mean delay to diagnosis was 16.9 months (SD = 15.2, range 1-120). Among patients who answered the follow-up call (n = 88), the overall success rate was 94.3%: 79/88 (89.8%) had primary success of the procedure, and 4/88 (4.5%) had a secondary success (repeat-RFA after pain recurrence). Mean follow-up time was 34.6 months (SD = 24.7, range 3-90). Few complications occurred: two mild reversible peripheral nerve injuries, one brachial plexus neuropathy, one broken electrode tip fragment, and one muscular hematoma. Osteoid osteoma can be effectively and safely treated by CT-guided RFA using the presented ablation protocol. Beneficial effects of the treatment persist at long-term follow-up.

  10. Percutaneous intervention in obstructive

    International Nuclear Information System (INIS)

    Souftas, V.

    2012-01-01

    , performed by the urologist. Before performing a lithotripsy, percutaneous access of the renal collecting system is necessary. Percutaneous ureteral lithotripsy is indicated for management of large renal stones. The kidneys are accessed either using ultrasound, if there is a dilated collecting system, or fluoroscopy, if there is a radiopaque stone. The most ideal access is a calyx that bears the stone. Once access is obtained an angled glide wire is used to cross the obstructing stone and gain access to the ureter. Two wires can then be advanced to the bladder to provide a 'working wire' and a 'safety wire'. Success of lithotripsy is 98-99% for targeted renal stones and 88-89% for ureteral stones. If using only fluoroscopy, a sheathed needle may be used to access the bladder under fluoroscopy. Once urine is aspirated through the sheathed needle, a 3Jwire is inserted into the bladder under fluoroscopy. Using an angled guiding catheter, the 3J-wire is exchanged for an Amplatz and serial dilatation of the tract is performed over the Amplatz. Finally, an 8-F to 12-F suprapubic Foley catheter is inserted over the Amplatz wire into the bladder. Success rate for suprapubic tube insertion has been reported to approach 100% and is comparable to surgical insertion. Complications include bleeding, infection, and bladder or bowel perforation. Perinephric/retroperitoneal urinomas/abscesses drainages are usually due to ureteral obstruction/ trauma from calculi and rupture of the collecting system or to iatrogenic trauma. Most often they are performed under CT guidance, with success rates 100% and very low complication rates. Pigtail drainage catheters 8-F (up to 14-F for abscesses) are used. Sometimes these procedures have to be combined with percutaneous nephrostomy and percutaneous or antegrade ureteral stent placement.

  11. Eventos adversos e motivos de descarte relacionados ao reuso de produtos médicos hospitalares em angioplastia coronária Adverse events and reasons for discard related to the reuse of cardiac catheters in percutaneous transluminal coronary angioplasty

    Directory of Open Access Journals (Sweden)

    Margarete Ártico Batista

    2006-09-01

    Full Text Available OBJETIVO: Descrever os eventos adversos ocorridos durante e após angioplastia coronária (ATC, possivelmente relacionados ao reuso de produtos médico-hospitalares, além de quantificar e identificar os motivos de descarte em relação ao primeiro uso e ao reuso. MÉTODO: Foram estudados 60 pacientes, sendo que 29 (48,3% apresentavam angina instável, 27 (45% IAM e quatro (6,7% outros diagnósticos. Durante o procedimento e na permanência na Unidade Intensiva Coronariana, atentou-se à possibilidade de ocorrência dos eventos adversos febre, hipertensão, hipotensão, calafrios, sudorese, sangramento, náuseas e vômitos. Foram avaliados sete produtos médico-hospitalares: introdutor, cateter-guia, fio-guia 0.35, fio-guia 0.014, cateter- balão para angioplastia, seringa com manômetro para insuflar balão (indeflator e torneira de três vias (manifold. No total de produtos (76 de primeiro uso e 410 reprocessados, verificou-se se houve descarte e se isto ocorreu antes ou durante o procedimento e quais os motivos para tanto. Utilizou-se o teste Qui Quadrado, admitindo-se erro alfa de 5%. RESULTADOS: Vinte e seis pacientes apresentaram eventos adversos. A hipotensão foi o evento mais prevalente e ocorreu em 11(18,3% casos. Não houve, porém, significância estatística entre o evento adverso hipotensão e reuso ou não dos produtos médico-hospitalares. Por não estarem íntegros, foram descartados três produtos de primeiro uso e 55 produtos dos reutilizados. CONCLUSÃO: Os eventos adversos apresentados pelos pacientes submetidos à angioplastia não estão associados ao reuso dos produtos médico-hospitalares. A integridade e funcionalidade foram os motivos principais de descarte.OBJECTIVE: To describe the adverse effects that occur during and after percutaneous transluminal coronary angioplasty (PTCA possibly related to the reuse of medical equipment. An additional objective is to quantify and identify the reasons of discard in respect to

  12. Complication rates of CT-guided transthoracic lung biopsy: meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Heerink, W.J.; Vliegenthart, R. [University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, University of Groningen, Groningen (Netherlands); University Medical Center Groningen, Department of Radiology, University of Groningen, Groningen (Netherlands); Bock, G.H. de [University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, University of Groningen, Groningen (Netherlands); University Medical Center Groningen, Department of Epidemiology, University of Groningen, Groningen (Netherlands); Jonge, G.J. de [University Medical Center Groningen, Department of Radiology, University of Groningen, Groningen (Netherlands); Groen, H.J.M. [University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, University of Groningen, Groningen (Netherlands); University Medical Center Groningen, Department of Pulmonary Medicine, University of Groningen, Groningen (Netherlands); Oudkerk, M. [University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, University of Groningen, Groningen (Netherlands)

    2017-01-15

    To meta-analyze complication rate in computed tomography (CT)-guided transthoracic lung biopsy and associated risk factors. Four databases were searched from 1/2000 to 8/2015 for studies reporting complications in CT-guided lung biopsy. Overall and major complication rates were pooled and compared between core biopsy and fine needle aspiration (FNA) using the random-effects model. Risk factors for complications in core biopsy and FNA were identified in meta-regression analysis. For core biopsy, 32 articles (8,133 procedures) were included and for FNA, 17 (4,620 procedures). Pooled overall complication rates for core biopsy and FNA were 38.8 % (95 % CI: 34.3-43.5 %) and 24.0 % (95 % CI: 18.2-30.8 %), respectively. Major complication rates were 5.7 % (95 % CI: 4.4-7.4 %) and 4.4 % (95 % CI: 2.7-7.0 %), respectively. Overall complication rate was higher for core biopsy compared to FNA (p < 0.001). For FNA, larger needle diameter was a risk factor for overall complications, and increased traversed lung parenchyma and smaller lesion size were risk factors for major complications. For core biopsy, no significant risk factors were identified. In CT-guided lung biopsy, minor complications were common and occurred more often in core biopsy than FNA. Major complication rate was low. For FNA, smaller nodule diameter, larger needle diameter and increased traversed lung parenchyma were risk factors for complications. (orig.)

  13. Use of Low-Fidelity Simulation Laboratory Training for Teaching Radiology Residents CT-Guided Procedures.

    Science.gov (United States)

    Picard, Melissa; Nelson, Rachel; Roebel, John; Collins, Heather; Anderson, M Bret

    2016-11-01

    To determine the benefit of the addition of low-fidelity simulation-based training to the standard didactic-based training in teaching radiology residents common CT-guided procedures. This was a prospective study involving 24 radiology residents across all years in a university program. All residents underwent standard didactic lecture followed by low-fidelity simulation-based training on three common CT-guided procedures: random liver biopsy, lung nodule biopsy, and drain placement. Baseline knowledge, confidence, and performance assessments were obtained after the didactic session and before the simulation training session. Approximately 2 months later, all residents participated in a simulation-based training session covering all three of these procedures. Knowledge, confidence, and performance data were obtained afterward. These assessments covered topics related to preprocedure workup, intraprocedure steps, and postprocedure management. Knowledge data were collected based on a 15-question assessment. Confidence data were obtained based on a 5-point Likert-like scale. Performance data were obtained based on successful completion of predefined critical steps. There was significant improvement in knowledge (P = .005), confidence (P simulation-based training to the standard didactic curriculum for all procedures. This study suggests that the addition of low-fidelity simulation-based training to a standard didactic-based curriculum is beneficial in improving resident knowledge, confidence, and tested performance of common CT-guided procedures. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  14. Dynamic telecytologic evaluation of imprint cytology samples from CT-guided lung biopsies: A feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Prosch, Helmut [Otto Wagner Hospital, Department of Radiology, Vienna (Austria); Medical University of Vienna, Department of Radiology, Vienna (Austria); Medical University of Vienna, Vienna General Hospital, Department of Radiology, Vienna (Austria); Hoffmann, Elisabeth; Schober, Ewald; Mostbeck, Gerhard [Otto Wagner Hospital, Department of Radiology, Vienna (Austria); Bernhardt, Klaus; Schalleschak, Johann [Otto Wagner Hospital, Department of Laboratory Medicine, Vienna (Austria); Rowhani, Marcel [Otto Wagner Hospital, Department of Respiratory and Critical Care Medicine, Vienna (Austria); Weber, Michael [Medical University of Vienna, Department of Radiology, Vienna (Austria)

    2011-09-15

    This study assessed the feasibility of telecytological evaluation of samples from CT-guided lung biopsies using a dynamic telecytological system in which the microscope was operated by personnel from the radiology department at the site of the biopsy and a cytologist off-site diagnosed the biopsy sample. 45 imprint samples from CT-guided biopsies of lung lesions were reviewed by two cytologists using a telecytological microscope (Olympus BX51, Tokyo, Japan). The telecytological microscope was operated by one radiologist and one radiology technician. The cytological samples were classified by a cytologist into four categories: benign, malignant, atypical cells of undetermined significance, and non-diagnostic. The results were compared with those of a previous consensus reading of two independent cytologists (gold standard). When the radiologist was operating the microscope, the diagnostic accuracy was 100% as both cytologists came to the correct diagnosis in all samples. When the technician operated the microscope, two diagnoses of cyotologist 1 differed from the gold standard. Thus, the accuracy for the technician was 95.56%. Telecytological evaluation of imprint samples from CT-guided lung biopsies is feasible because it can be performed with high diagnostic accuracy if personnel from the radiology department operate the microscope. (orig.)

  15. CT-guided interventions in children; Computertomografisch gesteuerte Interventionen bei Kindern

    Energy Technology Data Exchange (ETDEWEB)

    Honnef, D.; Wildberger, J.E.; Schubert, H.; Hohl, C.; Guenther, R.W.; Mahnken, A. [Technische Hochschule Aachen (Germany). Klinik fuer Radiologische Diagnostik

    2007-06-15

    In pediatric CT-guided interventions specific features have to be taken into account. Due to a lack of cooperation or limited ability to cooperate, procedures are often performed using analgosedation or general anesthesia. To provide radiation protection, justified indication for CT-guided intervention is necessary and sonography and MRI are to be preferred whenever possible. CT examinations also need to be dose-adapted with sequential scanning and a tube voltage and tube current reduction compared to pediatric diagnostic CT studies must be ensured. Gonad shields are recommended for male patients. Biopsy device selection depends on the assumed tumor entity since histology and also immunohistochemical, molecular pathological and cytogenetical analysis are necessary to differentiate pediatric tumors (small, round, blue cell tumors). In addition to diagnostic procedures, therapeutic interventions (drainage, injection therapies, neurolysis, and radiofrequency ablation) can also be used in children and can provide an alternative to surgery in selected cases. With justified indications and precise performance, CT-guided interventions can be successful in pediatric patients with limited risks. (orig.)

  16. CT-guided biopsy: diagnostic relevance, therapeutic consequences and economic aspects

    International Nuclear Information System (INIS)

    Schwarzenberg, H.; Mueller-Huelsbeck, S.; Link, J.; Brossmann, J.; Fahl, M.; Quirin, A.; Heller, M.

    1996-01-01

    Purpose: To evaluate the diagnostic and clinical relevance and therapeutic consequences of CT-guided biopsy with regard to economic aspects. Methods: 213 CT-guided biopsies in 190 were evaluated. All information regarding patient referral, reason for request, body region, underlying diagnosis, and clinical consequences were registered over a period of 22.2±9.4 month. Results: Patient referral to biopsy was mainly from the departments of surgery, internal medicine, and radiotherapy with the question of tumor and metastasis. Less than 5% of biopsies were performed in outpatients. Main regions were the lung (39%), the abdomen (35%), and the skeleton (11%). Biopsy and surgical histology corresponded in 73%. Largest diagnosis groups were benign unspecific tissues or other benign lesions in 24%. As a result of CTP no further procedures necessary in 22.5%. Follow-up studies or conservative treatment were indicated in 11.3%. Surgical procedures were needed in only 15.5%. There was only one complication requiring therapy. Conclusion: CT-guided biopsy is a safe procedure, which helps to avoid unnecessary cost-intensive diagnostics and surgical treatment. If CTP is performed early and in outpatients residence time in the hospital is reduced and thus money is saved. (orig.) [de

  17. CT-guided corticosteroid injection for solitary eosinophilic granuloma of the spine

    Energy Technology Data Exchange (ETDEWEB)

    Rimondi, Eugenio; Rossi, Giuseppe [Istituto Ortopedico Rizzoli, University of Bologna, Department of Radiology and Interventional Angiographic Radiology, Bologna (Italy); Mavrogenis, Andreas F. [Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopedics, Bologna (Italy); Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopaedics, Orthopaedic Oncology Service, Bologna (Italy); Ussia, Giuseppe; Angelini, Andrea [Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopedics, Bologna (Italy); Ruggieri, Pietro [Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopedics, Bologna (Italy); Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopaedics, Bologna (Italy)

    2011-06-15

    To evaluate the clinical and imaging outcome of patients with symptomatic eosinophilic granuloma of the spine treated with CT-guided intralesional methylprednisolone injection after biopsy. Patients (n =19) with symptomatic solitary eosinophilic granuloma of the spine treated by CT-guided intralesional methylprednisolone injection were retrospectively studied. There were 12 males and seven females with a mean age of 17 years (range, 3-43 years). The mean follow-up was 6 years (median, 4 years; range, 0.5-19 years). Spinal location included the cervical (two patients), thoracic (seven patients), lumbar spine (eight patients), and the sacrum (two patients). Vertebra plana was observed in two patients. All patients had biopsies before treatment. Complete resolution of pain and healing of the lesion was observed in 17 patients (89.5%); none of these patients had recurrence at the latest examination. Reconstitution of the T1 and L1 vertebra plana was observed in both patients. Two patients initially diagnosed and treated for a solitary eosinophilic granuloma had constant pain after the procedure; in these patients, 6 and 12 months after the procedure, respectively, imaging showed multifocal disease and systemic therapy was administered. Complications related to the procedure were not observed. General anesthesia was administered in two patients because of intolerable pain during the procedure. In view of the benign clinical course of eosinophilic granuloma, in patients with symptomatic lesions, CT-guided intralesional corticosteroid injection is a safe and effective outpatient treatment with a low complication rate. (orig.)

  18. CT-guided periradicular therapy in cervical and lumbar radicular syndromes

    International Nuclear Information System (INIS)

    Nian Dingfang; Zhou Jun; Li Wenhua; Cao Qingxuan; Xia Baosu; Apitzsch, D.E.

    2007-01-01

    Objective: To evaluate the effectiveness of CT-guided periradicular therapy (PRT) in cervical and lumber radicular syndromes. Methods: Seventy two cases of cervical and lumbar radicular syndromes were treated by CT-guided PRT. During PRT, 10-20 mg of Triamhexal and 3-4 ml of Carbostesin 0.25%(Bupivacainhydrochlorid) were injected into the space around the corresponding spinal root, once a week, all together six times as a course. Results: Four hundreds and forty six PRT procedures were carried out in 72 patients having a successful puncture and a satisfying spread of Triamhexal and Carbostesin around the spinal nerve root space for every time. After 6 to 24 months follow up, 62 patients showed a significant pain reduction or complete disappearance. Moderate improvement was not noted in 6 and no improvement in 4. The effective rate was 94.4% without any correlative complication. Conclusions: CT-guided PRT is an effective, easy and safe procedure to treat patients with refractory cervical or lumbar radicular pain syndromes. (authors)

  19. CT-guided cervical interlaminar epidural steroid injection for cervical radiculopathy

    International Nuclear Information System (INIS)

    Chen Wei; Wu Chungen; Wu Chaoxian; Cheng Yongde

    2009-01-01

    Objective: To evaluate the safety and effectiveness of CT-guided cervical interlaminar epidural steroid injection for the treatment of cervical radiculopathy. Methods: CT-guided cervical interlaminar epidural steroid injection was performed in 32 patients with cervical radioculopathy, encountered during the period of Dec. 2006 to June 2008, as the patients failed to respond to the conservative treatment in 2 weeks. The clinical data and the imaging findings were retrospectively analyzed. Before and after the procedure, visual analogue scale (VAS) and Odom criteria were used to evaluate the pain of the patient. Results: Three months after the injection, improvement judged by Odom criteria was seen in 28 patients (87.5%), and the mean pain relief value of VAS was 5.88 ± 1.10. No significant difference in effective rate and in VAS score (P>0.05) was found between protrusion group and degenerative group, between the group with the course over 6 months and the group with the course below 6 months, also between the group receiving one injection and the group receiving the second injection. Conclusion: CT-guided fine needle (23 gauge) puncture epidural steroid (Decadron) 'target spot' injection is an ideal alternative for the treatment of cervical radiculopathy, especially for the patients who fails to respond to the conservative treatment. (authors)

  20. Catheter Angiography

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Catheter Angiography Catheter angiography ...

  1. Catheter Angiography

    Medline Plus

    Full Text Available ... is injected through the catheter and reaches the blood vessels being studied, several sets of x-rays are taken. Then the catheter is removed and the incision site is closed by applying pressure on the area for approximately 10 to 20 ...

  2. Safe percutaneous suprapubic catheterisation.

    Science.gov (United States)

    Goyal, N K; Goel, A; Sankhwar, S N

    2012-11-01

    We describe our technique of percutaneous suprapubic catheter insertion with special reference to steps that help to avoid common complications of haematuria and catheter misplacement. The procedure is performed using a stainless steel reusable trocar under local infiltrative anaesthesia, usually at the bedside. After clinical confirmation of a full bladder, the trocar is advanced into the bladder through a skin incision. Once the bladder is entered, the obturator is removed and the assistant inserts a Foley catheter followed by rapid balloon inflation. Slight traction is applied to the catheter for about five minutes. Patients with previous lower abdominal surgery, an inadequately distended bladder or acute pelvic trauma do not undergo suprapubic catheterisation using this method. The procedure was performed in 72 men (mean age: 42.4 years, range: 18-78 years) with urinary retention with a palpable bladder. The average duration of the procedure was less than five minutes. No complications were noted in any of the patients. Trocar suprapubic catheter insertion is a safe and effective bedside procedure for emergency bladder drainage and can be performed by resident surgeons. The common complications associated with the procedure can be avoided with a few careful steps.

  3. Urinary catheter - infants

    Science.gov (United States)

    Bladder catheter - infants; Foley catheter - infants; Urinary catheter - neonatal ... A urinary catheter is a small, soft tube placed in the bladder. This article addresses urinary catheters in babies. WHY IS ...

  4. Technique of Peritoneal Catheter Placement under Fluoroscopic Guidance

    International Nuclear Information System (INIS)

    Abdel-Aal, A.K.; Gaddikeri, S.; Saddekni, S.

    2011-01-01

    Peritoneal catheters are mainly used for peritoneal dialysis in patients with end-stage renal disease. Other uses of this catheter include intraperitoneal chemotherapy and gene therapy for ovarian cancer and draining of uncontrolled refractory ascites in patients with liver cirrhosis. Traditionally, surgeons place most of these peritoneal catheters either by laparoscopy or open laparotomy. We detail our percutaneous approach to placing peritoneal catheters using fluoroscopic guidance. We emphasize the use of additional ultrasound guidance, including gray scale and color Doppler ultrasound, to determine the safest puncture site and to guide the initial needle puncture in order to avoid bowel perforation and injury to epigastric artery. We present our experience in placing peritoneal catheters using this technique in 95 patients with various indications. Fluoroscopic guided percutaneous placement of peritoneal catheters is a safe, minimally invasive, and effective alternative to open surgical or laparoscopic placement.

  5. Radiologically-guided catheter drainage of intrathoracic abscesses and empyemas

    International Nuclear Information System (INIS)

    Berger, H.; Steiner, W.; Bergman, C.; Anthuber, M.; Dienemann, H.

    1993-01-01

    Radiologically guided percutaneous catheter drainage was used in 38 patients to treat pleural empyemas (35 patients) and pulmonary abscesses (3 patients). Drainage was successful in 85.7% of empyemas including 11 cases with fistulous communications. Three percutaneously drained pulmonary abscesses required subsequent lobectomy. One patient died during the drainage procedure due to sepsis. No major complications related to the drainage procedure were observed. Guided percutaneous drainage proved to be a safe and successful alternative to closed drainage of pleural fluid collections. (orig.)

  6. Performance of intra-procedural 18-fluorodeoxyglucose PET/CT-guided biopsies for lesions suspected of malignancy but poorly visualized with other modalities

    International Nuclear Information System (INIS)

    Cornelis, F.; Silk, M.; Takaki, H.; Durack, J.C.; Erinjeri, J.P.; Sofocleous, C.T.; Siegelbaum, R.H.; Maybody, M.; Solomon, S.B.; Schoder, H.

    2014-01-01

    We sought to evaluate the safety and the diagnostic success rate of percutaneous biopsies performed under intra-procedural 18 F-deoxyglucose (FDG) positron-emission tomography/computed tomography (PET/CT) guidance for lesions difficult to see with conventional cross-sectional imaging. From 2011 to 2013, consecutive clinically indicated percutaneous PET/CT-guided biopsies of 106 masses (mean size, 3.3 cm; range, 0.7-15.9 cm; SD, 2.9 cm) in bones (n = 33), liver (n = 26), soft tissues (n = 18), lung (n = 15) and abdomen (n = 14) were reviewed. The biopsy procedures were performed following injection of a mean of 255 MBq (SD, 74) FDG. Mean maximal standardized uptake value (SUV) of lesions was 8.8 (SD, 6.3). A systematic review of the histopathological results and outcomes was performed. Biopsies were positive for malignancy in 76 cases (71.7 %, 76/106) and for benign tissue in 30 cases (28.3 %, 30/106). Immediate results were considered adequate for 100 PET/CT biopsies (94.3 %, 100/106) requiring no further exploration, and for the six others (5.7 %, 6/106) benign diagnoses were confirmed after surgery (n = 4) or follow-up (n = 2). The consequent overall sensitivity and the diagnostic success of biopsy were therefore 100 %. No significant differences in terms of detection of malignancy were observed between the different locations. Lesions > 2 cm or with SUV > 4 were not significantly more likely to be malignant. Complications occurred after four biopsies (3.7 %, 4/106). Intra-procedural PET/CT guidance appears as a safe and effective method and allows high diagnostic success of percutaneous biopsies for metabolically active lesions. (orig.)

  7. Percutaneous debridement and washout of walled-off abdominal abscess and necrosis using flexible endoscopy: a large single-center experience.

    Science.gov (United States)

    Mathers, Bradley; Moyer, Matthew; Mathew, Abraham; Dye, Charles; Levenick, John; Gusani, Niraj; Dougherty-Hamod, Brandy; McGarrity, Thomas

    2016-01-01

    Direct percutaneous endoscopic necrosectomy has been described as a minimally invasive intervention for the debridement of walled-off pancreatic necrosis (WOPN). In this retrospective cohort study, we aimed to confirm these findings in a US referral center and evaluate the clinical value of this modality in the treatment of pancreatic necrosis as well as other types of intra-abdominal fluid collections and necrosis. Twelve consecutive patients with WOPN or other abdominal abscess requiring debridement and washout underwent computed tomography (CT)-guided drainage catheter placement. Each patient then underwent direct percutaneous endoscopic necrosectomy and washout with repeat debridement performed until complete. Drains were then removed once output fell below 30 mL/day and imaging confirmed resolution. The primary endpoints were time to clinical resolution and sustained resolution at 1-year follow up.  Ten patients were treated for WOPN, one for necrotic hepatic abscesses, and one for omental necrosis. The median time to intervention was 85 days with an average of 2.3 necrosectomies performed. Complete removal of drains was accomplished in 11 patients (92 %). The median time to resolution was 57 days. No serious adverse events occurred; however, one patient developed pancreaticocutaneous fistulas. Ten patients completed 1-year surveillance of which none required drain replacement. No patients required surgery or repeat endoscopy. This series supports the premise that direct percutaneous endoscopic necrosectomy is a safe and effective intervention for intra-abdominal fluid collections and necrosis in appropriately selected patients. Our study demonstrates a high clinical success rate with minimal adverse events. This modality offers several potential advantages over surgical and transgastric approaches including use of improved accessibility, an excellent safety profile, and requirement for only deep or moderate sedation.

  8. Activity-based cost analysis of hepatic tumor ablation using CT-guided high-dose rate brachytherapy or CT-guided radiofrequency ablation in hepatocellular carcinoma.

    Science.gov (United States)

    Schnapauff, D; Collettini, F; Steffen, I; Wieners, G; Hamm, B; Gebauer, B; Maurer, M H

    2016-02-25

    To analyse and compare the costs of hepatic tumor ablation with computed tomography (CT)-guided high-dose rate brachytherapy (CT-HDRBT) and CT-guided radiofrequency ablation (CT-RFA) as two alternative minimally invasive treatment options of hepatocellular carcinoma (HCC). An activity based process model was created determining working steps and required staff of CT-RFA and CT-HDRBT. Prorated costs of equipment use (purchase, depreciation, and maintenance), costs of staff, and expenditure for disposables were identified in a sample of 20 patients (10 treated by CT-RFA and 10 by CT-HDRBT) and compared. A sensitivity and break even analysis was performed to analyse the dependence of costs on the number of patients treated annually with both methods. Costs of CT-RFA were nearly stable with mean overall costs of approximately 1909 €, 1847 €, 1816 € and 1801 € per patient when treating 25, 50, 100 or 200 patients annually, as the main factor influencing the costs of this procedure was the single-use RFA probe. Mean costs of CT-HDRBT decreased significantly per patient ablation with a rising number of patients treated annually, with prorated costs of 3442 €, 1962 €, 1222 € and 852 € when treating 25, 50, 100 or 200 patients, due to low costs of single-use disposables compared to high annual fix-costs which proportionally decreased per patient with a higher number of patients treated annually. A break-even between both methods was reached when treating at least 55 patients annually. Although CT-HDRBT is a more complex procedure with more staff involved, it can be performed at lower costs per patient from the perspective of the medical provider when treating more than 55 patients compared to CT-RFA, mainly due to lower costs for disposables and a decreasing percentage of fixed costs with an increasing number of treatments.

  9. Computed tomography-guided percutaneous trephine removal of the nidus in osteoid osteoma patients: experience of a single center in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Petrilli, Marcelo; Senerchia, Andreza Almeida; Petrilli, Antonio Sergio; Lederman, Henrique Manoel; Garcia Filho, Reynaldo Jesus, E-mail: andrezasenerchia@hotmail.com [Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, SP (Brazil). Instituto de Oncologia Pediatrica

    2015-07-15

    Objective: to report the results of computed tomography (CT)-guided percutaneous resection of the nidus in 18 cases of osteoid osteoma. Materials and methods: the medical records of 18 cases of osteoid osteoma in children, adolescents and young adults, who underwent CT-guided removal of the nidus between November, 2004 and March, 2009 were reviewed retrospectively for demographic data, lesion site, clinical outcome and complications after procedure. Results: clinical follow-up was available for all cases at a median of 29 months (range 6-60 months). No persistence of pre-procedural pain was noted on 17 patients. Only one patient experienced recurrence of symptoms 12 months after percutaneous resection, and was successfully retreated by the same technique, resulting in a secondary success rate of 18/18 (100%). Conclusion: CT-guided removal or destruction of the nidus is a safe and effective alternative to surgical resection of the osteoid osteoma nidus. (author)

  10. Septic Thrombophlebitis of the Cephalic Vein Caused by a Peripherally Inserted Venous Catheter

    Directory of Open Access Journals (Sweden)

    M Mirmohammadsadeghi

    2005-07-01

    Full Text Available Septic thrombophlebitis of a vein is a rare but life-threatening complication of an intravascular (IV catheter placed percutaneously in the veins. Most published clinical experiences with IV catheters, mainly in the outpatient settings, have reported very low rates of catheter-related bloodstream infection compared to rates with central venous catheters placed in a subclavian or internal jugular vein. Most of the complications reported with IV catheters have been non-infectious, particularly sterile phlebitis or thrombosis. We report a case of cephalic vein suppurative thrombophlebitis from an intravascular catheter and offer guidelines for diagnosis and management of this complication. Key words: Septic thrombophlebitis, Intravascular catheter, Suppurative thrombophlebitis

  11. Image guided percutaneous splenic interventions

    International Nuclear Information System (INIS)

    Kang, Mandeep; Kalra, Naveen; Gulati, Madhu; Lal, Anupam; Kochhar, Rohit; Rajwanshi, Arvind

    2007-01-01

    Aim: The objective of this study is to evaluate the efficacy and safety of image-guided percutaneous splenic interventions as diagnostic or therapeutic procedures. Materials and methods: We performed a retrospective review of our interventional records from July 2001 to June 2006. Ninety-five image-guided percutaneous splenic interventions were performed after informed consent in 89 patients: 64 men and 25 women who ranged in age from 5 months to 71 years (mean, 38.4 years) under ultrasound (n = 93) or CT (n = 2) guidance. The procedures performed were fine needle aspiration biopsy of focal splenic lesions (n = 78) and aspiration (n = 10) or percutaneous catheter drainage of a splenic abscess (n = 7). Results: Splenic fine needle aspiration biopsy was successful in 62 (83.78%) of 74 patients with benign lesions diagnosed in 43 (58.1%) and malignancy in 19 (25.67%) patients. The most common pathologies included tuberculosis (26 patients, 35.13%) and lymphoma (14 patients, 18.91%). Therapeutic aspiration or pigtail catheter drainage was successful in all (100%) patients. There were no major complications. Conclusions: Image-guided splenic fine needle aspiration biopsy is a safe and accurate technique that can provide a definitive diagnosis in most patients with focal lesions in the spleen. This study also suggests that image-guided percutaneous aspiration or catheter drainage of splenic abscesses is a safe and effective alternative to surgery

  12. Catheter Angiography

    Medline Plus

    Full Text Available ... the American College of Radiology (ACR) and the European Society of Urogenital Radiology note that the available ... will regain their normal function within five to seven days. Rarely, the catheter punctures the artery, causing ...

  13. Catheter Angiography

    Medline Plus

    Full Text Available ... diagnosis and treatment in a single procedure. An example is finding an area of severe arterial narrowing, ... contrast material, your radiologist may advise that you take special medication for 24 hours before catheter angiography ...

  14. Catheter Angiography

    Medline Plus

    Full Text Available ... possible to combine diagnosis and treatment in a single procedure. Catheter angiography produces very detailed, clear and ... possible to combine diagnosis and treatment in a single procedure. An example is finding an area of ...

  15. Catheter Angiography

    Medline Plus

    Full Text Available ... you are pregnant and discuss any recent illnesses, medical conditions, medications you're taking and allergies, especially ... is Catheter Angiography? Angiography is a minimally invasive medical test that helps physicians diagnose and treat medical ...

  16. Catheter Angiography

    Medline Plus

    Full Text Available ... spaghetti. top of page How does the procedure work? Catheter angiography works much the same as a ... angiogram may be performed in less than an hour; however, it may last several hours. top of ...

  17. Catheter Angiography

    Medline Plus

    Full Text Available ... a catheter, x-ray imaging guidance and an injection of contrast material to examine blood vessels in ... technologies and, in most cases, a contrast material injection is needed to produce pictures of blood vessels ...

  18. Catheter Angiography

    Medline Plus

    Full Text Available ... far outweighs the risk. If you have a history of allergy to x-ray contrast material, your ... Angiography (CTA) X-ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to Catheter Angiography Sponsored ...

  19. Catheter Angiography

    Medline Plus

    Full Text Available ... spaghetti. top of page How does the procedure work? Catheter angiography works much the same as a ... and x-rays. Manufacturers of intravenous contrast indicate mothers should not breastfeed their babies for 24-48 ...

  20. Catheter Angiography

    Medline Plus

    Full Text Available ... atherosclerosis (plaque). The use of a catheter makes it possible to combine diagnosis and treatment in a ... the aorta in the chest or abdomen or its major branches. show the extent and severity of ...

  1. Catheter Angiography

    Medline Plus

    Full Text Available ... story about radiology? Share your patient story here Images × Image Gallery Interventional radiologist performing an angiography exam View ... ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to Catheter Angiography Sponsored by Please note ...

  2. Catheter Angiography

    Medline Plus

    Full Text Available ... examine blood vessels in key areas of the body for abnormalities such as aneurysms and disease such ... to produce pictures of blood vessels in the body. Angiography is performed using: x-rays with catheters ...

  3. Catheter Angiography

    Medline Plus

    Full Text Available ... 20 minutes (or by using a special closure device). When the examination is complete, you may be ... contrast material, your radiologist may advise that you take special medication for 24 hours before catheter angiography ...

  4. Catheter Angiography

    Medline Plus

    Full Text Available ... rays ). top of page What are some common uses of the procedure? Catheter angiography is used to ... community, you can search the ACR-accredited facilities database . This website does not provide cost information. The ...

  5. Catheter Angiography

    Medline Plus

    Full Text Available ... spaghetti. top of page How does the procedure work? Catheter angiography works much the same as a ... possible to combine diagnosis and treatment in a single procedure. An example is finding an area of ...

  6. Catheter Angiography

    Medline Plus

    Full Text Available ... Once the catheter is guided to the area being examined, a contrast material is injected through the ... You should inform your physician of any medications being taken and if there are any allergies, especially ...

  7. Catheter Angiography

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Catheter Angiography ...

  8. Rapid needle-out patient-rollover approach after cone beam CT-guided lung biopsy: effect on pneumothorax rate in 1,191 consecutive patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Im [Seoul National University College of Medicine, Department of Radiology, Jongno-gu, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Park, Chang Min; Goo, Jin Mo [Seoul National University College of Medicine, Department of Radiology, Jongno-gu, Seoul (Korea, Republic of); Seoul National University, Cancer Research Institute, Seoul (Korea, Republic of); Lee, Sang Min [Seoul National University College of Medicine, Department of Radiology, Jongno-gu, Seoul (Korea, Republic of)

    2015-07-15

    To investigate the effect of rapid needle-out patient-rollover approach on the incidence of pneumothorax and drainage catheter placement due to pneumothorax in C-arm Cone-beam CT (CBCT)-guided percutaneous transthoracic needle biopsy (PTNB) of lung lesions. From May 2011 to December 2012, 1227 PTNBs were performed in 1191 patients with a 17-gauge coaxial needle. 617 biopsies were performed without (conventional-group) and 610 with rapid-rollover approach (rapid-rollover-group). Overall pneumothorax rates and incidences of pneumothorax requiring drainage catheter placement were compared between two groups. There were no significant differences in overall pneumothorax rates between conventional and rapid-rollover groups (19.8 % vs. 23.1 %, p = 0.164). However, pneumothorax rate requiring drainage catheter placement was significantly lower in rapid-rollover-group (1.6 %) than conventional-group (4.2 %) (p = 0.010). Multivariate analysis revealed male, age > 60, bulla crossed, fissure crossed, pleura to target distance > 1.3 cm, emphysema along needle tract, and pleural punctures ≥ 2 were significant risk factors of pneumothorax (p < 0.05). Regarding pneumothorax requiring drainage catheter placement, fissure crossed, bulla crossed, and emphysema along needle tract were significant risk factors (p < 0.05), whereas rapid-rollover approach was an independent protective factor (p = 0.002). The rapid needle-out patient-rollover approach significantly reduced the rate of pneumothorax requiring drainage catheter placement after CBCT-guided PTNB. (orig.)

  9. Prospective pilot study of CT-guided microwave ablation in the treatment of osteoid osteomas

    International Nuclear Information System (INIS)

    Prud'homme, Clara; Nueffer, Jean-Philippe; Runge, Michel; Dubut, Jonathan; Kastler, Bruno; Aubry, Sebastien

    2017-01-01

    The aims of this work were to assess the feasibility and efficacy of CT-guided microwave ablation (MWA) in the treatment of osteoid osteomas (OOs). Thirteen consecutive patients (range 11-31 years old) presenting with OO were prospectively included and treated by CT-guided MWA. Power and duration of MWA were both recorded. The patient's pain was assessed using a numeric pain rating scale (NRS), and side effects were recorded during procedures, after 1 day, 7 days and 1 month. The nidus vascularization and the volume of necrosis induced by MWA were assessed using contrast-enhanced MRI. Success was defined as the complete relief of the patient's pain 1 month after the first procedure, associated with necrosis of the nidus on follow-up MRI. The success rate was up to 92.3% (12/13). At 1 day, 7 days and 1 month, the median NRSs were respectively 5 [interquartile range (IQR) 2-5], 0 (IQR 0-1) and 0 (IQR 0-0). Side effects observed were one partial and self-resolving lesion of a sensory branch of the radial nerve and two skin burns. The median power of the MWA used was 60 W (IQR 50-60) with a 1.5-min duration (IQR 1-2), leading to MWA-induced necrosis measuring on average 23 x 15 x 16 mm. CT-guided MWA of OO has a success rate that appears to be almost similar to that of laser or radiofrequency ablation, but care must be taken to prevent nerve or skin lesions. (orig.)

  10. CT-guided intratumoral gene therapy in non-small-cell lung cancer

    International Nuclear Information System (INIS)

    Kauczor, H.U.; Heussel, C.P.; Thelen, M.; Schuler, M.; Huber, C.; Weymarn, A. von; Bongartz, G.; Rochlitz, C.

    1999-01-01

    The objective of this study was to prove the principle of CT-guided gene therapy by intratumoral injection of a tumor suppressor gene as an alternative treatment approach of incurable non-small-cell lung cancer. In a prospective clinical phase I trial six patients with non-small-cell lung cancer and a mutation of the tumor suppressor gene p53 were treated by CT-guided intratumoral gene therapy. Ten milliliters of a vector solution (replication-defective adenovirus with complete wild-type p53 cDNA) were injected under CT guidance. In four cases the vector solution was completely applied to the tumor center, whereas in two cases 2 ml aliquots were injected into different tumor areas. For the procedure the scan room had been approved as a biosafety cabinet. Gene transfer was assessed by reverse transcription and polymerase chain reaction in biopsy specimens obtained under CT guidance 24-48 h after therapy. Potential therapeutic efficacy was evaluated on day 28 after treatment using spiral CT. The CT-guided gene therapy was easily performed in all six patients without intervention-related complications. Besides flu-like symptoms, no significant adverse effects of gene therapy were noted. Three of the four patients with central injection exhibited gene transfer in the posttreatment biopsy. Gene transfer could not be proven in the two patients with multiple 2 ml injections. After 28 days, four of the six patients showed stable disease at the treated tumor site, whereas other tumor manifestations progressed. Computed tomography-guided injections are an adequate and easy-to-perform procedure for intratumoral gene therapy. (orig.)

  11. CT-Guided Biopsy of Small Liver Lesions: Visibility, Artifacts, and Corresponding Diagnostic Accuracy

    International Nuclear Information System (INIS)

    Stattaus, Joerg; Kuehl, Hilmar; Ladd, Susanne; Schroeder, Tobias; Antoch, Gerald; Baba, Hideo A.; Barkhausen, Joerg; Forsting, Michael

    2007-01-01

    Purpose. Our study aimed to determine the visibility of small liver lesions during CT-guided biopsy and to assess the influence of lesion visibility on biopsy results. Material and Methods. Fifty patients underwent CT-guided core biopsy of small focal liver lesions (maximum diameter, 3 cm); 38 biopsies were performed using noncontrast CT, and the remaining 12 were contrast-enhanced. Visibility of all lesions was graded on a 4-point-scale (0 = not visible, 1 = poorly visible, 2 = sufficiently visible, 3 = excellently visible) before and during biopsy (with the needle placed adjacent to and within the target lesion). Results. Forty-three biopsies (86%) yielded diagnostic results, and seven biopsies were false-negative. In noncontrast biopsies, the rate of insufficiently visualized lesions (grades 0-1) increased significantly during the procedure, from 10.5% to 44.7%, due to needle artifacts. This resulted in more (17.6%) false-negative biopsy results compared to lesions with good visualization (4.8%), although this difference lacks statistical significance. Visualization impairment appeared more often with an intercostal or subcostal vs. an epigastric access and with a subcapsular vs. a central lesion location, respectively. With contrast-enhanced biopsy the visibility of hepatic lesions was only temporarily improved, with a risk of complete obscuration in the late phase. Conclusion. In conclusion, visibility of small liver lesions diminished significantly during CT-guided biopsy due to needle artifacts, with a fourfold increased rate of insufficiently visualized lesions and of false-negative histological results. Contrast enhancement did not reveal better results

  12. Prospective pilot study of CT-guided microwave ablation in the treatment of osteoid osteomas

    Energy Technology Data Exchange (ETDEWEB)

    Prud' homme, Clara; Nueffer, Jean-Philippe; Runge, Michel; Dubut, Jonathan [University Hospital of Besancon, Department of Musculoskeletal Imaging, Besancon (France); Kastler, Bruno [University Hospital of Besancon, Department of Musculoskeletal Imaging, Besancon (France); I4S Laboratory, INSERM EA4268, University of Franche-Comte, Besancon (France); Aubry, Sebastien [University Hospital of Besancon, Department of Musculoskeletal Imaging, Besancon (France); Nanomedecine Laboratory, INSERM EA4662, University of Franche-Comte, Besancon (France)

    2017-03-15

    The aims of this work were to assess the feasibility and efficacy of CT-guided microwave ablation (MWA) in the treatment of osteoid osteomas (OOs). Thirteen consecutive patients (range 11-31 years old) presenting with OO were prospectively included and treated by CT-guided MWA. Power and duration of MWA were both recorded. The patient's pain was assessed using a numeric pain rating scale (NRS), and side effects were recorded during procedures, after 1 day, 7 days and 1 month. The nidus vascularization and the volume of necrosis induced by MWA were assessed using contrast-enhanced MRI. Success was defined as the complete relief of the patient's pain 1 month after the first procedure, associated with necrosis of the nidus on follow-up MRI. The success rate was up to 92.3% (12/13). At 1 day, 7 days and 1 month, the median NRSs were respectively 5 [interquartile range (IQR) 2-5], 0 (IQR 0-1) and 0 (IQR 0-0). Side effects observed were one partial and self-resolving lesion of a sensory branch of the radial nerve and two skin burns. The median power of the MWA used was 60 W (IQR 50-60) with a 1.5-min duration (IQR 1-2), leading to MWA-induced necrosis measuring on average 23 x 15 x 16 mm. CT-guided MWA of OO has a success rate that appears to be almost similar to that of laser or radiofrequency ablation, but care must be taken to prevent nerve or skin lesions. (orig.)

  13. The factor analysis of the incidence of pneumothorax after CT-guided transthoracic needle aspiration biopsy

    International Nuclear Information System (INIS)

    Zhong Tao; Yu Hongguang; Wang Yong; Yang Sifu; Wang Xiaoxuan

    2007-01-01

    Objective: To analyze the impact of multiple factors on the incidence of pneumothorax associated with CT-guided transthoracic needle aspiration biopsy. Methods: The sign of pneumothorax after 162 cases (lesion diameter from 1 cm to 6 cm) CT-guided transthoracic needle aspiration biopsy was observed and its relationship with multivariate factors were analyzed by multivariate logistic regression model. Results: Thirty-two cases presented pneumothorax accounting for 19. 8%. Single variate analysis showed that the sign of pneumothorax related to intercurrent COPD, distance from lesion and chest wall, needle dwelling time and lesion diameter. 67 patients of intercurrent COPD with postoperative pneumothorax occurred in 22 cases (32.8%); With respect to those having lesions close to the chest wall (48 cases), and the cases with the distance between the chest wall and lesions less than 2 cm (55 cases) and greater than 2 cm (59 cases), the postoperative pneumothorax occurred in 0, 14 (25.5%), 18 (30.5%) cases respectively; For those patients with needle in the chest residence time of less than 10 minutes (82 cases), 10-20 minutes (51 cases), more than 20 minutes (28 cases) after the occurrence of pneumothorax were 8 (9.6%), 10(19.6%), 14 (50%) cases respectively; In contrast, those with lesion diameter less than 2 cm (65 cases), 2-4 cm(52 cases), more than 4cm(45 cases) were 19 (29.2%), 8 (15.4%) and 5 (11.1% ) respectively. The multivariate logistic regression analysis showed that the prior three factor's were risk factors of pneumothorax (OR=4.652, 4.030, 2.855 respectively). Conclusions: To avoid the pneumothorax, caution must be taken with respect to CT-guided transthoracic needle aspiration biopsy, patients with intercurrent COPD, long distance between lesion and chest wall, and smaller lesion diameter. For operation the needle dwell time within thorax should be minimized. (authors)

  14. Variables affecting the risk of pneumothorax and intrapulmonal hemorrhage in CT-guided transthoracic biopsy

    International Nuclear Information System (INIS)

    Khan, M.F.; Straub, R.; Moghaddam, S.R.; Maataoui, A.; Gurung, J.; Thalhammer, A.; Vogl, T.J.; Jacobi, V.; Wagner, T.O.F.; Ackermann, H.

    2008-01-01

    The influence of various variables on the rate of pneumothorax and intrapulmonal hemorrhage associated with computed tomography (CT)-guided transthoracic needle biopsy of the lung were evaluated retrospectivly. One hundred and thirty-three patients underwent CT guided biopsy of a pulmonary lesion. Two patients were biopsied twice. Variables analyzed were lesion size, lesion location, number of pleural needle passes, lesion margin, length of intrapulmonal biopsy path and puncture time. Eighteen-gauge (18G) cutting needles (Trucut, Somatex, Teltow, Germany) were used for biopsy. Pneumothorax occured in 23 of 135 biopsies (17%). Chest tube placement was required in three out of 23 cases of pneumothorax (2% of all biopsies). Pneumothorax rate was significantly higher when the lesions were located in the lung parenchyma compared with locations at the pleura or chest wall (P < 0.05), but all pneumothorax cases which required chest tube treatment occured in lesions located less than 2 cm from the pleura. Longer puncture time led to an increase in pneumothorax rate (P < 0.05). Thirty-seven (27%) out of 135 biopsies showed perifocal hemorrhage. Intrapulmonal biopsy paths longer than 4 cm showed significantly higher numbers of perifocal hemorrhage and pneumothorax (P < 0.05). Significantly more hemorrhage occured when the pleura was penetrated twice during the puncture (P < 0.05). Lesion size <4 cm is strongly correlated with higher occurence of perifocal hemorrhage (P < 0.05). Lesion margination showed no significant effect on complication rate. CT-guided biopsy of smaller lesions correlates with a higher bleeding rate. Puncture time should be minimized to reduce pneumothorax rate. Passing the pleura twice significantly increases the risk of hemorrhage. Intrapulmonal biopsy paths longer than 4 cm showed significantly higher numbers of perifocal hemorrhage as well as pneumothorax. (orig.)

  15. Complications in CT-guided Procedures: Do We Really Need Postinterventional CT Control Scans?

    Energy Technology Data Exchange (ETDEWEB)

    Nattenmüller, Johanna, E-mail: johanna.nattenmueller@med.uni-heidelberg.de; Filsinger, Matthias, E-mail: Matthias_filsinger@web.de; Bryant, Mark, E-mail: mark.bryant@med.uni-heidelberg.de; Stiller, Wolfram, E-mail: Wolfram.Stiller@med.uni-heidelberg.de; Radeleff, Boris, E-mail: boris.radeleff@med.uni-heidelberg.de; Grenacher, Lars, E-mail: lars.grenacher@med.uni-heidelberg.de; Kauczor, Hans-Ullrich, E-mail: hu.kauczor@med.uni-heidelberg.de; Hosch, Waldemar, E-mail: waldemar.hosch@urz.uni-heidelberg.de [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology (Germany)

    2013-06-19

    PurposeThe aim of this study is twofold: to determine the complication rate in computed tomography (CT)-guided biopsies and drainages, and to evaluate the value of postinterventional CT control scans.MethodsRetrospective analysis of 1,067 CT-guided diagnostic biopsies (n = 476) and therapeutic drainages (n = 591) in thoracic (n = 37), abdominal (n = 866), and musculoskeletal (ms) (n = 164) locations. Severity of any complication was categorized as minor or major. To assess the need for postinterventional CT control scans, it was determined whether complications were detected clinically, on peri-procedural scans or on postinterventional scans only.ResultsThe complication rate was 2.5 % in all procedures (n = 27), 4.4 % in diagnostic punctures, and 1.0 % in drainages; 13.5 % in thoracic, 2.0 % in abdominal, and 3.0 % in musculoskeletal procedures. There was only 1 major complication (0.1 %). Pneumothorax (n = 14) was most frequent, followed by bleeding (n = 9), paresthesia (n = 2), material damage (n = 1), and bone fissure (n = 1). Postinterventional control acquisitions were performed in 65.7 % (701 of 1,067). Six complications were solely detectable in postinterventional control acquisitions (3 retroperitoneal bleeds, 3 pneumothoraces); all other complications were clinically detectable (n = 4) and/or visible in peri-interventional controls (n = 21).ConclusionComplications in CT-guided interventions are rare. Of these, thoracic interventions had the highest rate, while pneumothoraces and bleeding were most frequent. Most complications can be detected clinically or peri-interventionally. To reduce the radiation dose, postinterventional CT controls should not be performed routinely and should be restricted to complicated or retroperitoneal interventions only.

  16. CT-Guided, Ethanol Sympatholysis for Primary Axillary–Palmar Hyperhidrosis

    Energy Technology Data Exchange (ETDEWEB)

    Tsitskari, Maria, E-mail: mariadote@hotmail.com [American Medical Center, Vascular & Interventional Radiology (Cyprus); Friehs, Gerhard, E-mail: gerhardf@amc.com.cy; Zerris, Vassilis, E-mail: vassilisz@amc.com.cy [American Medical Center, Neurosurgery (Cyprus); Georgiades, Christos, E-mail: g-christos@hotmail.com [Johns Hopkins Hospital, Vascular & Interventional Radiology (United States)

    2016-12-15

    PurposePrimary hyperhidrosis is an excessive sweating due to an overactive sympathetic system. Our objective was to test the feasibility and provide early data on the safety/efficacy of CT-guided sympatholysis, for primary hyperhidrosis.Materials and MethodsNine consecutive patients with axillary–palmar hyperhidrosis were treated between 2013 and 2015. CT-guided sympathetic block was performed in the outpatients at T-2, T-3, and T-4, bilaterally using alcohol under local anesthesia. Immediate postprocedure CT was obtained to assess the complications as per Common Terminology Criteria for Adverse Events, version 4. Technical success and clinical success were recorded. Primary and secondary efficacy were assessed by phone and clinical visits; mean follow-up was 12 months (6–26 months). Descriptive statistics was used to report the outcomes.ResultsOne procedure was aborted due to eyelid ptosis after lidocaine injection. All other eight patients (5:3, F:M) (median age 32) had immediate cessation of sweating. Two major complications (pneumothorax, one requiring a chest tube) occurred. Two patients recurred with unilateral and one with bilateral symptoms. One of the unilateral recurrence and the bilateral recurrence patients was retreated successfully. Median follow-up was 1 year. No cases of Horner’s or compensatory hyperhidrosis were observed.ConclusionsCT-guided EtOH sympatholysis for axillary/palmar primary hyperhidrosis is feasible. Technical failure rate was 11 %. Primary and secondary efficacy are 75 and 94 %, respectively, to a median follow-up of 1 year. Risk profile appears favorable. Despite a small sample size, results confirm feasibility and encourage a larger study.

  17. Complications in CT-guided Procedures: Do We Really Need Postinterventional CT Control Scans?

    International Nuclear Information System (INIS)

    Nattenmüller, Johanna; Filsinger, Matthias; Bryant, Mark; Stiller, Wolfram; Radeleff, Boris; Grenacher, Lars; Kauczor, Hans-Ullrich; Hosch, Waldemar

    2014-01-01

    PurposeThe aim of this study is twofold: to determine the complication rate in computed tomography (CT)-guided biopsies and drainages, and to evaluate the value of postinterventional CT control scans.MethodsRetrospective analysis of 1,067 CT-guided diagnostic biopsies (n = 476) and therapeutic drainages (n = 591) in thoracic (n = 37), abdominal (n = 866), and musculoskeletal (ms) (n = 164) locations. Severity of any complication was categorized as minor or major. To assess the need for postinterventional CT control scans, it was determined whether complications were detected clinically, on peri-procedural scans or on postinterventional scans only.ResultsThe complication rate was 2.5 % in all procedures (n = 27), 4.4 % in diagnostic punctures, and 1.0 % in drainages; 13.5 % in thoracic, 2.0 % in abdominal, and 3.0 % in musculoskeletal procedures. There was only 1 major complication (0.1 %). Pneumothorax (n = 14) was most frequent, followed by bleeding (n = 9), paresthesia (n = 2), material damage (n = 1), and bone fissure (n = 1). Postinterventional control acquisitions were performed in 65.7 % (701 of 1,067). Six complications were solely detectable in postinterventional control acquisitions (3 retroperitoneal bleeds, 3 pneumothoraces); all other complications were clinically detectable (n = 4) and/or visible in peri-interventional controls (n = 21).ConclusionComplications in CT-guided interventions are rare. Of these, thoracic interventions had the highest rate, while pneumothoraces and bleeding were most frequent. Most complications can be detected clinically or peri-interventionally. To reduce the radiation dose, postinterventional CT controls should not be performed routinely and should be restricted to complicated or retroperitoneal interventions only

  18. Clinical application of CT-guided radiofrequency ablation for the treatment of metastatic bone neoplasms

    International Nuclear Information System (INIS)

    Gong Ju; Lu Zhijun; Wang Zhongmin; Zhang Liyun; Zheng Yunfeng; Chen Kemin

    2009-01-01

    Objective: To investigate the clinical efficacy of CT-guided radiofrequency ablation (RFA) for the treatment of metastatic bone neoplasms. Methods: Under intravenous aneaesthesia, CT- guided RFA was performed in 20 patients with metastatic bone tumor. The degree of pain was evaluated at 24 hours, 3 and 6 months after the operation by brief pain inventory (BPI). Results: All patients were followed up for 6 months and survived so far. The average peak pain score before the operation was 8.1 (6-10), which decreased significantly to 6.1, 4.6, 3.3 and 3.0 at 24 hours, 1, 3 and 6 months after the operation respectively (P<0.001). The mean pain score before the operation was 6.3, which decreased significantly to 4.0, 2.3, 2.13 and 1.9 at 24 hours, 1, 3 and 6 months after the operation respectively (P<0.001). After RFA treatment, the KPS scores of all patients increased while the CT values of the bone lesions decreased. No major complications occurred both during and after the operation. One patient with vertebral lamina destruction suffered from lower limb hypoesthesia after RFA procedure, and the lower limb sensation was restored within 48 hours after the injection of prednisone was employed. Conclusion: CT-guided radiofisequency ablation is a safe, effective, minimally-invasive and up-to-date technique for the treatment of metastatic bone neoplasms with excellent anti-pain effect, its short-term response is sure and reliable. (authors)

  19. Percutaneous transluminal coronary angioplasty

    International Nuclear Information System (INIS)

    Przybojewski, J.Z.; Weich, H.F.H.

    1984-01-01

    The purpose of this article is to review PTCA, percutaneous transluminal coronary angioplasty, which can be considered to be a truly revolutionary and fairly simple invasive form of intervention to atherosclerotic obstruction. The 'epidemic' of IHD, ischaemic heart disease, in the Republic of South Africa calls for the employment of this technique, which has already been carried out in a few teaching hospitals in this country. Very recently, modified balloon dilatation catheters have been used percutaneously in the non-operative transluminal correction of congenital coarctation of the aorta in infants and children, congenital pulmonary value stenosis, and hypoplasia and stenosis of the pulmonary arteries. It has also been employed for PTCA and for the simultaneous occlusion of coronary-bronchial artery anastomosis using a detachable balloon. The isotopes thallium 201 and technetium 99 were also used in scintiscanning

  20. CT-guided injection for ganglion impar blockade: a radiological approach to the management of coccydynia

    International Nuclear Information System (INIS)

    Datir, A.; Connell, D.

    2010-01-01

    Aim: To evaluate the role of computed tomography (CT) in needle placement for ganglion impar blocks, and to determine the efficacy of CT-guided ganglion impar blocks in the management of coccydynia. Materials and methods: The results of ganglion impar blockade in eight patients with coccydynia secondary to trauma or unknown cause were reviewed. The diagnosis of coccydynia was based on clinical history, location of pain, and response to previous diagnostic and therapeutic procedures. The eight patients were treated with CT-guided ganglion impar blocks to manage their coccyx pain after conservative procedures, including oral medication and cushions, failed to provide relief. All patients were subjected to ganglion impar blocks under a thin-section CT-guided technique for needle placement, using a mixture of bupivacaine and triamcinolone. The patients were followed-up for a period of 6-months. Results: Eight patients were treated in this study with a total of 11 injections. A technical success of 100% was achieved in all cases with accurate needle placement without any complications and all the patients tolerated the procedure well. Out of eight, three patients (37%) had complete relief of pain on the follow-up intervals up to 6 months. Three out of eight patients (37%), had partial relief of symptoms and a second repeat injection was given at the 3 month interval of the follow-up period. At the end of the 6-month follow-up period, six out of eight patients (75%) experienced symptomatic relief (four complete relief and two partial relief) without any additional resort to conventional pain management. Twenty-five percent (two out of eight) did not have any symptomatic improvement. The mean visual analogue score (VAS) pre-procedure was 8 (range 6-10) and had decreased to 2 (range 0-5) in six out of eight patients. Conclusion: CT can be used as an imaging method to identify the ganglion and guide the needle in ganglion impar blockade. The advantages of CT-guided

  1. CT-guided injection for ganglion impar blockade: a radiological approach to the management of coccydynia

    Energy Technology Data Exchange (ETDEWEB)

    Datir, A., E-mail: apdatir@gmail.co [Jackson Memorial Hospital, Miami, FL (United States); Connell, D. [Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex (United Kingdom)

    2010-01-15

    Aim: To evaluate the role of computed tomography (CT) in needle placement for ganglion impar blocks, and to determine the efficacy of CT-guided ganglion impar blocks in the management of coccydynia. Materials and methods: The results of ganglion impar blockade in eight patients with coccydynia secondary to trauma or unknown cause were reviewed. The diagnosis of coccydynia was based on clinical history, location of pain, and response to previous diagnostic and therapeutic procedures. The eight patients were treated with CT-guided ganglion impar blocks to manage their coccyx pain after conservative procedures, including oral medication and cushions, failed to provide relief. All patients were subjected to ganglion impar blocks under a thin-section CT-guided technique for needle placement, using a mixture of bupivacaine and triamcinolone. The patients were followed-up for a period of 6-months. Results: Eight patients were treated in this study with a total of 11 injections. A technical success of 100% was achieved in all cases with accurate needle placement without any complications and all the patients tolerated the procedure well. Out of eight, three patients (37%) had complete relief of pain on the follow-up intervals up to 6 months. Three out of eight patients (37%), had partial relief of symptoms and a second repeat injection was given at the 3 month interval of the follow-up period. At the end of the 6-month follow-up period, six out of eight patients (75%) experienced symptomatic relief (four complete relief and two partial relief) without any additional resort to conventional pain management. Twenty-five percent (two out of eight) did not have any symptomatic improvement. The mean visual analogue score (VAS) pre-procedure was 8 (range 6-10) and had decreased to 2 (range 0-5) in six out of eight patients. Conclusion: CT can be used as an imaging method to identify the ganglion and guide the needle in ganglion impar blockade. The advantages of CT-guided

  2. Radiation exposure during CT-guided biopsies: recent CT machines provide markedly lower doses.

    Science.gov (United States)

    Guberina, Nika; Forsting, Michael; Ringelstein, Adrian; Suntharalingam, Saravanabavaan; Nassenstein, Kai; Theysohn, Jens; Wetter, Axel

    2018-03-28

    To examine radiation dose levels of CT-guided interventional procedures of chest, abdomen, spine and extremities on different CT-scanner generations at a large multicentre institute. 1,219 CT-guided interventional biopsies of different organ regions ((A) abdomen (n=516), (B) chest (n=528), (C) spine (n=134) and (D) extremities (n=41)) on different CT-scanners ((I) SOMATOM-Definition-AS+, (II) Volume-Zoom, (III) Emotion6) were included from 2013-2016. Important CT-parameters and standard dose-descriptors were retrospectively examined. Additionally, effective dose and organ doses were calculated using Monte-Carlo simulation, following ICRP103. Overall, radiation doses for CT interventions are highly dependent on CT-scanner generation: the newer the CT scanner, the lower the radiation dose imparted to patients. Mean effective doses for each of four procedures on available scanners are: (A) (I) 9.3mSv versus (II) 13.9mSv (B) (I) 7.3mSv versus (III) 11.4mSv (C) (I) 6.3mSv versus (II) 7.4mSv (D) (I) 4.3mSv versus (II) 10.8mSv. Standard dose descriptors [standard deviation (SD); CT dose index vol (CTDI vol ); dose-length product (DLP body ); size-specific dose estimate (SSDE)] were also compared. Effective dose, organ doses and SSDE for various CT-guided interventional biopsies on different CT-scanner generations following recommendations of the ICRP103 are provided. New CT-scanner generations involve markedly lower radiation doses versus older devices. • Effective dose, organ dose and SSDE are provided for CT-guided interventional examinations. • These data allow identifying organs at risk of higher radiation dose. • Detailed knowledge of radiation dose may contribute to a better individual risk-stratification. • New CT-scanner generations involve markedly lower radiation doses compared to older devices.

  3. PET/CT-guided interventional procedures: rationale, justification, initial study, and research plan

    Energy Technology Data Exchange (ETDEWEB)

    Wong, K.; Rahill, J.; Cleary, K. [Computer Aided Interventions and Medical Robotics (CAIMR), Imaging Science and Information Systems (ISIS) Center, Georgetown Univ. Medical Center, Washington, DC (United States); Petrillo, S.; Earl-Graef, D. [Dept. of Radiology, Georgetown Univ. Hospital, MedStar Health, Washington, DC (United States); Banovac, F.; Levy, E. [Computer Aided Interventions and Medical Robotics (CAIMR), Imaging Science and Information Systems (ISIS) Center, Georgetown Univ. Medical Center, Washington, DC (United States); Dept. of Radiology, Georgetown Univ. Hospital, MedStar Health, Washington, DC (United States); Shekhar, R. [Dept. of Radiology, Univ. of Maryland Medical Center, Baltimore, MD (United States)

    2007-06-15

    Positron-emission tomography (PET) and PET/CT (computed tomography) are becoming increasingly important for diagnosis and treatment of cancer. Clinically relevant changes can sometimes be seen on PET that are not seen on other imaging modalities. However, PET is not suitable for guiding biopsy as the images are not obtained in real-time. Therefore, our research group has begun developing a concept for PET/CT-guided interventional procedures. This paper presents the rationale for this concept, outlines our research plan, and includes an initial study to evaluate the relative sensitivity of CT and PET/CT in detecting suspicious lesions. (orig.)

  4. Development of the robot system to assist CT-guided brain surgery

    International Nuclear Information System (INIS)

    Koyama, H.; Funakubo, H.; Komeda, T.; Uchida, T.; Takakura, K.

    1999-01-01

    The robot technology was introduced into the stereotactic neurosurgery for application to biopsy, blind surgery, and functional neurosurgery. The authors have developed a newly designed the robot system to assist CT-guided brain surgery, designed to allow a biopsy needle to reach the targget such as a cerebral tumor within a brain automatically on the basis of the X,Y, and Z coordinates obtained by CT scanner. In this paper we describe construction of the robot, the control of the robot by CT image, robot simulation, and investigated a phantom experiment using CT image. (author)

  5. Percutaneous drainage of lung abscess

    Energy Technology Data Exchange (ETDEWEB)

    Ri, Jong Min; Kim, Yong Joo; Kang, Duk Sik [Kyung-Pook National University Hospital, Daegu (Korea, Republic of)

    1992-05-15

    Medical treatment using antibiotics and postural drainage has been widely adopted as a treatment method of pulmonary abscess, accompanied by surgical methods in cases intractable to drug therapy. However long-term therapy may be required, and the tolerance of organisms to antibiotics or other complications are apt to be encountered, during medical treatment. To shorten the convalescent period or to decrease the risk of invasive procedures, rather simple and relatively easy interventional techniques such as transbronchial or percutaneous catheter drainage have been successfully tried. We have performed 12 cases of percutaneous drainages of lung abscesses under fluoroscope guidance. This report is on the results of this procedure.

  6. Percutaneous drainage of lung abscess

    International Nuclear Information System (INIS)

    Ri, Jong Min; Kim, Yong Joo; Kang, Duk Sik

    1992-01-01

    Medical treatment using antibiotics and postural drainage has been widely adopted as a treatment method of pulmonary abscess, accompanied by surgical methods in cases intractable to drug therapy. However long-term therapy may be required, and the tolerance of organisms to antibiotics or other complications are apt to be encountered, during medical treatment. To shorten the convalescent period or to decrease the risk of invasive procedures, rather simple and relatively easy interventional techniques such as transbronchial or percutaneous catheter drainage have been successfully tried. We have performed 12 cases of percutaneous drainages of lung abscesses under fluoroscope guidance. This report is on the results of this procedure

  7. Percutaneous drainage of lung abscesses

    International Nuclear Information System (INIS)

    van Sonnenberg, E.; D'Agostino, H.; Casola, G.; Vatney, R.R.; Wittich, G.R.; Harker, C.

    1989-01-01

    The authors performed percutaneous drainage of lung abscesses in 12 patients. Indications for drainage were septicemia and persistence or worsening of radiographic findings. These lung abscesses were refractory to intravenous antibiotics and to bronchial toilet. Etiology of the abscesses included pneumonia (most frequently), trauma, postoperative development, infected necrotic neoplasm, and infected sequestration. Guidelines for drainage included passage of the catheter through contiguously abnormal lung and pleura, inability of the patient to cough, and/or bronchial obstruction precluding bronchial drainage. Cure was achieved in 11 of 12 patients. Catheters were removed on an average of 16 days after insertion. Antibiotics were administered an average of 18 days before drainage. No major complications occurred

  8. Pancreatic cancer seeding of percutaneous needle tract

    Directory of Open Access Journals (Sweden)

    Qiao Zhou, MD

    2017-03-01

    Full Text Available A 65-year old African-American female presents with biliary ductal dilatation due to an obstructive pancreatic head mass. Percutaneous transhepatic cholangiogram performed and biliary drainage catheter placement for decompression of the biliary system. The patient had a Whipple procedure performed several months later. On follow up CT imaging, there was interval development and enlargement of a subcutaneous lesion by the right oblique muscles. Biopsy of this lesion revealed pancreatic adenocarcinoma from percutaneous seeding of the transhepatic needle tract.

  9. Radiologic interventional retrieval of retained central venous catheter fragment in prematurity: case report

    International Nuclear Information System (INIS)

    Park, Jee Won; Jo, Jung Hyun; Park, Byeong Ho

    2007-01-01

    The fracture of a central venous catheter is a rare but potentially serious complication. Moreover, removal of the broken catheter pieces is considerably challenging, especially for premature infants. We report 3 case studies of the percutaneous transcatheter retrieval of broken catheter parts in 3 premature infants. We confirmed the location of the catheter fragments via a DSA venogram with diluted contrast media. Using the minimum amount of contrast, and extreme caution, we made certain no contrast-induced nephrotoxicity of air embolism occurred during catheter manipulation. In addition, when the broken fragment was curled or attached to the cardiac wall, we used a hook-shaped catheter to facilitate the capturing of the catheter with a loopsnare. This report demonstrates the feasibility of removing a retained catheter fragment in a premature infant using a percutaneous transcatheter approach

  10. Percutaneous targeted argon-helium cryoablation for renal carcinoma under CT guidance

    International Nuclear Information System (INIS)

    Xu Jian; Cao Jianmin; Lu Guangming; Shi Donghong; Kong Weidong; Gao Dazhi

    2008-01-01

    Objective: To establish initially the technique and evaluate the principle, safety and short term efficacy of argon-helium superconductor operation system (or Ar-He knife) targeted cryotherapy for renal carcinoma. Methods: Seven patients with renal carcinoma were treated with CT-guided percutaneous Ar-He knife targeted cryotherapy. Results: After cryotherapy, no serious complications, such as bleeding, skin cold injury, infection, implantation metastasis inside the puncture path occurred, and one month later, CT scans showed low-density local necrosis in all tumors of the 7 cases, but the tumor reduction in size was found only in 2 cases. Conclusion: CT guiding percutaneous Ar-He knife targeted cryoablation for renal carcinoma is a safe, effective and minimally invasive therapeutic method, particularly for inoperable cases. (authors)

  11. Using a Motion Sensor-Equipped Smartphone to Facilitate CT-Guided Puncture

    International Nuclear Information System (INIS)

    Hirata, Masaaki; Watanabe, Ryouhei; Koyano, Yasuhiro; Sugata, Shigenori; Takeda, Yukie; Nakamura, Seiji; Akamune, Akihisa; Tsuda, Takaharu; Mochizuki, Teruhito

    2017-01-01

    PurposeTo demonstrate the use of “Smart Puncture,” a smartphone application to assist conventional CT-guided puncture without CT fluoroscopy, and to describe the advantages of this application.Materials and MethodsA puncture guideline is displayed by entering the angle into the application. Regardless of the angle at which the device is being held, the motion sensor ensures that the guideline is displayed at the appropriate angle with respect to gravity. The angle of the smartphone’s liquid crystal display (LCD) is also detected, preventing needle deflection from the CT slice image. Physicians can perform the puncture procedure by advancing the needle using the guideline while the smartphone is placed adjacent to the patient. In an experimental puncture test using a sponge as a target, the target was punctured at 30°, 50°, and 70° when the device was tilted to 0°, 15°, 30°, and 45°, respectively. The punctured target was then imaged with a CT scan, and the puncture error was measured.ResultsThe mean puncture error in the plane parallel to the LCD was less than 2°, irrespective of device tilt. The mean puncture error in the sagittal plane was less than 3° with no device tilt. However, the mean puncture error tended to increase when the tilt was increased.ConclusionThis application can transform a smartphone into a valuable tool that is capable of objectively and accurately assisting CT-guided puncture procedures.

  12. Results and complications of CT-guided biopsy with CT fluoroscopy

    International Nuclear Information System (INIS)

    Saika, Yoshinori; Ogura, Yasuharu; Doi, Kenji; Misaki, Toshimasa; Shimizu, Masashi; Narabayashi, Isamu

    2002-01-01

    We studied the results and complications of CT-guided biopsy with CT fluoroscopy performed 66 lesions in 64 patients from March 1999 to February 2001. In addition to the conventional procedure of CT-guided biopsy, we use CT fluoroscopy for confirmation of the location of the tip of the biopsy needle and the accurate contact, in some cases, at the time of puncturing. Examination results showed malignancy in 36 lesions and benign findings in 30 lesions. The sensitivity was 85.7%, specificity was 100.0%, and accuracy was 90.9%. Pneumothorax occurred in 20 out of 64 patients (31.3%). In a study on 26 small lesions (≤2 cm) in 25 patients, the sensitivity was 81.8%, specificity was 100.0%, accuracy was 92.3%. Pneumothorax occurred in 12 out of 25 patients (48.0%), more frequently than in patients with large lesions. In a study on 6 false negative cases, they tended to be intrapulmonary on location, small in diameter, and far from the skin puncture point. Examination results were satisfactory, especially in terms of accuracy in small lesions (≤2 cm). However, when the lesions were small, pneumothorax occurred frequently (48.0%). (author)

  13. Predictors of pneumothorax after CT-guided transthoracic needle lung biopsy: the role of quantitative CT.

    Science.gov (United States)

    Chami, H A; Faraj, W; Yehia, Z A; Badour, S A; Sawan, P; Rebeiz, K; Safa, R; Saade, C; Ghandour, B; Shamseddine, A; Mukherji, D; Haydar, A A

    2015-12-01

    To evaluate the association of quantitative computed tomography (CT) measures of emphysema with the occurrence of pneumothorax after CT-guided needle lung biopsy (NLB) accounting for other risk factors. One hundred and sixty-three CT-guided NLBs performed between 2008 and 2013 with available complete chest CT within 30 days were reviewed for the occurrence of post-procedure pneumothorax. Percent emphysema was determined quantitatively as the percentage of lung voxels below -950 HU on chest CT images using automated software. Multivariable regression was used to assess the association of percent emphysema volume with the occurrence of post-procedure pneumothorax. The association of percent emphysema volume with the pneumothorax size and need for chest tube placement after NLB was also explored. Percent emphysema was significantly associated with the incidence of post-NLB pneumothorax (OR=1.10 95% confidence interval: 1.01-1.15; p=0.03) adjusting for lower-lobe lesion location, needle path length, lesion size, number of passes, and pleural needle trajectory angle. Percent emphysema was not associated with the size of the pneumothorax, nor the need for chest tube placement after NLB. Percent emphysema determined quantitatively from chest CT is a significant predictor of post-NLB pneumothorax. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  14. CT-guided stereotaxic biopsy in 104 cases of brain tumors

    International Nuclear Information System (INIS)

    Niizuma, Hiroshi; Nakasato, Nobukazu; Jokura, Hidehumi; Otsuki, Taisuke; Katakura, Ryuichi; Suzuki, Jiro

    1988-01-01

    Biopsy of suspected brain tumor was performed on 104 cases using Leksell's CT-guided stereotaxic system. The entire operation was performed in the CT room. A Backlund's spiral biopsy needle was advanced to the target point in a stepwise fashion and two to nine tissue samples were obtained from one to three biopsy tracks. Tissue sampling was impossible in two cases because the tumors were too hard for biopsy needle to advance. Also, sampling was sometimes difficult in the case of soft and necrotic tumor, cystic tumor, already treated (irradiated) tumor and the lesion including old blood clot. After the biopsy, minimal bleeding occurred in nine cases, however, stopped within 10 minutes by controlling the blood pressure. A minimum sized hematoma was visible on the postoperative CT in four cases. Postoperative neurological deterioration was seen in two cases. One case was transient and the other seemed to be in his natural course. Anyway, there were neither cases of operative mortality nor severely complicated cases in these series. Useful pathological diagnosis was possible in 83 cases (80 %). Accurate diagnosis was not possible in the remaining 21 cases, however, their histological datum such as necrosis, blood clot, and so on were very useful to estimate the lesions. In summary, accurate diagnosis rate of CT-guided stereotaxic needle biopsy was 80 %. However, it appeared to be a safe and useful procedure in the diagnosis of intracranial mass lesions. (author)

  15. Using a Motion Sensor-Equipped Smartphone to Facilitate CT-Guided Puncture

    Energy Technology Data Exchange (ETDEWEB)

    Hirata, Masaaki, E-mail: masaaki314@gmail.com [Matsuyama Shimin Hospital, Department of Radiology (Japan); Watanabe, Ryouhei; Koyano, Yasuhiro [Matsuyama Shimin Hospital, Department of Surgery (Japan); Sugata, Shigenori; Takeda, Yukie [Ehime Prefectural Imabari Hospital, Department of Radiology (Japan); Nakamura, Seiji; Akamune, Akihisa [Matsuyama Shimin Hospital, Department of Radiology (Japan); Tsuda, Takaharu; Mochizuki, Teruhito [Ehime University Graduate School of Medicine, Department of Radiology (Japan)

    2017-04-15

    PurposeTo demonstrate the use of “Smart Puncture,” a smartphone application to assist conventional CT-guided puncture without CT fluoroscopy, and to describe the advantages of this application.Materials and MethodsA puncture guideline is displayed by entering the angle into the application. Regardless of the angle at which the device is being held, the motion sensor ensures that the guideline is displayed at the appropriate angle with respect to gravity. The angle of the smartphone’s liquid crystal display (LCD) is also detected, preventing needle deflection from the CT slice image. Physicians can perform the puncture procedure by advancing the needle using the guideline while the smartphone is placed adjacent to the patient. In an experimental puncture test using a sponge as a target, the target was punctured at 30°, 50°, and 70° when the device was tilted to 0°, 15°, 30°, and 45°, respectively. The punctured target was then imaged with a CT scan, and the puncture error was measured.ResultsThe mean puncture error in the plane parallel to the LCD was less than 2°, irrespective of device tilt. The mean puncture error in the sagittal plane was less than 3° with no device tilt. However, the mean puncture error tended to increase when the tilt was increased.ConclusionThis application can transform a smartphone into a valuable tool that is capable of objectively and accurately assisting CT-guided puncture procedures.

  16. Trans-sphenoidal treatment of postsurgical cerebrospinal fluid fistula: CT-guided closure

    International Nuclear Information System (INIS)

    Floris, R.; Salvatore, C.; Simonetti, G.

    1998-01-01

    Cerebrospinal fluid (CSF) leakage after trans-sphenoidal surgery is a troublesome complication with a risk of meningitis and pneumocephalus. We suggest CT-guided intrasphenoidal injection of fibrin sealant through a 12-gauge needle as a simple alternative to surgical management of CSF fistulae. We treated eight patients, operated via the trans-sphenoidal route (five pituitary adenomas, three craniopharyngiomas), for a postoperative CSF leak by CT-guided intrasphenoidal injection of fibrin sealant alone in three cases and fibrin sealant and autologous blood in 5. CT was obtained 10 days after the procedure in all cases. In four patients, the CSF leak was closed successfully at the first attempt. The procedure was repeated on the four remaining patients because only a reduction in leakage was obtained at the first attempt. This procedure preserves olfaction and avoids the risk of frontal lobe damage. It could therefore represent the treatment of choice in many cases of anterior cranial fossa postsurgical CSF leaks. (orig.) (orig.)

  17. Recurrence of primary aldosteronism after percutaneous ethanol injection

    Directory of Open Access Journals (Sweden)

    Fan-Chi Chang

    2012-03-01

    Full Text Available Adrenalectomy is the definite treatment for aldosterone-producing adenoma (APA. Percutaneous ethanol or acetic acid injection with computed tomography (CT guidance has been described as a safe, noninvasive, and effective alternative treatment modality in patients with high surgical risk. We report on a man who was 49 years of age and presented with treatment-resistant hypertension and was later diagnosed with APA. CT-guided percutaneous ethanol injection (PEI was performed for this high surgical risk patient. He had aldosteronism recurrence 4 years after the ethanol injection, so a second PEI was performed. The tumor size was reduced and his blood pressure was normalized. Therefore, we suggest that clinicians should closely check aldosterone to renin ration and potassium level if percutaneous chemical ablation is considered in functioning adrenal adenomas.

  18. Evaluation of the long-term efficacy of CT-guided epidural steroid injection for the treatment of sciatica

    International Nuclear Information System (INIS)

    Tong Guohai; Wang Wei; Chen Wei; Chen Kemin

    2005-01-01

    Objective: To evaluate the long-term efficacy of CT-guided epidural steroid injection for the treatment of sciatica. Methods: CT-guided epidural steroid injection was performed in 180 patients with sciatica from May 1998 to March 2004, and all patients had failure to previous conservative treatment. Visual analogue scale was used to evaluate the pain of the patient before and after the treatment. Results: Follow-up was taken for 112 cases during 1-6 years after the treatment, 89 patients (79.5%) had successful long-term outcome and 80 patients (71.4%) were satisfied. Conclusions: CT-guided epidural steroid injection can reduce low back pain and radical pain. It should be preferentially considered as the first choice when conservative treatments are failed. (authors)

  19. Pneumothorax Complicating Coaxial and Non-coaxial CT-Guided Lung Biopsy: Comparative Analysis of Determining Risk Factors and Management of Pneumothorax in a Retrospective Review of 650 Patients.

    Science.gov (United States)

    Nour-Eldin, Nour-Eldin A; Alsubhi, Mohammed; Emam, Ahmed; Lehnert, Thomas; Beeres, Martin; Jacobi, Volkmar; Gruber-Rouh, Tatjana; Scholtz, Jan-Erik; Vogl, Thomas J; Naguib, Nagy N

    2016-02-01

    To assess the scope and determining risk factors related to the development of pneumothorax throughout CT-guided biopsy of pulmonary lesions in coaxial and non-coaxial techniques and the outcome of its management. The study included CT-guided percutaneous lung biopsies in 650 consecutive patients (407 males, 243 females; mean age 54.6 years, SD 5.2) from November 2008 to June 2013 in a retrospective design. Patients were classified according to lung biopsy technique into coaxial group (318 lesions) and non-coaxial group (332 lesions). Exclusion criteria for biopsy were lesions pneumothorax were classified into: (a) Technical risk factors, (b) patient-related risk factors, and (c) lesion-associated risk factors. Radiological assessments were performed by two radiologists in consensus. Mann-Whitney U test and Fisher's exact tests were used for statistical analysis. p values pneumothorax complicating CT-guided lung biopsy was less in the non-coaxial group (23.2 %, 77 out of 332) than the coaxial group (27 %, 86 out of 318). However, the difference in incidence between both groups was statistically insignificant (p = 0.14). Significant risk factors for the development of pneumothorax in both groups were emphysema (p pneumothorax in the non-coaxial group was significantly correlated to the number of specimens obtained (p = 0.006). This factor was statistically insignificant in the coaxial group (p = 0.45). The biopsy yield was more diagnostic and conclusive in the coaxial group in comparison to the non-coaxial group (p = 0.008). Simultaneous incidence of pneumothorax and pulmonary hemorrhage was 27.3 % (21/77) in non-coaxial group and in 30.2 % (26/86) in coaxial group. Conservative management was sufficient for treatment of 91 out of 101 patients of pneumothorax in both groups (90.1 %). Manual evacuation of pneumothorax was efficient in 44/51 patients (86.3 %) in both groups and intercostal chest tube was applied after failure of manual evacuation (7

  20. CT-Guided Percutaneous Fine-Needle Aspiration Biopsy of the Inferior Vena Cava Wall: A Posterior Coaxial Approach

    International Nuclear Information System (INIS)

    Kos, Sebastian; Bilecen, Deniz; Baumhoer, Daniel; Guillaume, Nicolas; Jacob, Augustinus L.

    2010-01-01

    A 72-year-old man was referred to our department with an incidentally diagnosed bronchogenic carcinoma of the right upper lobe. Positron emission tomography (PET) combined with computed tomography (PET-CT) revealed an unexpected hot spot in the ventral wall of the infrarenal segment of the inferior vena cava (IVC). Diagnostic biopsy of this lesion was performed under CT guidance with semiautomated 20G fine-needle aspiration (FNA) through a 19G coaxial needle. Cytology revealed few carcinoma cells, which led to the remarkable diagnosis of a distant metastasis to the IVC wall. Both the immediate postinterventional CT control and the further surveillance period of the patient were unremarkable; in particular, no signs of bleeding complications were detected. We conclude that coaxial FNA of an IVC wall lesion is technically feasible and may even help diagnose distant metastasis.

  1. Percutaneous transcatheter sclerotherapy of oophoritic cysts

    International Nuclear Information System (INIS)

    Huang Youhua; Xu Qiang; Sun Jun; Shen Tao; Shi Hongjian; Tang Qingfang; Chen Qiying; Zhou Mingxia; Li Hongyao

    2005-01-01

    Objective: To evaluate the clinical value of percutaneous transcatheter sclerotherapy in oophoritic cysts. Methods: Seventy six oophoritic cysts incluoling 48 simple and 28 chocolate cysts of 64 patients were treated with percutaneous transcatheter sclerotherapy under CT guidance. 4F multisideholes pigtail catheter was introduced into cyst using absolute alcohol as sclerosing agents. Results: The successful rate of percutaneous oophoritc cyst puncture was 100% in all 64 patients. Among them 58 were cured (90.6%), 6 improved significantly (9.4%). The total effective rate reached 100% with no serious complications. Conclusions: Catheterization sclerotherapy for oophoritic cyst is a simple, complete, safe and effective method. (authors)

  2. Catheter Angiography

    Medline Plus

    Full Text Available ... rare, and radiology departments are well-equipped to deal with them. There is a small risk that ... standard x-ray contrast. Catheter angiography should be done very cautiously—if at all—in patients who ...

  3. Catheter Angiography

    Medline Plus

    Full Text Available ... key areas of the body for abnormalities such as aneurysms and disease such as atherosclerosis (plaque). The use of a catheter makes ... including the: brain neck heart chest abdomen (such as the kidneys and liver) pelvis legs and feet ...

  4. Catheter Angiography

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician ... Catheter Angiography? Angiography is a minimally invasive medical test that helps physicians diagnose and treat medical conditions. ...

  5. Extrapeural locating method: significance in CT-guided transthoracic pulmonary biopsy

    International Nuclear Information System (INIS)

    Tang Guangjian; Wang Rengui; Liu Jianxin; Sun Jingtao

    2008-01-01

    Objective: To evaluate the usefulness of extrapleural locating method in CT-guided transthoracic pulmonary biopsy to prevent or reduce the size of peumothorax. Methods: One hundred and fifteen cases of CT-guided transthoracic pulmonary biopsy with the pulmonary lesions not in direct contact with the pleura were selected. Of 115 cases, 46 were performed with extrapleural locating method (EPL) and 69 cases with lesion edge locating method (LEL). Taking the maximum distance between the partial and visceral pleura (MPVD) measured on the CT image after the procedure as the index of the volume of pneumothorax. The incidence and volume of pneumothorax of both groups were compared and statistically analysed with R x C Chi-Square test. The retention time of the biopsy needle in the lung parenchyma of the two group was documented and the average time was calculated in each group. Results: The incidence of pneumothorax was 45.7% (21/46), median 0.4 cm with EPL group, and 66.7% (46/69) and median 0.3cm with LEL group. When the distance between the lesion and pleura was equal or smaller than 2 cm (≤2cm), the incidence of pneumothorax was 39.4% (13/33) with EPL group and 73.2% (30/41) with LEL group, and the difference of incidence and volume of the pneumothorax between two groups was statistically significant(χ 2 =9.981, P=0.019). When the distance was larger than 2 cm (>2 cm), the incidence and volume of pneumothorax between two groups were not significant statistically. The average retention time of the biopsy needle in the lung parenchyma was (7.2 ± 1.8) s with EPL group and (58.3 ± 11.6) s with LEL group. Conclusion: The extrapleural locating method can reduce effectively the retention time of the biopsy needle in the lung parenchyma and the incidence and volume of pneumothorax in CT-guided transthoracic pulmonary biopsy. (authors)

  6. Peritoneal seeding of cholangiocarcinoma in patients with percutaneous biliary drainage

    International Nuclear Information System (INIS)

    Miller, G.A. Jr.; Heaston, D.K.; Moore, A.V. Jr.; Mills, S.R.; Dunnick, N.R.

    1983-01-01

    Percutaneous transhepatic catheter decompression is performed increasingly as an adjunct or alternative to surgery in patients with benign or malignant biliary obstruction. The authors recently saw three patients with cholangiocarcinoma in whom metastatic seeding of the peritoneal serosa was identified some months after initial percutaneous transhepatic biliary drainage. Although no tumor was found along the hepatic tract of the biliary drainage catheters to implicate the drainage tubes as the direct source of peritoneal spread, the occurrence of this rare type of metastasis of cholangiocarcinoma in patients with potential access of tumor cells to the peritoneal cavity via the catheter tracts does suggest such a relation. The clinical history of one patient is presented

  7. Use of cone-beam CT and live 3-D needle guidance to facilitate percutaneous nephrostomy and nephrolithotripsy access in children and adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Hawkins, C.M. [Emory University School of Medicine, Department of Radiology and Imaging Sciences, Atlanta, GA (United States); Kukreja, Kamlesh [Texas Children' s Hospital, Department of Radiology, Houston, TX (United States); Singewald, Timothy; Johnson, Neil D.; Racadio, John M. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Minevich, Eugene; Reddy, Pramod [Cincinnati Children' s Hospital Medical Center, Department of Urology, Cincinnati, OH (United States)

    2016-04-15

    Gaining access into non-dilated renal collecting systems for percutaneous nephrolithotripsy, particularly in patients with prohibitive body habitus and/or scoliosis, is often challenging using conventional techniques. To evaluate the feasibility of cone-beam CT for percutaneous nephrostomy placement for subsequent percutaneous nephrolithotripsy in children and adolescents. A retrospective review of percutaneous nephrostomy revealed use of cone-beam CT and 3-D guidance in 12 percutaneous nephrostomy procedures for 9 patients between 2006 and 2015. All cone-beam CT-guided percutaneous nephrostomies were for pre-lithotripsy access and all 12 were placed in non-dilated collecting systems. Technical success was 100%. There were no complications. Cone-beam CT with 3-D guidance is a technically feasible technique for percutaneous nephrostomy in children and adolescents, specifically for nephrolithotripsy access in non-dilated collecting systems. (orig.)

  8. Application of electronic endoscopy and CT-guided stereotactic aspiration to intracerebral hematoma

    International Nuclear Information System (INIS)

    Kusaka, Masahiko

    1991-01-01

    According to the development of computer technology and operative instruments, stereotactic neurosurgery became more precise, and extended as its indication. CT-guided stereotactic aspiration of intracerebral hematoma is superior operative procedure with rare complications. Using Stereotactic Aqua-Stream and Aspirator at the same time, hematoma was removed sufficiently. However, stereotactic neurosurgery had a major weak points, it was a blind operation. An endoscope (FVS-1000, M and M Co.) and SASA (Marui Medical Co.) were applied in 5 cases of intracerebral hematoma. In physiological saline, the endoscope had 32.9 deg angle of visual field, 1 mm - 25 mm depth of vision, and 16 pair/mm resolution. It was excellent ability for neurosurgery. Using for clinical cases, the bloody fluid in the hematoma cavity disturbed visibility. It was a difficult problem. Influence of bloody fluid concentration to depth of vision and resolution was investigated, and method of making clear visibility was described. (author)

  9. Clinical evaluation of CT-guided stereotaxic evacuation of hypertensive intracerebral hematomas

    International Nuclear Information System (INIS)

    Kimura, Masato; Yoshinaga, Shiya; Nakayama, Yoshiya; Hirakawa, Toshihiko; Tanaka, Akira; Tomonaga, Masamichi

    1989-01-01

    The clinical results of CT-guided stereotaxic evacuation of hypertensive intracerebral hematomas which had been done in our department during the last 16 months were evaluated. They included 18 cases; 8 of thalamic, 9 of putaminal and one of cerebellar hematoma. The patients were 11 males and 7 females, with an average age of 57. The time interval from oneset to surgery was 1-21 days, 9.5 days on average. The hematoma volume estimated on a CT scan was 6-35 ml and the average rate of hematoma removal by surgery was 75%. Intraoperative monitoring with ultrasonography and postoperative infusion of Urokinase increased the removal rate. In 14 cases, the mental ability and motor function improved within days after surgery and rehabilitation was started within a short period. However, the recovery in aged people was generally poor. Rebleeding occurred postoperatively in one case, necessitating a subsequent craniotomy. (author)

  10. Cerebellar and brainstem infarction as a complication of CT-guided transforaminal cervical nerve root block

    Energy Technology Data Exchange (ETDEWEB)

    Suresh, S. [The Royal National Orthopaedic Hospital NHS Trust, London (United Kingdom); Berman, J. [The Royal National Orthopaedic Hospital NHS Trust, Anaesthetic Department, London (United Kingdom); Connell, David A. [The Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, London (United Kingdom)

    2007-05-15

    A 60-year-old man with a 4-year history of intractable neck pain and radicular pain in the C5 nerve root distribution presented to our department for a CT-guided transforaminal left C5 nerve root block. He had had a similar procedure on the right 2 months previously, and had significant improvement of his symptoms with considerable pain relief. On this occasion he was again accepted for the procedure after the risks and potential complications had been explained. Under CT guidance, a 25G spinal needle was introduced and after confirmation of the position of the needle, steroid was injected. Immediately the patient became unresponsive, and later developed a MR-proven infarct affecting the left vertebral artery (VA) territory. This is the first report of a major complication of a cervical root injection under CT guidance reported in the literature. We present this case report and the literature review of the potential complications of this procedure. (orig.)

  11. Brachial Plexus Injury from CT-Guided RF Ablation Under General Anesthesia

    International Nuclear Information System (INIS)

    Shankar, Sridhar; Sonnenberg, Eric van; Silverman, Stuart G.; Tuncali, Kemal; Flanagan, Hugh L.; Whang, Edward E.

    2005-01-01

    Brachial plexus injury in a patient under general anesthesia (GA) is not uncommon, despite careful positioning and, particularly, awareness of the possibility. The mechanism of injury is stretching and compression of the brachial plexus over a prolonged period. Positioning the patient within the computed tomography (CT) gantry for abdominal or chest procedures can simulate a surgical procedure, particularly when GA is used. The potential for brachial plexus injury is increased if the case is prolonged and the patient's arms are raised above the head to avoid CT image degradation from streak artifacts. We report a case of profound brachial plexus palsy following a CT-guided radiofrequency ablation procedure under GA. Fortunately, the patient recovered completely. We emphasize the mechanism of injury and detail measures to combat this problem, such that radiologists are aware of this potentially serious complication

  12. Cerebellar and brainstem infarction as a complication of CT-guided transforaminal cervical nerve root block

    International Nuclear Information System (INIS)

    Suresh, S.; Berman, J.; Connell, David A.

    2007-01-01

    A 60-year-old man with a 4-year history of intractable neck pain and radicular pain in the C5 nerve root distribution presented to our department for a CT-guided transforaminal left C5 nerve root block. He had had a similar procedure on the right 2 months previously, and had significant improvement of his symptoms with considerable pain relief. On this occasion he was again accepted for the procedure after the risks and potential complications had been explained. Under CT guidance, a 25G spinal needle was introduced and after confirmation of the position of the needle, steroid was injected. Immediately the patient became unresponsive, and later developed a MR-proven infarct affecting the left vertebral artery (VA) territory. This is the first report of a major complication of a cervical root injection under CT guidance reported in the literature. We present this case report and the literature review of the potential complications of this procedure. (orig.)

  13. Complications of Percutaneous Nephrostomy, Percutaneous Insertion of Ureteral Endoprosthesis, and Replacement Procedures

    International Nuclear Information System (INIS)

    Kaskarelis, Ioannis S.; Papadaki, Marina G.; Malliaraki, Niki E.; Robotis, Epaminondas D.; Malagari, Katerina S.; Piperopoulos, Ploutarchos N.

    2001-01-01

    Purpose: The aim of the present study was to record and identify the frequency of complications following percutaneous nephrostomy, replacement of nephrostomy drains and percutaneous insertion of ureteral endoprostheses.Methods: During a 10-year period 341 patients were referred to our department with indications for percutaneous nephrostomy and/or percutaneous insertion of a ureteral endoprosthesis, and a total of 1036 interventional procedures were performed (nephrostomy, catheter change, stenting).Results: There were three major complications (0.29%): two patients died during the first 30 days after the procedure, due to aggravation of their condition caused by the procedure, and one patient had retroperitoneal bleeding requiring surgery. There were 76 complications of intermediate severity (7.33%): catheter or stent displacement (n = 37, 3.57%) catheter occlusion (n = 18, 1.73%), hematuria (n = 12, 1.16%), and urinary tract infection (n = 9, 0.87%). The 55 minor complications (5.3%) comprised inflammation of the skin at the site of insertion of the percutaneous catheter.Conclusion: The small number of complications observed during acts of interventional uroradiology prove transcutaneous manipulations to be safe medical procedures

  14. CT-guided celiac plexus block with absolute alcohol : the anterior approach

    International Nuclear Information System (INIS)

    Lee, Jeong Min; Lee, Mi Suk; Jang, Young Ik; Kim, Jeong Hoi; Ym, Seong Hee; Lee, Jin Hee; Han, Young Min; Kim, Chong Soo; Choi, Ki Chul

    1997-01-01

    To evaluate the safety and efficacy of CT-guided celiac plexus block (CPB) using an anterior approach, and to determine the role of CT in this procedure. CPB was attempted in 15 patients(10 men and 5 women;mean age, 62.3 years) with intractable upper abdominal pain due to terminal malignancy of the pancreas, liver, bowel,and kidney. To permit an anterior approach, patients lied supine on the CT scan table during the procedure. One or two 21-guage needles were placed just anterior to the diaphragmatic crus at or between the levels of the celiac and superior mesenteric arteries and 10-40ml of 99.9% alcohol was injected. Pain relief following the procedure was assessed and pain was graded on a visual analogue scale (VAS) from 0 to 10. There were no technical failures and no neurologic or hemorrhagic complications. Abdominal pain during alcohol injection occurred in all patients, and transient hypotension in three. One patient with recurrent cancer of the pancreatic head died of sepsis five days after the procedure;the cause of sepsis was difficult to determine, but there was thought to be a biliary source of infection. Two days after block, 13 of 15 procedures(86.7%) had produced at least partial pain relief;in 12 patients, relief was good. With CT guidance, more directed positioning of the needle is possible, allowing alcohol to be deposited in specific ganglion areas. CT-guided celiac plexus block using an anterior approach was an easy and effective way of reducing intractable upper abdominal pain due to terminal malignancies. CT guidance allowed precise needle placement and a safer procedure

  15. Predictors of pneumothorax after CT-guided transthoracic needle lung biopsy: the role of quantitative CT

    International Nuclear Information System (INIS)

    Chami, H.A.; Faraj, W.; Yehia, Z.A.; Badour, S.A.; Sawan, P.; Rebeiz, K.; Safa, R.; Saade, C.; Ghandour, B.; Shamseddine, A.; Mukherji, D.; Haydar, A.A.

    2015-01-01

    Aim: To evaluate the association of quantitative computed tomography (CT) measures of emphysema with the occurrence of pneumothorax after CT-guided needle lung biopsy (NLB) accounting for other risk factors. Materials and methods: One hundred and sixty-three CT-guided NLBs performed between 2008 and 2013 with available complete chest CT within 30 days were reviewed for the occurrence of post-procedure pneumothorax. Percent emphysema was determined quantitatively as the percentage of lung voxels below −950 HU on chest CT images using automated software. Multivariable regression was used to assess the association of percent emphysema volume with the occurrence of post-procedure pneumothorax. The association of percent emphysema volume with the pneumothorax size and need for chest tube placement after NLB was also explored. Results: Percent emphysema was significantly associated with the incidence of post-NLB pneumothorax (OR=1.10 95% confidence interval: 1.01–1.15; p=0.03) adjusting for lower-lobe lesion location, needle path length, lesion size, number of passes, and pleural needle trajectory angle. Percent emphysema was not associated with the size of the pneumothorax, nor the need for chest tube placement after NLB. Conclusion: Percent emphysema determined quantitatively from chest CT is a significant predictor of post-NLB pneumothorax. - Highlights: • Examine the association between quantitative emphysema measures & post NLB pneumothorax. • The risk of post-NLB pneumothorax increases with every unit increase in percent emphysema. • Percent emphysema is a significant predictor of pneumothorax post transthoracic NLB. • Quantitative analysis of chest CT offers clinicians' objective measures to assess pneumothorax risk.

  16. CT-guided interstitial 125I seed implantation for intractable pelvic recurrence of rectal carcinomas

    International Nuclear Information System (INIS)

    Lin Zhenwen; Chu Hong; Kong Jian; Dou Yongchong

    2011-01-01

    Objective: To evaluate the therapeutic effect and safety of CT-guided interstitial 125 I seed implantation in treating intractable pelvic recurrence of rectal carcinomas. Methods: During the period from April 2010 to September 2010 CT-guided interstitial 125 I seed implantation was carried out in 11 patients with pelvic recurrence of rectal carcinoma which developed after the patients had received comprehensive treatments such as surgical resection, chemotherapy and/or radiotherapy. The clinical data were retrospectively analyzed. The clinical symptoms, the tumor size and the quality of life (QOL) before the treatment and at two and six months after the treatment were recorded, and the complications were observed. The results were compared. All the patients were followed up for six months. Results: At two and six months after the treatment, the improvement rate of the clinical symptoms was 100.0% (11/11) and 90.9% (10/11) respectively, while the effective reduction of the tumor size was 90.9% (10/11) and 81.8% (9/11) respectively. At two and six months after the treatment the QOL score was (56.0±3.66) and (54.4±5.41) respectively, both of which were higher than the QOL score determined before the treatment (42.5±6.93), the difference between them was statistically significant (P 125 I seed implantation has satisfactory short-term effect. This treatment is also quite safe and effective for patients who are unbearable to external radiation therapy due to the tissue dose restriction. (authors)

  17. Fatal paradoxical pulmonary air embolism complicating percutaneous computed tomography-guided needle biopsy of the lung

    International Nuclear Information System (INIS)

    Chakravarti, Rajesh; Singh, Virendra; Isaac, Rethish; John, Joseph

    2004-01-01

    A 63-year-old man with left upper zone haziness on chest X-ray and an infiltrative lesion with a pleural mass in the left upper lobe on CT scan was scheduled for CT-guided percutaneous trans-thoracic needle biopsy. During the procedure, the patient had massive haemoptysis and cardiorespiratory arrest and could not be revived. Post-mortem CT showed air in the right atrium, right ventricle, pulmonary artery and also in the left atrium and aorta. A discussion on paradoxical air embolism following percutaneous trans-thoracic needle biopsy is presented Copyright (2004) Blackwell Publishing Asia Pty Ltd

  18. Risk factor analysis of pulmonary hemorrhage complicating CT-guided lung biopsy in coaxial and non-coaxial core biopsy techniques in 650 patients

    Energy Technology Data Exchange (ETDEWEB)

    Nour-Eldin, Nour-Eldin A., E-mail: nour410@hotmail.com [Institute for Diagnostic and Interventional Radiology, Johan Wolfgang Goethe – University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany); Diagnostic and Interventional Radiology Department, Cairo University Hospital, Cairo (Egypt); Alsubhi, Mohammed [Institute for Diagnostic and Interventional Radiology, Johan Wolfgang Goethe – University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany); Naguib, Nagy N. [Institute for Diagnostic and Interventional Radiology, Johan Wolfgang Goethe – University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany); Diagnostic and Interventional Radiology Department, Alexandria University Hospital, Alexandria (Egypt); Lehnert, Thomas; Emam, Ahmed; Beeres, Martin; Bodelle, Boris; Koitka, Karen; Vogl, Thomas J.; Jacobi, Volkmar [Institute for Diagnostic and Interventional Radiology, Johan Wolfgang Goethe – University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany)

    2014-10-15

    Purpose: To evaluate the risk factors involved in the development of pulmonary hemorrhage complicating CT-guided biopsy of pulmonary lesions in coaxial and non-coaxial techniques. Materials and methods: Retrospective study included CT-guided percutaneous lung biopsies in 650 consecutive patients (407 males, 243 females; mean age 54.6 years, SD: 5.2) from November 2008 to June 2013. Patients were classified according to lung biopsy technique in coaxial group (318 lesions) and non-coaxial group (332 lesions). Exclusion criteria for biopsy were: lesions <5 mm in diameter, uncorrectable coagulopathy, positive-pressure ventilation, severe respiratory compromise, pulmonary arterial hypertension or refusal of the procedure. Risk factors for pulmonary hemorrhage complicating lung biopsy were classified into: (a) patient's related risk factors, (b) lesion's related risk factors and (d) technical risk factors. Radiological assessments were performed by two radiologists in consensus. Mann–Whitney U test and Fisher's exact tests for statistical analysis. p values <0.05 were considered statistically significant. Results: Incidence of pulmonary hemorrhage was 19.6% (65/332) in non-coaxial group and 22.3% (71/318) in coaxial group. The difference in incidence between both groups was statistically insignificant (p = 0.27). Hemoptysis developed in 5.4% (18/332) and in 6.3% (20/318) in the non-coaxial and coaxial groups respectively. Traversing pulmonary vessels in the needle biopsy track was a significant risk factor of the development pulmonary hemorrhage (incidence: 55.4% (36/65, p = 0.0003) in the non-coaxial group and 57.7% (41/71, p = 0.0013) in coaxial group). Other significant risk factors included: lesions of less than 2 cm (p value of 0.01 and 0.02 in non-coaxial and coaxial groups respectively), basal and middle zonal lesions in comparison to upper zonal lung lesions (p = 0.002 and 0.03 in non-coaxial and coaxial groups respectively), increased lesion

  19. Risk factor analysis of pulmonary hemorrhage complicating CT-guided lung biopsy in coaxial and non-coaxial core biopsy techniques in 650 patients

    International Nuclear Information System (INIS)

    Nour-Eldin, Nour-Eldin A.; Alsubhi, Mohammed; Naguib, Nagy N.; Lehnert, Thomas; Emam, Ahmed; Beeres, Martin; Bodelle, Boris; Koitka, Karen; Vogl, Thomas J.; Jacobi, Volkmar

    2014-01-01

    Purpose: To evaluate the risk factors involved in the development of pulmonary hemorrhage complicating CT-guided biopsy of pulmonary lesions in coaxial and non-coaxial techniques. Materials and methods: Retrospective study included CT-guided percutaneous lung biopsies in 650 consecutive patients (407 males, 243 females; mean age 54.6 years, SD: 5.2) from November 2008 to June 2013. Patients were classified according to lung biopsy technique in coaxial group (318 lesions) and non-coaxial group (332 lesions). Exclusion criteria for biopsy were: lesions <5 mm in diameter, uncorrectable coagulopathy, positive-pressure ventilation, severe respiratory compromise, pulmonary arterial hypertension or refusal of the procedure. Risk factors for pulmonary hemorrhage complicating lung biopsy were classified into: (a) patient's related risk factors, (b) lesion's related risk factors and (d) technical risk factors. Radiological assessments were performed by two radiologists in consensus. Mann–Whitney U test and Fisher's exact tests for statistical analysis. p values <0.05 were considered statistically significant. Results: Incidence of pulmonary hemorrhage was 19.6% (65/332) in non-coaxial group and 22.3% (71/318) in coaxial group. The difference in incidence between both groups was statistically insignificant (p = 0.27). Hemoptysis developed in 5.4% (18/332) and in 6.3% (20/318) in the non-coaxial and coaxial groups respectively. Traversing pulmonary vessels in the needle biopsy track was a significant risk factor of the development pulmonary hemorrhage (incidence: 55.4% (36/65, p = 0.0003) in the non-coaxial group and 57.7% (41/71, p = 0.0013) in coaxial group). Other significant risk factors included: lesions of less than 2 cm (p value of 0.01 and 0.02 in non-coaxial and coaxial groups respectively), basal and middle zonal lesions in comparison to upper zonal lung lesions (p = 0.002 and 0.03 in non-coaxial and coaxial groups respectively), increased lesion

  20. CT-guided needle biopsy of lung lesions: A survey of severe complication based on 9783 biopsies in Japan

    International Nuclear Information System (INIS)

    Tomiyama, Noriyuki; Yasuhara, Yoshifumi; Nakajima, Yasuo; Adachi, Shuji; Arai, Yasuaki; Kusumoto, Masahiko; Eguchi, Kenji; Kuriyama, Keiko; Sakai, Fumikazu; Noguchi, Masayuki; Murata, Kiyoshi; Murayama, Sadayuki; Mochizuki, Teruhito; Mori, Kiyoshi; Yamada, Kozo

    2006-01-01

    Purpose: The aim of our study was to update the rate of severe complications following CT-guided needle biopsy in Japan via a mailed survey. Materials and methods: Postal questionnaires regarding CT-guided needle biopsy were sent out to multiple hospitals in Japan. The questions regarded: the total number and duration of CT-guided lung biopsies performed at each hospital, and the complication rates and numbers of pneumothorax, hemothorax, air embolism, tumor seeding, tension pneumothorax and other rare complications. Each severe complication was followed with additional questions. Results: Data from 9783 biopsies was collected from 124 centers. Pneumothorax was the most common complication, and occurred in 2412 (35%) of 6881 cases. A total of 39 (35%) hospitals reported 74 (0.75%) cases with severe complications. There were six cases (0.061%) with air embolism, six cases (0.061%) with tumor seeding at the site of the biopsy route, 10 cases (0.10%) with tension pneumothorax, six cases (0.061%) with severe pulmonary hemorrhage or hemoptysis, nine cases (0.092%) with hemothorax, and 27 cases (0.26%) with others, including heart arrest, shock, and respiratory arrest. From a total of 62 patients with severe complications, 54 patients (0.55%) recovered without sequela, however one patient (0.01%) recovered with hemiplegia due to cerebral infarction, and the remaining seven patients (0.07%) died. Conclusions: This is the first national study documenting severe complications with respect to CT-guided needle biopsy in Japan. The complication rate in Japan is comparable to internationally published figures. We believe this data will improve both clinicians as well as patients understanding of the risk versus benefit of CT-guided needle biopsy, resulting better decisions

  1. Indwelling catheter care

    Science.gov (United States)

    Foley catheter ... You will need to make sure your indwelling catheter is working properly. You will also need to ... not get an infection or skin irritation. Make catheter and skin care part of your daily routine. ...

  2. False coronary dissection with the new Monorail angioplasty balloon catheter.

    Science.gov (United States)

    Esplugas, E; Cequier, A R; Sabaté, X; Jara, F

    1990-01-01

    During percutaneous transluminal coronary angioplasty, the appearance of persistent staining in the vessel by contrast media suggests coronary dissection. We report seven patients in whom a false image of severe coronary dissection was observed during angioplasty performed with the new Monorail balloon catheter. This image emerges at the moment of balloon inflation, is distally located to the balloon, and disappears with balloon catheter deflation. No complications were associated with the appearance of this image.

  3. Value of Micronester coils in port-catheter implantation for continuous hepatic arterial infusion chemotherapy with fixed catheter tip method

    International Nuclear Information System (INIS)

    Yamagami, Takuji; Kato, Takeharu; Hirota, Tatsuya; Yoshimatsu, Rika; Matsumoto, Tomohiro; Nishimura, Tsunehiko; White, Robert I.

    2008-01-01

    To retrospectively evaluate the use of Micronester coils in port-catheter implantation with the fixed catheter tip method in comparison with other previously used coils. The cohort of this study was 143 consecutive patients with unresectable advanced liver cancer for whom a port-catheter system was percutaneously implanted. In the most recent 32 patients, Micronester coils were used for catheter tip fixation. Details of embolic agents for fixation, persistent blood flow beyond the distal end of the indwelling catheter, and complications were compared between cases without and with Micronester coils. In all, percutaneous port-catheter placement was successful. Mean number of coils used for fixation was 4.2 without Micronester coils vs. 2.5 with Micronester coils. N-butyl cyanoacrylate (NBCA)-Lipiodol was additionally used for catheter tip fixation in 85.6% of 111 procedures without Micronester coils and in 50% of 32 using Micronester coils. The gastroduodenal artery beyond the distal end was not detected at the final examination after any procedure. Catheter dislocation occurred in five and hepatic arterial obstruction or severe stenosis in eight. The number of coils used and necessity of NBCA-Lipiodol could be decreased with usage of Micronester coils without decreasing fixation ability compared to other coils. (orig.)

  4. CT-guided vertebroplasty: analysis of technical results, extraosseous cement leakages, and complications in 500 procedures

    Energy Technology Data Exchange (ETDEWEB)

    Pitton, Michael Bernhard; Herber, Sascha; Koch, Ulrike; Oberholzer, Katja; Dueber, Christoph [Johannes Gutenberg-University of Mainz, Department of Diagnostic and Interventional Radiology, Mainz (Germany); Drees, Philip [University Hospital, Johannes Gutenberg-University of Mainz, Department of Orthopedic Surgery, Mainz (Germany)

    2008-11-15

    The aim of this study was to analyze the technical results, the extraosseous cement leakages, and the complications in our first 500 vertebroplasty procedures. Patients with osteoporotic vertebral compression fractures or osteolytic lesions caused by malignant tumors were treated with CT-guided vertebroplasty. The technical results were documented with CT, and the extraosseous cement leakages and periinterventional clinical complications were analyzed as well as secondary fractures during follow-up. Since 2002, 500 vertebroplasty procedures have been performed on 251 patients (82 male, 169 female, age 71.5 {+-} 9.8 years) suffering from osteoporotic compression fractures (n = 217) and/or malignant tumour infiltration (n = 34). The number of vertebrae treated per patient was 1.96 {+-} 1.29 (range 1-10); the numbers of interventions per patient and interventions per vertebra were 1.33 {+-} 0.75 (range 1-6) and 1.01 {+-} 0.10, respectively. The amount of PMMA cement was 4.5 {+-} 1.9 ml and decreased during the 5-year period of investigation. The procedure-related 30-day mortality was 0.4% (1 of 251 patients) due to pulmonary embolism in this case. The procedure-related morbidity was 2.8% (7/251), including one acute coronary syndrome beginning 12 h after the procedure and one missing patellar reflex in a patients with a cement leak near the neuroformen because of osteolytic destruction of the respective pedicle. Additionally, one patient developed a medullary conus syndrome after a fall during the night after vertebroplasty, two patients reached an inadequate depth of conscious sedation, and two cases had additional fractures (one pedicle fracture, one rib fracture). The overall CT-based cement leak rate was 55.4% and included leakages predominantly into intervertebral disc spaces (25.2%), epidural vein plexus (16.0%), through the posterior wall (2.6%), into the neuroforamen (1.6%), into paravertebral vessels (7.2%), and combinations of these and others. During follow

  5. CT-guided vertebroplasty: analysis of technical results, extraosseous cement leakages, and complications in 500 procedures

    International Nuclear Information System (INIS)

    Pitton, Michael Bernhard; Herber, Sascha; Koch, Ulrike; Oberholzer, Katja; Dueber, Christoph; Drees, Philip

    2008-01-01

    The aim of this study was to analyze the technical results, the extraosseous cement leakages, and the complications in our first 500 vertebroplasty procedures. Patients with osteoporotic vertebral compression fractures or osteolytic lesions caused by malignant tumors were treated with CT-guided vertebroplasty. The technical results were documented with CT, and the extraosseous cement leakages and periinterventional clinical complications were analyzed as well as secondary fractures during follow-up. Since 2002, 500 vertebroplasty procedures have been performed on 251 patients (82 male, 169 female, age 71.5 ± 9.8 years) suffering from osteoporotic compression fractures (n = 217) and/or malignant tumour infiltration (n = 34). The number of vertebrae treated per patient was 1.96 ± 1.29 (range 1-10); the numbers of interventions per patient and interventions per vertebra were 1.33 ± 0.75 (range 1-6) and 1.01 ± 0.10, respectively. The amount of PMMA cement was 4.5 ± 1.9 ml and decreased during the 5-year period of investigation. The procedure-related 30-day mortality was 0.4% (1 of 251 patients) due to pulmonary embolism in this case. The procedure-related morbidity was 2.8% (7/251), including one acute coronary syndrome beginning 12 h after the procedure and one missing patellar reflex in a patients with a cement leak near the neuroformen because of osteolytic destruction of the respective pedicle. Additionally, one patient developed a medullary conus syndrome after a fall during the night after vertebroplasty, two patients reached an inadequate depth of conscious sedation, and two cases had additional fractures (one pedicle fracture, one rib fracture). The overall CT-based cement leak rate was 55.4% and included leakages predominantly into intervertebral disc spaces (25.2%), epidural vein plexus (16.0%), through the posterior wall (2.6%), into the neuroforamen (1.6%), into paravertebral vessels (7.2%), and combinations of these and others. During follow-up (15

  6. CT-guided screw fixation of vertical sacral fractures in local anaesthesia using a standard CT; CT-kontrollierte Schraubenosteosynthese von vertikalen Frakturen des hinteren Beckenringes in Lokalanaesthesie

    Energy Technology Data Exchange (ETDEWEB)

    Reuther, G.; Dehne, I. [Thueringen-Klinik, Saalfeld (Germany). Radiologische Klinik; Roehner, U.; Will, T.; Petereit, U. [Thueringen-Klinik, Saalfeld (Germany). Orthopaedics and Trauma Surgery

    2014-12-15

    To evaluate time efficiency, radiation dose, precision and complications of percutaneous iliosacral screw placement under CT-guidance in local anaesthesia. Retrospective analysis of 143 interventions in 135 patients during a period of 42 months. Implant failures could be evaluated in 85/182 screws and bony healing or refracturing in 46/182 screws. A total of 182 iliosacral screw placements in 179 vertical sacral fractures (105 unilateral, 37 bilateral) took place in 135 patients. 166/179 of the sacral fractures were detected in Denis zone 1, 10 in Denis zone 2 and 3 in Denis zone 3. No screw misplacements including the simultaneous bilateral procedures were noted. The average time for a unilateral screw placement was 23 minutes (range: 14-52 minutes) and 35 minutes (range: 21-60 minutes) for simultaneous bilateral screwing. The dose length product was 365 mGy x cm (range: 162-1014 mGy x cm) for the unilateral and 470 mGy x cm (range: 270-1271 mGy x cm) for the bilateral procedure. 1 gluteal bleeding occurred as the only acute minor complication (0.7%). Fracture healing was verified with follow-up CTs in 42/46 sacral fractures after screw placement. Backing out occurred in 12/85 screws between 6 and 69 days after intervention. In 8 patients contralateral stress fractures were detected after unilateral screw placement between day 10 and 127 (average: 48 days). CT-guided iliosacral screw placement in sacral fractures is a safe tool providing a very high precision. The radiation dose is in the order of a diagnostic CT of the pelvis for both unilateral and bilateral screws. Contralateral stress fractures in unilateral screw placements have to be considered during the first weeks after intervention.

  7. CT-guided {sup 125}I brachytherapy for mediastinal metastatic lymph nodes recurrence from esophageal carcinoma: Effectiveness and safety in 16 patients

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Fei, E-mail: gaof@sysucc.org.cn [State Key Laboratory of Oncology in South China, Guangzhou 510060 (China); Department of Interventional Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060 (China); Li, Chuanxing, E-mail: licx@sysucc.org.cn [State Key Laboratory of Oncology in South China, Guangzhou 510060 (China); Department of Interventional Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060 (China); Gu, Yangkui, E-mail: guyk@sysucc.org.cn [State Key Laboratory of Oncology in South China, Guangzhou 510060 (China); Department of Interventional Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060 (China); Huang, Jinhua, E-mail: huangjh@sysucc.org.cn [State Key Laboratory of Oncology in South China, Guangzhou 510060 (China); Department of Interventional Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060 (China); Wu, Peihong, E-mail: vivian-link@163.com [State Key Laboratory of Oncology in South China, Guangzhou 510060 (China); Department of Interventional Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060 (China)

    2013-02-15

    Objectives: To retrospectively evaluate effectiveness and safety of CT-guided {sup 125}I brachytherapy in 16 patients with mediastinal metastatic lymph nodes recurrence from esophageal carcinoma. Materials and methods: Sixteen metastatic lymph nodes in 16 patients were percutaneously treated in 19 {sup 125}I brachytherapy sessions. Each metastatic lymph node was treated with computed tomographic (CT) guidance. Follow-up contrast material-enhanced CT or positron emission tomographic (PET) scans were reviewed and the treatment's effectiveness was evaluated. Results: Months are counted from the first time of {sup 125}I brachytherapy and the median duration of follow-up was 11 months (range, 5–16 months). The local control rates after 3, 6, 10 and 15 months were 75.0, 50.0, 42.9 and 33.3% respectively. At the time of writing, four patients are alive without evidence of recurrence at 16, 9, 16 and 9 months. The 4 patients presented good control of local tumor and no systemic recurrence, and survived throughout the follow-up period. The other 12 patients died of multiple hematogenous metastases 5–15 months after brachytherapy. A small amount of local hematoma occurred in 2 patients that involved applicator insertion through the lung. Two patients presented pneumothorax with pulmonary compression of 30 and 40% after the procedure and recovered after drainage. One patient had minor displacement of radioactive seeds. Severe complications such as massive bleeding and radiation pneumonitis did not occur. Conclusion: {sup 125}I radioactive seed implantation is effective and may be safely applied to mediastinal metastatic lymph nodes recurrence from esophageal carcinoma.

  8. CT-guided biopsies and drainage; CT-gesteuerte Punktionen und Drainagen

    Energy Technology Data Exchange (ETDEWEB)

    Scheppers, I.; Wollschlaeger, D. [Staedtisches Klinikum Karlsruhe gGmbH, Zentralinstitut fuer Bildgebende Diagnostik, Karlsruhe (Germany)

    2011-11-15

    Following the implementation of computed tomography (CT) or ultrasound-guided biopsy of solid tumors and the puncture and drainage of liquid processes, the number of surgical open biopsies and curative operations for abscess drainage has declined. Such CT-guided interventions are performed in nearly every organ. Instead of aspiration biopsies, more and more core biopsies are being performed to allow histopathological evaluation and thus allowing targeted therapy. This article is intended to give a general overview of techniques, materials, indications and contraindications. Ultrasound-guided biopsies as well as large bore vacuum biopsies of the breast are not included in this review. (orig.) [German] Infolge der Durchfuehrung von bildgesteuerten Biopsien solider Raumforderungen und Punktionen mit Drainageeinlage bei liquiden Prozessen ist die Zahl chirurgischer Exzisionsbiopsien und Abszesssanierungen zurueckgegangen. Diese Eingriffe werden in nahezu allen Organgebieten durchgefuehrt. Neben den Aspirationsbiopsien werden haeufig Schneid- oder Stanzbiopsien durchgefuehrt. Nach histologischer und immunhistologischer Untersuchung der hierbei gewonnenen Proben in der Pathologie kann fruehzeitig die nachfolgende Therapie geplant werden. Der vorliegende Beitrag soll einen allgemeinen Ueberblick ueber Methoden, Materialien, Indikationen und Kontraindikationen geben. Die ultraschallgesteuerten Biopsien sowie die Vakuumsaugbiopsien im Rahmen des Mammographiescreenings werden bewusst nicht besprochen. (orig.)

  9. CT-guided stereotaxic implantation of Ommaya reservoir for cystic brain tumor

    Energy Technology Data Exchange (ETDEWEB)

    Nakasato, Nobukazu; Niizuma, Hiroshi; Johkura, Hidefumi; Katoh, Seiya; Otsuki, Taisuke; Katakura, Ryuichi; Suzuki, Jiro

    1988-02-01

    We report the use of CT-guided stereotaxic system to implant Ommaya reservoir in 26 patients with cystic brain tumors consisting of 16 gliomas, 3 craniopharyngiomas, 3 metastatic brain tumors and 5 other and unknown pathologies, on the way of their biopsy. The entire procedure was carried out in the CT room using Leksell's CT stereotaxic system. In 24 cases with supratentorial tumors, it was at the option of the operator to take any approach such as frontal, posterior temporal and parietal approaches. Especially in 3 cases of craniopharyngioma, we inserted the tube into their cyst directly so that the ventricle should not be open to the cyst. Also in cases of a pontine glioma and a C-P angle metastatic tumor, we used retromastoid approach to the posterior fossa by making patient's heads turned about 30 to 40 deg to contralateral side of the approach, with slight flexion of the neck. Minimal bleeding occurred during operation in one case, however, it showed no clinical symptoms. Advantages of this method are as follows: Operative invasion is minimal; The surgeon can check the course of the cannula and position of the tip of Ommaya tube even at operation, and can modify it, if necessary.

  10. Diagnosis of mediastinal neoplasms using mediastinoscopy and CT-guided needle biopsy supported by gene analysis

    International Nuclear Information System (INIS)

    Chiba, Wataru; Sawai, Satoru; Ishida, Hisao; Hanawa, Takeshi; Matsubara, Yoshito; Ikeda, Sadao; Kinoshita, Moritoshi; Ikei, Nobuhiro.

    1993-01-01

    Of 140 cases of mediastinal neoplasms in our hospital, histological diagnosis was confirmed in 129 cases. We examined the methods of preoperative biopsy with those 129 cases. Biopsy had been performed in 25 cases. Mediastinoscopy was performed in seven cases, needle biopsy in eight cases, lymph node biopsy in eight cases, esophageal biopsy using a gastrofiberscope in one case, transbronchial biopsy using a bronchoscope in one case. The true positive rates of those methods were 100% for both mediastinoscopy and lymph node biopsy, and 75% for needle biopsy. Preoperative misdiagnosis occurred in two cases of needle biopsy. The postoperative histological diagnosis was malignant lymphoma in both cases. We performed gene analysis of the immunoglobulin heavy chain gene, light chain κ and λ genes, and the T-cell receptor β gene by use of biopsied specimens, and we found rearrangement bands of these genes in the cases of malignant lymphoma. Therefore, we summarize that gene analysis is a reliable method if malignant lymphoma is suspected. If a needle biopsy is performed under CT guidance, the needle is sure to puncture the tumor. We concluded, therefore, that if a tumor is located in the anterior mediastinum, CT-guided needle biopsy should be performed first of all. Mediastinoscopy is a useful method if the tumor is located in the mid-mediastinum. (author)

  11. CT-guided stereotaxic implantation of Ommaya reservoir for cystic brain tumor

    International Nuclear Information System (INIS)

    Nakasato, Nobukazu; Niizuma, Hiroshi; Johkura, Hidefumi; Katoh, Seiya; Otsuki, Taisuke; Katakura, Ryuichi; Suzuki, Jiro

    1988-01-01

    We report the use of CT-guided stereotaxic system to implant Ommaya reservoir in 26 patients with cystic brain tumors consisting of 16 gliomas, 3 craniopharyngiomas, 3 metastatic brain tumors and 5 other and unknown pathologies, on the way of their biopsy. The entire procedure was carried out in the CT room using Leksell's CT stereotaxic system. In 24 cases with supratentorial tumors, it was at the option of the operator to take any approach such as frontal, posterior temporal and parietal approaches. Especially in 3 cases of craniopharyngioma, we inserted the tube into their cyst directly so that the ventricle should not be open to the cyst. Also in cases of a pontine glioma and a C-P angle metastatic tumor, we used retromastoid approach to the posterior fossa by making patient's heads turned about 30 to 40 deg to contralateral side of the approach, with slight flexion of the neck. Minimal bleeding occurred during operation in one case, however, it showed no clinical symptoms. Advantages of this method are as follows: Operative invasion is minimal; The surgeon can check the course of the cannula and position of the tip of Ommaya tube even at operation, and can modify it, if necessary. (author)

  12. CT-guided iodine-125 seed permanent implantation for recurrent head and neck cancers

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Yu L; Meng, Na; Wang, Jun J; Jiang, Ping [Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191 (China); Yuan, Hui SH; Liu, Chen [Department of Radiology, Peking University Third Hospital, Beijing, 100191 (China); Qu, Ang; Yang, Rui J [Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191 (China)

    2010-07-30

    To investigate the feasibility, and safety of {sup 125}I seed permanent implantation for recurrent head and neck carcinoma under CT-guidance. A retrospective study on 14 patients with recurrent head and neck cancers undergone {sup 125}I seed implantation with different seed activities. The post-plan showed that the actuarial D90 of {sup 125}I seeds ranged from 90 to 218 Gy (median, 157.5 Gy). The follow-up was 3 to 60 months (median, 13 months). The median local control was 18 months (95% CI, 6.1-29.9 months), and the 1-, 2-, 3-, and 5- year local controls were 52%, 39%, 39%, and 39%, respectively. The 1-, 2-, 3-, and 5- survival rates were 65%, 39%, 39% and 39%, respectively, with a median survival time of 20 months (95% CI, 8.7-31.3 months). Of all patients, 28.6% (4/14) died of local recurrence, 7.1% (1/14) died of metastases, one patient died of hepatocirrhosis, and 8 patients are still alive to the date of data analysis. CT-guided {sup 125}I seed implantation is feasible and safe as a salvage or palliative treatment for patients with recurrent head and neck cancers.

  13. The experimental study of CT-guided hepatocyte growth factor gene therapy for cerebral ischemic diseases

    International Nuclear Information System (INIS)

    Zhang Xiaobo; Jin Zhengyu; Li Mingli; Wang Renzhi; Li Guilin; Kong Yanguo; Wang Jianming; Gao Shan; Guan Hongzhi; Wang Detian; Luo Yufeng

    2006-01-01

    Objectives: To investigate the feasibility of CT guided hepatocyte growth factor (HGF) gene therapy for cerebral ischemic diseases. Methods: Human HGF cDNA was ligated to pIRES 2 -EGFP vector. The recombinant plasmid was transfected into the penumbra tissue with liposome, guided by CT perfusion images. After seven days of transfer with recombinant plasmid, the cut sections of rat brain tissues of the treated and control groups were analyzed including immunohistochemistry, vessel count, cerebral blood flow and infarct volume etc. in order to investigate HGF gene expression and biological effect. Results: Enzymatic digestion and electrophoresis confirmed that HGF fragments had been correctly cloned into the space between the BamH I and Sal I sites of pIRES 2 -EGFP. After 7 days of HGF gene transfection, expression of HGF in transfected neurocytes of treated group was observed with immunohistochemistry. The number of vessels in penumbra tissues transfected with HGF vectors and the CBF measured by perfusion CT all were significantly increased than those of the controls (P 2 -EGFP-HGF complexes can transfect the penumbra tissues and definitely express HGF protein. The HGF gene products can stimulate angiogenesis, promote collateral circulation formation and reduce infarct volume in vivo and therefore is beneficial to the treatment of cerebral ischemia. (authors)

  14. CT-guided radiolabelled aerosol studies for assessing pulmonary impairment in children with bronchiectasis

    International Nuclear Information System (INIS)

    Pifferi, M.; Baldini, M.; Caramella, D.; Bartolozzi, C.; Di Mauro, M.; Cangiotti, A.M.

    2000-01-01

    Objective. To determine whether CT-guided mucociliary clearance studies allow differentiation between bronchiectasis associated with primary ciliary dyskinesia (PCD) and those unrelated to congenital or genetically transmitted defects. Materials and methods. Fifteen children aged 4-18 years with a CT diagnosis of bronchiectasis were included in the study. Six had PCD, while in nine cases no congenital disorder was demonstrated. Results. CT showed bronchiectasis in 26 (29 %) of 90 lung regions. Radiolabelled aerosol studies were conducted globally for each lung and on the regions affected by bronchiectasis. Global half-time of activity (t 1/2 ) values of patients with PCD were significantly higher (P 1/2 values. Patients with bronchiectasis unrelated to congenital disorders showed significantly higher regional t 1/2 values in the affected regions with respect to the corresponding global pulmonary t 1/2 (P < 0.06). Conclusions. The combination of morphological CT information with functional data concerning the clearance of radiolabelled aerosol adds to our understanding of pulmonary impairment in children with bronchiectasis. In particular, regional studies allow the recognition of different mucociliary clearance patterns in bronchiectasis associated with PCD and those unrelated to congenital or genetically transmitted defects. (orig.)

  15. CT-guided high-dose-rate brachytherapy of unresectable hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Collettini, Federico; Schreiber, Nadja; Schnapauff, Dirk; Denecke, Timm; Hamm, Bernd; Gebauer, Bernhard; Wust, Peter; Schott, Eckart

    2015-01-01

    The purpose of the present study was to evaluate the clinical outcome of CT-guided high-dose-rate brachytherapy (CT-HDRBT) in patients with unresectable hepatocellular carcinoma (HCC). Over a 6-year period, 98 patients with 212 unresectable HCC underwent CT-HDRBT applying a 192 Ir source at our institution. Magnetic resonance imaging (MRI) follow-up was performed 6 weeks after the intervention and then every 3 months. The primary endpoint was local tumor control (LTC); secondary endpoints included progression-free survival (PFS) and overall survival (OS). Patients were available for MRI evaluation for a mean follow-up of 23.1 months (range 4-64 months; median 20 months). Mean tumor diameter was 5 cm (range 1.8-12 cm). Eighteen of 212 (8.5 %) tumors showed local progression after a mean LTC of 21.1 months. In all, 67 patients (68.4 %) experienced distant tumor progression. The mean PFS was 15.2 months. Forty-six patients died during the follow-up period. Median OS was 29.2 months. Actuarial 1-, 2-, and 3-year OS rates were 80, 62, and 46 %, respectively. CT-HDRBT is an effective therapy to attain local tumor control in patients with unresectable HCC. Prospective randomized studies comparing CT-HDRBT with the standard treatments like Radiofrequency ablation (RFA) and chemoembolization (TACE) are mandatory. (orig.) [de

  16. CT-guided unilateral thalamotomy with macroelectrode mapping for the treatment of Parkinson's disease

    International Nuclear Information System (INIS)

    Valalik, I.; Julow, J.; Sagi, S; Solymosi, D.

    2001-01-01

    Objective. To evaluate the effect of unilateral thalamotomy in patients with Parkinson's disease. Methods. The junction of the ventralis oralis posterior and ventralis intermedius nuclei targeted under CT-guidance, and confirmed by impedance recording and macrostimulation. Results. At the 6-month assessment the tremor has been completely abolished in 37 patients (82.2 %), and reduced in 6 patients (13.3 %). The unified Parkinson's disease rating scale tremor score decreased by 92.5 %, rigidity improved by 65.9 %. Axial symptoms and bradykinesia showed smaller improvement. The levodopa and anti-cholinergic medication significantly reduced. An improvement in the quality of life measured by the Parkinson's disease questionnaire (PDQ-39) has been observed. The dimensions of mobility, activities of daily living, emotional well being, and Stigma were significantly (P < 0.05) better, other changes were not significant. The single index improved from 47.8 ± 7.8 to 28.9 ± 6.3. Transient complications noted in 9 patients (20 %), mild persistent morbidity observed in 3 patients (6.7 %). At the 1, 2 and 3-year follow-up neither contralateral tremor, rigidity, nor bradykinesia progression was statistically significant. Conclusions. CT-guided thalamotomy with macro-electrode mapping provides a safe, effective and long lasting control of tremor and rigidity, reduces the need for medication, and improves the quality of life. (author)

  17. CT-guided core biopsy of malignant lung lesions: how many needle passes are needed?

    International Nuclear Information System (INIS)

    Lim, Chaehun; Han, Dae Hee; Lee, Kyo Young; Kim, Young Kyoon; Ko, Jeong Min

    2013-01-01

    The study aims to determine the number of needle pass in the CT-guided core needle biopsy (CNB) in making a diagnosis of pulmonary malignancy. A total of 434 CNB records were retrospectively reviewed. The specimen obtained from each needle pass was put in a formalin container and then labelled for separate histopathological reporting. The patients were divided into five groups according to the total number of needle passes (n=1, n=2, n=3, n=4 and n≥5). In each of the groups 2–4, it was analysed how many needle passes are required before a plateau in diagnostic yield is achieved. CNB produced 283 true-positive and 23 false-negative diagnosis of malignancy. Cumulative sensitivity significantly (P<0.05) increased between the first and second as well as the second and the third (if done) needle passes, but not between the third and fourth ones. Three coaxial needle passes might be optimal in the diagnosis of lung malignancy.

  18. CT-guided spinal injection: initial experience with Sprotte tip needles

    Energy Technology Data Exchange (ETDEWEB)

    Pua, Uei [Tan Tock Seng Hospital, Department of Diagnostic Radiology, Singapore (Singapore)

    2010-09-15

    The purpose of this paper is to describe our initial experience and to illustrate the potential benefits of using small caliber (25 and 27 G), noncutting pencil point needles (Sprotte) with single puncture coaxial technique in CT-guided spinal intervention (CTSI). From January 2009 to June 2009, Sprotte needles with single puncture coaxial technique were used in a total of ten patients for selective nerve root block (SNRB), facet joint block, and pars block under CT fluoroscopy (total of 16 target structures). All procedures were performed without conscious sedation, and visual analog scale (VAS) scores were recorded to determine pain related to needle placement. Total CT fluoroscopy time and out-of-plane needle deviation were obtained. Final needle position was documented by contrast injection for SNRBs and image capture for joint space cannulation. Sixteen out of the 16 structures were successfully targeted. No increase in VAS scores associated with needle placement was recorded, after infiltration of local anesthesia. Optimal peri-neurograms were obtained in all cases of SNRB, despite the side-hole opening in the Sprotte needles. Mean CT fluoroscopy time was 2 s (range 2-8 s per structure), and there was no case of out-of-plane needle deviation that required adjustment of the CT gantry. The use of small caliber Sprotte needles in CTSI is technically feasible and represents a potential refinement to current techniques in the management of chronic spinal pain. (orig.)

  19. Painful percutaneous transthoracic needle biopsy of Schwannoma: a case report

    International Nuclear Information System (INIS)

    Kim, Sung Hoon; Chun, Kyung Ah; Kim, Young Joo; Park, Seog Hee; Shin, Kyung Sub; Lee, Eun Jung

    1995-01-01

    Percutaneous aspiration needle biopsy of the intrathoracic disease is a safe, easy, and accurate diagnostic method. It usually causes mild pain or discomfort during the procedure. We had a patient who complained of severe sharp pain, well localized at the biopsy site of the target mass during CT-guided transthoracic aspiration biopsy. It was pathologically confirmed as an intrathoracic schwannoma after special staining. To our knowledge, there has been no published report of such a painful percutaneous needle biopsy in a patient with schwannoma in Korea. Two cases were reported in other radiologic journals. The severe sharp pain developed during the transthoracic aspiration needle biopsy is a reliable sign of neurogenic tumor, therefore the participating radiologist should recommend specific immumochemical stain for neurogenic tumor to pathologist

  20. Preoperative Computed Tomography-Guided Percutaneous Hookwire Localization of Metallic Marker Clips in the Breast with a Radial Approach: Initial Experience

    Energy Technology Data Exchange (ETDEWEB)

    Uematsu, T.; Kasami, M.; Uchida, Y.; Sanuki, J.; Kimura, K.; Tanaka, K.; Takahashi, K. [Dept. of Diagnostic Radiology, Dept. of Pathology, and Dept. of Breast Surgery, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka (Japan)

    2007-07-15

    Background: Hookwire localization is the current standard technique for radiological marking of nonpalpable breast lesions. Stereotactic directional vacuum-assisted breast biopsy (SVAB) is of sufficient sensitivity and specificity to replace surgical biopsy. Wire localization for metallic marker clips placed after SVAB is needed. Purpose: To describe a method for performing computed tomography (CT)-guided hookwire localization using a radial approach for metallic marker clips placed percutaneously after SVAB. Material and Methods: Nineteen women scheduled for SVAB with marker-clip placement, CT-guided wire localization of marker clips, and, eventually, surgical excision were prospectively entered into the study. CT-guided wire localization was performed with a radial approach, followed by placement of a localizing marker-clip surgical excision. Feasibility and reliability of the procedure and the incidence of complications were examined. Results: CT-guided wire localization surgical excision was successfully performed in all 19 women without any complications. The mean total procedure time was 15 min. The median distance on CT image from marker clip to hookwire was 2 mm (range 0-3 mm). Conclusion: CT-guided preoperative hookwire localization with a radial approach for marker clips after SVAB is technically feasible.

  1. Preoperative computed tomography-guided percutaneous hookwire localization of metallic marker clips in the breast with a radial approach: initial experience.

    Science.gov (United States)

    Uematsu, T; Kasami, M; Uchida, Y; Sanuki, J; Kimura, K; Tanaka, K; Takahashi, K

    2007-06-01

    Hookwire localization is the current standard technique for radiological marking of nonpalpable breast lesions. Stereotactic directional vacuum-assisted breast biopsy (SVAB) is of sufficient sensitivity and specificity to replace surgical biopsy. Wire localization for metallic marker clips placed after SVAB is needed. To describe a method for performing computed tomography (CT)-guided hookwire localization using a radial approach for metallic marker clips placed percutaneously after SVAB. Nineteen women scheduled for SVAB with marker-clip placement, CT-guided wire localization of marker clips, and, eventually, surgical excision were prospectively entered into the study. CT-guided wire localization was performed with a radial approach, followed by placement of a localizing marker-clip surgical excision. Feasibility and reliability of the procedure and the incidence of complications were examined. CT-guided wire localization surgical excision was successfully performed in all 19 women without any complications. The mean total procedure time was 15 min. The median distance on CT image from marker clip to hookwire was 2 mm (range 0-3 mm). CT-guided preoperative hookwire localization with a radial approach for marker clips after SVAB is technically feasible.

  2. Nursing care for patients with local recurrent rectal cancer after CT-guided 125I seed implantation therapy

    International Nuclear Information System (INIS)

    Yuan Li; Wei Fan; Ren Caifeng; Tu Mingmei; Qian Guixiang

    2010-01-01

    Objective: To discuss the nursing care strategy for patients with local recurrent rectal cancer who has been treated with CT-guided 125 I seed implantation therapy. Methods: Twenty patients with local recurrent rectal cancer received a series of nursing interventions, including comfort care and pain care. The clinical results were observed and analyzed. Results: The therapy was smoothly accomplished in all patients. The pain was remarkably relived and the anxiety was alleviated. No displacement of implanted 125 I seed occurred. Conclusion: For patients with local recurrent rectal cancer occurred after CT-guided 125 I seed implantation therapy, careful nursing can effectively relieve the pain and anxiety feeling,and the living quality can also be markedly improved. (authors)

  3. Percutaneous necrosectomy in patients with acute, necrotizing pancreatitis

    Energy Technology Data Exchange (ETDEWEB)

    Bruennler, T.; Langgartner, J.; Lang, S.; Salzberger, B.; Schoelmerich, J. [University Hospital of Regensburg, Department of Internal Medicine 1, Regensburg (Germany); Zorger, N.; Herold, T.; Feuerbach, S.; Hamer, O.W. [University Hospital of Regensburg, Department of Radiology, Regensburg (Germany)

    2008-08-15

    The objective of this retrospective study was to evaluate the outcome of patients with acute necrotizing pancreatitis treated by active percutaneous necrosectomy. By searching the radiological, surgical and internal medicine databases, all patients with acute necrotizing pancreatitis treated by active percutaneous necrosectomy between 1992 and 2004 were identified. Demographic, laboratory, and clinical data, and details about invasive procedures were collected by reviewing patient charts, radiological and surgical reports. The computed tomography severity index (CTSI) scores were determined by reviewing CT images. Eighteen patients were identified. Median Ranson score on admission was 2. The Acute Physiology and Chronic Health Evaluation (APACHE) II score was median 22. Median CTSI score was 7. Initially all patients were treated with CT-guided drainage placement. Because passive drainage proved not to be effective, subsequent minimally invasive, percutaneous necrosectomy was performed. Eight out of 18 patients recovered fully without the need for surgery. Ten of 18 patients required additional surgical necrosectomy. For one of ten patients, percutaneous necrosectomy allowed postponing surgery by 39 days. Four of ten surgically treated patients died: three from septic multiorgan failure, one from pulmonary embolism. Percutaneous minimally invasive necrosectomy can be regarded as a safe and effective complementary treatment modality in patients with necrotizing pancreatitis. It is suitable for a subset of patients to avoid or delay surgery. (orig.)

  4. Percutaneous necrosectomy in patients with acute, necrotizing pancreatitis

    International Nuclear Information System (INIS)

    Bruennler, T.; Langgartner, J.; Lang, S.; Salzberger, B.; Schoelmerich, J.; Zorger, N.; Herold, T.; Feuerbach, S.; Hamer, O.W.

    2008-01-01

    The objective of this retrospective study was to evaluate the outcome of patients with acute necrotizing pancreatitis treated by active percutaneous necrosectomy. By searching the radiological, surgical and internal medicine databases, all patients with acute necrotizing pancreatitis treated by active percutaneous necrosectomy between 1992 and 2004 were identified. Demographic, laboratory, and clinical data, and details about invasive procedures were collected by reviewing patient charts, radiological and surgical reports. The computed tomography severity index (CTSI) scores were determined by reviewing CT images. Eighteen patients were identified. Median Ranson score on admission was 2. The Acute Physiology and Chronic Health Evaluation (APACHE) II score was median 22. Median CTSI score was 7. Initially all patients were treated with CT-guided drainage placement. Because passive drainage proved not to be effective, subsequent minimally invasive, percutaneous necrosectomy was performed. Eight out of 18 patients recovered fully without the need for surgery. Ten of 18 patients required additional surgical necrosectomy. For one of ten patients, percutaneous necrosectomy allowed postponing surgery by 39 days. Four of ten surgically treated patients died: three from septic multiorgan failure, one from pulmonary embolism. Percutaneous minimally invasive necrosectomy can be regarded as a safe and effective complementary treatment modality in patients with necrotizing pancreatitis. It is suitable for a subset of patients to avoid or delay surgery. (orig.)

  5. CT-Guided Biopsy in Suspected Spondylodiscitis--The Association of Paravertebral Inflammation with Microbial Pathogen Detection.

    Directory of Open Access Journals (Sweden)

    Daniel Spira

    Full Text Available To search for imaging characteristics distinguishing patients with successful from those with futile microbiological pathogen detection by CT-guided biopsy in suspected spondylodiscitis.34 consecutive patients with suspected spondylodiscitis underwent CT-guided biopsy for pathogen detection. MR-images were assessed for inflammatory infiltration of disks, adjacent vertebrae, epidural and paravertebral space. CT-images were reviewed for arrosion of adjacent end plates and reduced disk height. Biopsy samples were sent for microbiological examination in 34/34 patients, and for additional histological analysis in 28/34 patients.Paravertebral infiltration was present in all 10/10 patients with positive microbiology and occurred in only 12/24 patients with negative microbiology, resulting in a sensitivity of 100% and a specificity of 50% for pathogen detection. Despite its limited sensitivities, epidural infiltration and paravertebral abscesses showed considerably higher specificities of 83.3% and 90.9%, respectively. Paravertebral infiltration was more extensive in patients with positive as compared to negative microbiology (p = 0.002. Even though sensitivities for pathogen detection were also high in case of vertebral and disk infiltration, or end plate arrosion, specificities remained below 10%.Inflammatory infiltration of the paravertebral space indicated successful pathogen detection by CT-guided biopsy. Specificity was increased by the additional occurrence of epidural infiltration or paravertebral abscesses.

  6. Effects of a Multidisciplinary Approach to Improve Volume of Diagnostic Material in CT-Guided Lung Biopsies.

    Science.gov (United States)

    Ferguson, Philip E; Sales, Catherine M; Hodges, Dalton C; Sales, Elizabeth W

    2015-01-01

    Recent publications have emphasized the importance of a multidisciplinary strategy for maximum conservation and utilization of lung biopsy material for advanced testing, which may determine therapy. This paper quantifies the effect of a multidisciplinary strategy implemented to optimize and increase tissue volume in CT-guided transthoracic needle core lung biopsies. The strategy was three-pronged: (1) once there was confidence diagnostic tissue had been obtained and if safe for the patient, additional biopsy passes were performed to further increase volume of biopsy material, (2) biopsy material was placed in multiple cassettes for processing, and (3) all tissue ribbons were conserved when cutting blocks in the histology laboratory. This study quantifies the effects of strategies #1 and #2. This retrospective analysis comparing CT-guided lung biopsies from 2007 and 2012 (before and after multidisciplinary approach implementation) was performed at a single institution. Patient medical records were reviewed and main variables analyzed include biopsy sample size, radiologist, number of blocks submitted, diagnosis, and complications. The biopsy sample size measured was considered to be directly proportional to tissue volume in the block. Biopsy sample size increased 2.5 fold with the average total biopsy sample size increasing from 1.0 cm (0.9-1.1 cm) in 2007 to 2.5 cm (2.3-2.8 cm) in 2012 (Pstrategy to CT-guided lung biopsies was effective in significantly increasing tissue volume and number of blocks available for advanced diagnostic testing.

  7. CT-guided lung biopsy: incidence of pneumothorax after instillation of NaCl into the biopsy track

    Energy Technology Data Exchange (ETDEWEB)

    Billich, Christian; Brenner, Gerhard; Schmidt, Stefan A.; Brambs, Hans-Juergen; Pauls, Sandra [University of Ulm, Department of Diagnostic and Interventional Radiology, Ulm (Germany); Muche, Rainer [University of Ulm, Institute of Biometrics, Ulm (Germany); Krueger, Stefan [University of Ulm, Department of Internal Medicine, Ulm (Germany)

    2008-06-15

    This study was conducted to evaluate whether instillation of NaCl 0.9% solution into the biopsy track reduces the incidence of pneumothoraces after CT-guided lung biopsy. A total of 140 consecutive patients with pulmonary lesions were included in this prospective study. All patients were alternatingly assigned to one of two groups: group A in whom the puncture access was sealed by instillation of NaCl 0.9% solution during extraction of the guide needle (n = 70) or group B for whom no sealing was performed (n = 70). CT-guided biopsy was performed with a 18-G coaxial system. Localization of lesion (pleural, peripheral, central), lesion size, needle-pleural angle, rate of pneumothorax and alveolar hemorrhage were evaluated. In group A, the incidence of pneumothorax was lower compared to group B (8%, 6/70 patients vs. 34%, 24/70 patients; P < 0.001). All pneumothoraces occurred directly post punctionem after extraction of the guide needle. One patient in group A and eight patients in group B developed large pneumothoraces requiring chest tube placement (P = 0.01). The frequency of pneumothorax was independent of other variables. After CT-guided biopsy, instillation of NaCl 0.9% solution into the puncture access during extraction of the needle significantly reduces the incidence of pneumothorax. (orig.)

  8. CT-guided lung biopsy: incidence of pneumothorax after instillation of NaCl into the biopsy track

    International Nuclear Information System (INIS)

    Billich, Christian; Brenner, Gerhard; Schmidt, Stefan A.; Brambs, Hans-Juergen; Pauls, Sandra; Muche, Rainer; Krueger, Stefan

    2008-01-01

    This study was conducted to evaluate whether instillation of NaCl 0.9% solution into the biopsy track reduces the incidence of pneumothoraces after CT-guided lung biopsy. A total of 140 consecutive patients with pulmonary lesions were included in this prospective study. All patients were alternatingly assigned to one of two groups: group A in whom the puncture access was sealed by instillation of NaCl 0.9% solution during extraction of the guide needle (n 70) or group B for whom no sealing was performed (n = 70). CT-guided biopsy was performed with a 18-G coaxial system. Localization of lesion (pleural, peripheral, central), lesion size, needle-pleural angle, rate of pneumothorax and alveolar hemorrhage were evaluated. In group A, the incidence of pneumothorax was lower compared to group B (8%, 6/70 patients vs. 34%, 24/70 patients; P < 0.001). All pneumothoraces occurred directly post punctionem after extraction of the guide needle. One patient in group A and eight patients in group B developed large pneumothoraces requiring chest tube placement (P 0.01). The frequency of pneumothorax was independent of other variables. After CT-guided biopsy, instillation of NaCl 0.9% solution into the puncture access during extraction of the needle significantly reduces the incidence of pneumothorax. (orig.)

  9. The short- and medium-term effectiveness of CT-guided selective cervical nerve root injection for pain and disability

    Energy Technology Data Exchange (ETDEWEB)

    Desai, Amidevi; Saha, Shouvik; Sharma, Naveen; Huckerby, Lauren; Houghton, Russell [Guy' s and St. Thomas' Hospitals, Department of Radiology, London (United Kingdom)

    2014-07-15

    CT-guided cervical nerve root injection with corticosteroid and/or local anesthetic is a recognized technique in the evaluation and treatment of cervical radiculopathy. There are few prospective studies on the efficacy of the various techniques employed in cervical nerve root injection. We present our results from a 1-year prospective series using a CT-guided anterolateral transforaminal approach for cervical nerve root injection of bupivacaine and dexamethasone. Pain using a numeric rating scale was assessed at pre-injection, 15 min post-injection, 1 month, and 3 months. Disability was assessed using the Oswestry Neck Disability Index (NDI) questionnaire at pre-injection, 1 month post-injection, and 3 months. In total, 50 patients were followed for 3 months. The mean reductions in pain were: 15 min (77 %), 1 month (39 %), and 3 months (33 %). The mean reductions in NDI were: 1 month (26 %) and 3 months (also 26 %). Results were statistically significant. CT-guided selective cervical nerve root injection in the treatment of cervical radicular pain and related disability produces statistically significant reductions in pain and disability to at least 3 months post-procedure. (orig.)

  10. Three-dimensional C-arm CT-guided transjugular intrahepatic portosystemic shunt placement: Feasibility, technical success and procedural time

    Energy Technology Data Exchange (ETDEWEB)

    Ketelsen, Dominik; Groezinger, Gerd; Maurer, Michael; Grosse, Ulrich; Horger, Marius; Nikolaou, Konstantin; Syha, Roland [University of Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Lauer, Ulrich M. [University of Tuebingen, Internal Medicine I, Department of Gastroenterology, Hepatology and Infectious disease, Tuebingen (Germany)

    2016-12-15

    Establishment of transjugular intrahepatic portosystemic shunts (TIPS) constitutes a standard procedure in patients suffering from portal hypertension. The most difficult step in TIPS placement is blind puncture of the portal vein. This study aimed to evaluate three-dimensional mapping of portal vein branches and targeted puncture of the portal vein. Twelve consecutive patients suffering from refractory ascites by liver cirrhosis were included in this retrospective study to evaluate feasibility, technical success and procedural time of C-arm CT-targeted puncture of the portal vein. As a control, 22 patients receiving TIPS placement with fluoroscopy-guided blind puncture were included to compare procedural time. Technical success could be obtained in 100 % of the study group (targeted puncture) and in 95.5 % of the control group (blind puncture). Appropriate, three-dimensional C-arm CT-guided mapping of the portal vein branches could be achieved in all patients. The median number of punctures in the C-arm CT-guided study group was 2 ± 1.3 punctures. Procedural time was significantly lower in the study group (14.8 ± 8.2 min) compared to the control group (32.6 ± 22.7 min) (p = 0.02). C-arm CT-guided portal vein mapping is technically feasible and a promising tool for TIPS placement resulting in a significant reduction of procedural time. (orig.)

  11. The short- and medium-term effectiveness of CT-guided selective cervical nerve root injection for pain and disability

    International Nuclear Information System (INIS)

    Desai, Amidevi; Saha, Shouvik; Sharma, Naveen; Huckerby, Lauren; Houghton, Russell

    2014-01-01

    CT-guided cervical nerve root injection with corticosteroid and/or local anesthetic is a recognized technique in the evaluation and treatment of cervical radiculopathy. There are few prospective studies on the efficacy of the various techniques employed in cervical nerve root injection. We present our results from a 1-year prospective series using a CT-guided anterolateral transforaminal approach for cervical nerve root injection of bupivacaine and dexamethasone. Pain using a numeric rating scale was assessed at pre-injection, 15 min post-injection, 1 month, and 3 months. Disability was assessed using the Oswestry Neck Disability Index (NDI) questionnaire at pre-injection, 1 month post-injection, and 3 months. In total, 50 patients were followed for 3 months. The mean reductions in pain were: 15 min (77 %), 1 month (39 %), and 3 months (33 %). The mean reductions in NDI were: 1 month (26 %) and 3 months (also 26 %). Results were statistically significant. CT-guided selective cervical nerve root injection in the treatment of cervical radicular pain and related disability produces statistically significant reductions in pain and disability to at least 3 months post-procedure. (orig.)

  12. An experimental study about efficacy of the drain catheters

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Bum Gyu; Nho, Joon Young; Woo, Hyo Cheol; Hwang, Woo Cheol; Park, Choong Ki; Yoon, Jong Sup [Hallym University College of Medicine, Seoul (Korea, Republic of)

    1993-09-15

    Although percutaneous abscess drainage has become and accepted alternative from of therapy for selected patients with abscess, it is well known that there are several factors in the failure of adequate drainage such as pre- and post-procedural management, technique itself, various features of abscess, and selection and application of catheters. Among these factors, we made an experiment about drainage efficacy of commonly used various catheters with different viscosities of water-glycerin solution under the two different pressure gradients. The experimental values of flow rate were very lower than the calculated values. An efficacy of experimental value was 4-14%. Because the inner diameter of fittings and stopcocks was usually smaller than the inner diameter of catheters, these factors also affected the drain efficacy. Finally, we thought that it will be very helpful to the treatment of patient as well as to study about the catheter drainage, if the drain efficacy of individual catheters has been notified.

  13. Preventing Inadvertent Placement of Foley Catheter into Prostatic ...

    African Journals Online (AJOL)

    Percutaneous suprapubic trocar cystostomy (SPC) is often needed to drain the bladder when urethral catheterization either fails or is not advisable.[1] It is ... vertical or slightly tilting its tip toward umbilicus during foley placement, prevents the inadvertent migration of catheter into prostatic urethra and further complications.

  14. Design and validation of a CT-guided robotic system for lung cancer brachytherapy.

    Science.gov (United States)

    Dou, Huaisu; Jiang, Shan; Yang, Zhiyong; Sun, Luqing; Ma, Xiaodong; Huo, Bin

    2017-09-01

    Currently, lung brachytherapy in clinical setting is a complex procedure. Operation accuracy depends on accurate positioning of the template; however, it is difficult to guarantee the positioning accuracy manually. Application of robotic-assisted systems can simplify the procedure and improve the manual positioning accuracy. Therefore, a novel CT-guided robotic system was developed to assist the lung cancer brachytherapy. A four degree-of-freedom (DOF) robot, controlled by a lung brachytherapy treatment planning system (TPS) software, was designed and manufactured to assist the template positioning. Target position of the template can be obtained from the treatment plan, thus the robot is driven to the target position automatically. The robotic system was validated in both the laboratory and the CT environment. In laboratory environment, a 3D laser tracker and an inertial measurement unit (IMU) were used to measure the mechanical accuracy in air, which includes positioning accuracy and position repeatability. Working reliability was also validated in this procedure by observing the response reliability and calculating the position repeatability. Imaging artifacts and accuracy of the robot registration were validated in the CT environment by using an artificial phantom with fiducial markers. CT images were obtained and used to test the image artifact and calculate the registration accuracy. Phantom experiments were conducted to test the accuracy of needle insertion by using a transparent hydrogel phantom with a high imitation artificial phantom. Also, the efficiency was validated in this procedure by comparing time costs in manual positioning with robotic positioning under the same experimental conditions. The robotic system achieved the positioning accuracy of 0.28 ± 0.25 mm and the position repeatability of 0.09 ± 0.11 mm. Experimental results showed that the robot was CT-compatible and responded reliably to the control commands. The mean registration accuracy

  15. Clinical Outcomes of Patients Receiving Integrated PET/CT-Guided Radiotherapy for Head and Neck Carcinoma

    International Nuclear Information System (INIS)

    Vernon, Matthew R.; Maheshwari, Mohit; Schultz, Christopher J.; Michel, Michelle A.; Wong, Stuart J.; Campbell, Bruce H.; Massey, Becky L.; Wilson, J. Frank; Wang Dian

    2008-01-01

    Purpose: We previously reported the advantages of 18 F-fluorodeoxyglucose-positron emission tomography (PET) fused with CT for radiotherapy planning over CT alone in head and neck carcinoma (HNC). The purpose of this study was to evaluate clinical outcomes and the predictive value of PET for patients receiving PET/CT-guided definitive radiotherapy with or without chemotherapy. Methods and Materials: From December 2002 to August 2006, 42 patients received PET/CT imaging as part of staging and radiotherapy planning. Clinical outcomes including locoregional recurrence, distant metastasis, death, and treatment-related toxicities were collected retrospectively and analyzed for disease-free and overall survival and cumulative incidence of recurrence. Results: Median follow-up from initiation of treatment was 32 months. Overall survival and disease-free survival were 82.8% and 71.0%, respectively, at 2 years, and 74.1% and 66.9% at 3 years. Of the 42 patients, seven recurrences were identified (three LR, one DM, three both LR and DM). Mean time to recurrence was 9.4 months. Cumulative risk of recurrence was 18.7%. The maximum standard uptake volume (SUV) of primary tumor, adenopathy, or both on PET did not correlate with recurrence, with mean values of 12.0 for treatment failures vs. 11.7 for all patients. Toxicities identified in those patients receiving intensity modulated radiation therapy were also evaluated. Conclusions: A high level of disease control combined with favorable toxicity profiles was achieved in a cohort of HNC patients receiving PET/CT fusion guided radiotherapy plus/minus chemotherapy. Maximum SUV of primary tumor and/or adenopathy was not predictive of risk of disease recurrence

  16. Clinical efficacy of CT-guided 125I seed implantation therapy for advanced pancreatic cancer

    International Nuclear Information System (INIS)

    Wang Zhongmin; Lu Jian; Gong Ju; Zheng Yunfeng; Zhang Liyun; Huang Gang; Chen Kemin

    2009-01-01

    Objective: To discuss the clinical efficacy of CT-guided radioactive 125 I seed implantation treatment for unresectable pancreatic cancer. Methods: Forty patients with inoperable pancreatic cancer were enrolled in this study, including 25 males and 15 females with an median age of 69 years (38-89 years). Treatment planning system (TPS) was used to reconstruct 3-dimensional images of pancreatic tumor and to define the quantity and distribution of 125 I seeds. The radioactivity of 125 I seeds was 0.5 - 0.8 mCi / seed. The seeds were implanted into pancreatic tumor under CT guidance at intervals of 1 cm and were kept away from vessels, pancreatic duct and other adjacent important organs. The tumor matched peripheral dose (MPD) was 60-140 Gy. The median amount of implanted 125 I seeds was 36 (18-68) in number. CT scan was performed immediately after the procedure to check the quality of the seeds. In addition, 10 patients received concurrent chemotherapy with arterial infusion of gemcitabin and 5-fluororacil (5-Fu) for 3 to 4 therapeutic courses. Results: The median diameter of the tumors was 4.9 cm. The follow-up period was 2 to 28 months. After the treatment the refractory pain was significantly relieved (P 125 I seed implantation is a safe, effective and minimally-invasive brachytherapy for unresectable pancreatic cancer with reliable short-term efficacy. It has an excellent anti-pain effect. The curative results can be further improved when chemotherapy is employed together. However, its long-term efficacy needs to be observed. (authors)

  17. CT -guided sclerotherapy for simple renal cysts: Value of ethanol concentration monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Jin Hong; Du, Yong; Li, Yang; Yang, Han Feng; Xu, Xiao Xue; Zheng, Hou Jun [The Affiliated Hospital of North Sichuan Medical College, Nanchong (China)

    2014-02-15

    The aim of our study was to evaluate the differences between sclerotherapy with and without ethanol concentration monitoring for the treatment of simple renal cysts. Sixty-seven patients with 70 simple renal cysts were randomly assigned to two groups in a 12-month prospective controlled trial. One group (group A) was treated with computed tomography (CT)-guided sclerotherapy without ethanol concentration monitoring (33 patients with 35 cysts), whereas the other group (group B) had ethanol concentration monitoring (34 patients with 35 cysts) during the procedure. Treatment outcomes between the two groups were compared 12 months later with follow-up ultrasound examination. After the 12-month follow-up period, the overall success rate was 74.3% in group A and 94.3% in group B (p = 0.022). The mean cyst size before and after treatment was 8.6 ± 2.0 cm and 2.3 ± 2.9 cm, respectively, in group A, and 8.4 ± 1.7 cm and 0.8 ± 1.9 cm, respectively, in group B. The final size of the cysts in group B was significantly smaller than that in group A (p = 0.015). The likelihood of treatment with ethanol concentration monitoring being successful was approximately 16 times higher than without ethanol concentration monitoring (p = 0.026; odds ratio = 15.7; 95% confidence interval: 1.38-179.49). There were no major complications in either group. Monitoring of Hounsfield units (HU) of ethanol by CT is an effective method in the treatment of simple renal cysts with ethanol sclerotherapy. The ethanol sclerotherapy procedure can be terminated at the point of clear fluid aspiration because the HU (-190) of CT scan corresponds to it.

  18. Smartphone-Guided Needle Angle Selection During CT-Guided Procedures.

    Science.gov (United States)

    Xu, Sheng; Krishnasamy, Venkatesh; Levy, Elliot; Li, Ming; Tse, Zion Tsz Ho; Wood, Bradford John

    2018-01-01

    In CT-guided intervention, translation from a planned needle insertion angle to the actual insertion angle is estimated only with the physician's visuospatial abilities. An iPhone app was developed to reduce reliance on operator ability to estimate and reproduce angles. The iPhone app overlays the planned angle on the smartphone's camera display in real-time based on the smartphone's orientation. The needle's angle is selected by visually comparing the actual needle with the guideline in the display. If the smartphone's screen is perpendicular to the planned path, the smartphone shows the Bull's-Eye View mode, in which the angle is selected after the needle's hub overlaps the tip in the camera. In phantom studies, we evaluated the accuracies of the hardware, the Guideline mode, and the Bull's-Eye View mode and showed the app's clinical efficacy. A proof-of-concept clinical case was also performed. The hardware accuracy was 0.37° ± 0.27° (mean ± SD). The mean error and navigation time were 1.0° ± 0.9° and 8.7 ± 2.3 seconds for a senior radiologist with 25 years' experience and 1.5° ± 1.3° and 8.0 ± 1.6 seconds for a junior radiologist with 4 years' experience. The accuracy of the Bull's-Eye View mode was 2.9° ± 1.1°. Combined CT and smart-phone guidance was significantly more accurate than CT-only guidance for the first needle pass (p = 0.046), which led to a smaller final targeting error (mean distance from needle tip to target, 2.5 vs 7.9 mm). Mobile devices can be useful for guiding needle-based interventions. The hardware is low cost and widely available. The method is accurate, effective, and easy to implement.

  19. MRI study for CT-guided stereotactic aspiration of intracerebral hematoma

    International Nuclear Information System (INIS)

    Takahashi, Toshie; Okada, Hitoshi; Kaneko, Uichi; Nishino, Akiko; Ueno, Shinji; Owada, Yuji.

    1994-01-01

    Twenty-five patients with acute hypertensive intracerebral hematomas, diagnosed by computed tomography (CT), underwent CT-guided stereotactic aspiration. Magnetic resonance (MR) images were obtained immediately before aspiration, using T 1 -weighted (TR=500 msec, TE=15 msec) and T 2 -weighted (TR=2500 msec, TE=120 msec) sequences and a 0.5 Tesla MR system. On the basis of the MR images the hematomas were divided into peripheral, central, and core segments. The signal intensities were divided into seven grades based on the comparison with white matter. The sequential changes in each segment on the MR images were evaluated, and the ratio of hematoma removal vs. size of residual hematoma was assessed by preoperative MR imaging and pre-and post-operative CT. The hematomas were located in the putamen in 13 cases, the thalamus in 8, combined in 2, and subcortex in 2. The hematomas, targeted in their centers, were evacuated by the aspiration procedure alone, 1 to 12 days after onset (day 0=day of onset). The results were as follows : 1) The proportion of hematomas removed was high after day 4. 2) Sequential T 1 -weighted images showed that the peripheral segments gradually increased in signal intensity, appearing as high-intensity rings that gradually filled and could be easily aspirated. 3) In those cases in which sequential T 2 -weighted images showed the central segments gradually increasing in signal intensity, the hematomas were easily aspirated if the signal was either iso-intense or hyper-intense. 4) Several hematomas had a core that appeared as a high intensity signal on T1-weighted images and as a low intensity signal on T 2 -weighted images; these hematomas could not be aspirated. (author)

  20. Initial experience of Fag-PET/CT guided Imr of head-and-neck carcinoma

    International Nuclear Information System (INIS)

    Wang Dian; Schultz, Christopher J.; Jursinic, Paul A.; Bialkowski, Mirek; Zhu, X. Ronald; Brown, W. Douglas; Rand, Scott D.; Michel, Michelle A.; Campbell, Bruce H.; Wong, Stuart; Li, X. Allen; Wilson, J. Frank

    2006-01-01

    Purpose: The purpose of this study is to evaluate the impact of 18 F-fluorodeoxyglucose positron emission tomography (Fag-PET) fused with planning computed tomography (CT) on tumor localization, which guided intensity-modulated radiotherapy (Imr) of patients with head-and-neck carcinoma. Methods and Materials: From October 2002 through April 2005, we performed Fag-PET/CT guided Imr for 28 patients with head-and-neck carcinoma. Patients were immobilized with face masks that were attached with five fiducial markers. Fag-PET and planning CT scans were performed on the same flattop table in one session and were then fused. Target volumes and critical organs were contoured, and Imr plans were generated based on the fused images. Results: All 28 patients had abnormal increased uptake in Fag-PET/CT scans. PET/CT resulted in CT-based staging changes in 16 of 28 (57%) patients. PET/CT fusions were successfully performed and were found to be accurate with the use of the two commercial planning systems. Volume analysis revealed that the PET/CT-based gross target volumes (GTVs) were significantly different from those contoured from the CT scans alone in 14 of 16 patients. In addition, 16 of 28 patients who were followed for more than 6 months did not have any evidence of locoregional recurrence in the median time of 17 months. Conclusion: Fused images were found to be useful to delineate GTV required in IMRT planning. PET/CT should be considered for both initial staging and treatment planning in patients with head-and-neck carcinoma