Computed-tomography-guided punctures using a new guidance device

2005 ◽  
Vol 46 (5) ◽  
pp. 505-509 ◽  
Author(s):  
A. Magnusson ◽  
E. Radecka ◽  
M. Lönnemark ◽  
H. Raland
Keyword(s):  
Computed Tomography ◽  
Entry Point ◽  
Maximum Diameter ◽  
Ct Guided ◽  
New Device ◽  
Needle Path ◽  
Laser Guide ◽  
Pelvic Lesions ◽  
Guidance Device

Purpose: To evaluate a new adjunctive guidance device, a puncture guide, constructed to simplify computed tomography (CT)-guided punctures and to make the procedure more accurate and safe. Material and Methods: 17 patients referred for CT-guided punctures were included in the study. There were 10 thoracic and 7 abdominal or pelvic lesions with a mean maximum diameter of 29±18 mm. All punctures were performed using a laser guide combined with the new device. The needle guide created a streak artefact in the image, indicating the needle path. Results: The puncture was successful at the first attempt in 15 of the 17 patients. The artefact was visible in all patients, and in the majority there was a distinct artefact reaching from the entry point to the lesion. The deviation between the angle of the streak artefact and the final angle of the needle was 1.1°. Conclusion: The benefits of the puncture guide were the artefact pointing at the target, the needle support, and accuracy when performing CT-guided punctures.

scholarly journals Computed tomography-guided percutaneous biopsy of head and neck masses: techniques, outcomes, and complications

2021 ◽  
Vol 54 (5) ◽  
pp. 295-302
Author(s):  
Mauricio Kauark Amoedo ◽  
Chiang Jeng Tyng ◽  
Paula Nicole Vieira Pinto Barbosa ◽  
Rayssa Araruna Bezerra de Melo ◽  
Maria Fernanda Arruda Almeida ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Head And Neck ◽  
Histological Analysis ◽  
False Negative ◽  
Maximum Diameter ◽  
Related Factor ◽  
Ct Guided ◽  
Core Needle ◽  
Neck Masses ◽  
Head And Neck Masses

Abstract Objective: To assess the technique, efficacy, and safety of computed tomography (CT)-guided percutaneous biopsies of head and neck masses. Materials and Methods: This was a retrospective, single-center study of CT-guided percutaneous core-needle biopsies of head and neck masses. For the analysis of diagnostic accuracy, biopsy results were compared with the final diagnosis, which was determined by histological examination and clinical follow-up. Results: We evaluated 74 biopsies performed in 68 patients. The mean age of the patients was 55.6 years. Most of the lesions (79.7%) were located in the suprahyoid region, and the maximum diameter ranged from 11 mm to 128 mm. The most common approaches were paramaxillary (in 32.4%), retromandibular (in 21.6%), and periorbital (in 14.9%). Five patients (6.8%) developed minor complications. The presence of a complication did not show a statistically significant association with any clinical, radiological, or procedure-related factor. Sufficient material for histological analysis was obtained in all procedures. Thirty-eight biopsies (51.4%) yielded a histological diagnosis of malignancy. There was a false-negative result in three cases (8.3%), and there were no false-positive results. The procedure had a sensitivity of 92.7%, a specificity of 100%, and an accuracy of 96.0%. Conclusion: Our results demonstrate that CT-guided percutaneous core-needle biopsy of head and neck lesions is a safe, effective procedure for obtaining biological material for histological analysis.

scholarly journals Soft-Tip Stylet and Saline Instillation Technique: Making Difficult Percutaneous CT-Guided Biopsies Possible

2022 ◽  
Author(s):  
Zafar Neyaz
Keyword(s):  
Computed Tomography ◽  
Medical Literature ◽  
Full Potential ◽  
Fatty Tissue ◽  
Ct Guided ◽  
Needle Path ◽  
Guided Biopsy ◽  
Educational Exhibit ◽  
Saline Instillation ◽  
Vital Structure

AbstractFinding a safe needle path during percutaneous computed tomography-guided biopsy is sometimes difficult due to concern for injuring a vital structure. Saline instillation technique has been used to displace the structure out of the way. Another useful tool is a soft-tip stylet. A soft-tip also referred as blunt-tip stylet for the introducer cannula is provided with some coaxial biopsy sets in additional to standard sharp-tip stylet. While the sharp-tip stylet is fitted with introducer cannula for piercing skin, muscle, and fascia, a soft-tip stylet may be used for avoiding injury to structures like vessels and bowel loops especially while advancing introducer cannula through fatty tissue. Additionally, it is also useful for avoiding injury to nerves and giving pleural anesthesia. Although its use has been described in medical literature, many radiologists are still not utilizing this tool to its full potential. In this educational exhibit, various applications of soft-tip stylet and saline instillation technique have been depicted using representative cases.

scholarly journals Phantom study for comparison between computed tomography- and C-Arm computed tomography-guided puncture applied by residents in radiology

2021 ◽  
Author(s):  
Timo C. Meine ◽  
Jan B. Hinrichs ◽  
Thomas Werncke ◽  
Saif Afat ◽  
Lorenz Biggemann ◽  
...  
Keyword(s):  
Computed Tomography ◽  
The Self ◽  
Ct Guidance ◽  
Spatial Skills ◽  
Ct Guided ◽  
Needle Path ◽  
Manual Skills ◽  
Level Of Training ◽  
Guided Puncture ◽  
Navigation Software

Purpose Comparison of puncture deviation and puncture duration between computed tomography (CT)- and C-arm CT (CACT)-guided puncture performed by residents in training (RiT). Methods In a cohort of 25 RiTs enrolled in a research training program either CT- or CACT-guided puncture was performed on a phantom. Prior to the experiments, the RiT’s level of training, experience playing a musical instrument, video games, and ball sports, and self-assessed manual skills and spatial skills were recorded. Each RiT performed two punctures. The first puncture was performed with a transaxial or single angulated needle path and the second with a single or double angulated needle path. Puncture deviation and puncture duration were compared between the procedures and were correlated with the self-assessments. Results RiTs in both the CT guidance and CACT guidance groups did not differ with respect to radiologic experience (p = 1), angiographic experience (p = 0.415), and number of ultrasound-guided puncture procedures (p = 0.483), CT-guided puncture procedures (p = 0.934), and CACT-guided puncture procedures (p = 0.466). The puncture duration was significantly longer with CT guidance (without navigation tool) than with CACT guidance with navigation software (p < 0.001). There was no significant difference in the puncture duration between the first and second puncture using CT guidance (p = 0.719). However, in the case of CACT, the second puncture was significantly faster (p = 0.006). Puncture deviations were not different between CT-guided and CACT-guided puncture (p = 0.337) and between the first and second puncture of CT-guided and CACT-guided puncture (CT: p = 0.130; CACT: p = 0.391). The self-assessment of manual skills did not correlate with puncture deviation (p = 0.059) and puncture duration (p = 0.158). The self-assessed spatial skills correlated positively with puncture deviation (p = 0.011) but not with puncture duration (p = 0.541). Conclusion The RiTs achieved a puncture deviation that was clinically adequate with respect to their level of training and did not differ between CT-guided and CACT-guided puncture. The puncture duration was shorter when using CACT. CACT guidance with navigation software support has a potentially steeper learning curve. Spatial skills might accelerate the learning of image-guided puncture. Key Points:  Citation Format

scholarly journals Aortic dissection during transoesophageal echocardiography: a case report

2020 ◽  
Author(s):  
Rin Hoshina ◽  
Hideyuki Kishima ◽  
Takanao Mine ◽  
Masaharu Ishihara
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Aortic Dissection ◽  
Right Coronary Artery ◽  
Bypass Graft ◽  
Transoesophageal Echocardiography ◽  
Ascending Aorta ◽  
Maximum Diameter ◽  
Abnormal Finding ◽  
The Right

Abstract Background Transoesophageal echocardiography (TOE) is a safe and useful tool. In our case, we are presenting a rare case of a patient with aortic dissection during TOE procedure. Case summary A 79-year-old woman was referred to our hospital for recurrent paroxysmal atrial fibrillation (AF) with palpitation. Pre-procedural cardiac computed tomography (CT) showed slight dilated ascending aorta (maximum diameter: 40 mm). We decided to perform catheter ablation (CA) for AF, and recommended TOE before the CA because she had a CHADS2 score of 4. On the day before the CA, TOE was performed. Her physical examinations at the time of TOE procedure were unremarkable. At 3 min after probe insertion, there was no abnormal finding of the ascending aorta. At 5 min after the insertion, TOE showed ascending aortic dissection without pericardial effusion. After waking, she had severe back pain and underwent a contrast-enhanced CT. Computed tomography demonstrated Stanford type A aortic dissection extending from the aortic root to the bifurcation of common iliac arteries, and tight stenosis in the right coronary artery (maximum diameter; 49 mm). The patient underwent a replacement of the ascending aorta, and a coronary artery bypass graft surgery for the right coronary artery. Discussion Transoesophageal echocardiography would have to be performed under sufficient sedation with continuous blood pressure monitoring in patients who have risk factors of aortic dissection. The risk–benefit of TOE must be considered before a decision is made. Depending on the situation, another modality instead of TOE might be required.

scholarly journals Isolated iliac artery aneurysm in association with congenital pelvic kidney treated with iliac branch device: case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Guilherme Centofanti ◽  
Kenji Nishinari ◽  
Bruna De Fina ◽  
Rafael Noronha Cavalcante ◽  
Mariana Krutman ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Iliac Artery ◽  
Computed Tomography Angiography ◽  
Common Iliac Artery ◽  
Artery Aneurysm ◽  
Maximum Diameter ◽  
Pelvic Kidney ◽  
Iliac Artery Aneurysm ◽  
Left Common Iliac Artery ◽  
Common Iliac Artery Aneurysm

Abstract Background Association of abdominal aortic aneurysm with congenital pelvic kidney is rare and association with isolated iliac artery aneurysm is not yet described in the literature. Case presentation We present a case of successful repair of an isolated common iliac artery aneurysm associated with a congenital pelvic kidney treated by an endovascular technique. A 75-year-old man was referred for the treatment of an asymptomatic left common iliac artery aneurysm. A computed tomography angiography revealed an isolated left common iliac artery aneurysm and a left pelvic kidney. The maximum diameter of the aneurysm was 32 mm. The congenital pelvic kidney was supplied by three small superior polar arteries that emerged from the proximal non-aneurysmal portion of the common iliac artery and the main artery that arose from the left internal iliac artery. The aneurysm exclusion was accomplished by using an iliac branch device (Gore Excluder Iliac Branch, Flagstaff, AZ). The 1 and 6 months computed tomography angiography after the procedure demonstrated complete exclusion of the aneurysm and preservation of all renal arteries. Conclusion Treating patients with an association of iliac artery aneurysms and pelvic kidneys can be a challenge due the variable arterial anatomy. The use of iliac branch device is a safe and effective alternative in selected cases.

scholarly journals Safety and reliability of computed tomography-guided lipiodol marking for undetectable pulmonary lesions

2020 ◽  
Vol 30 (4) ◽  
pp. 546-551
Author(s):  
Kazuhiro Ito ◽  
Junichi Shimada ◽  
Masanori Shimomura ◽  
Kunihiko Terauchi ◽  
Motohiro Nishimura ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lesion Size ◽  
Ct Guided ◽  
Pulmonary Lesions ◽  
Pleural Surface ◽  
Intraoperative Fluoroscopy ◽  
Safety And Reliability ◽  
Preoperative Ct ◽  
The Mean ◽  
Lipiodol Marking

Abstract OBJECTIVES This study aimed to evaluate the safety and reliability of percutaneous computed tomography (CT)-guided lipiodol marking for undetectable pulmonary lesions before video-assisted thoracic surgery (VATS). METHODS We retrospectively analysed the cases of CT-guided lipiodol marking followed by VATS in 9 institutes from May 2006 to March 2018. Lipiodol (0.2–0.5 ml) was percutaneously injected closely adjacent to undetectable pulmonary lesions with computed-tomography guidance. Lipiodol spots were identified using C-arm-shaped fluoroscopy during VATS. We grasped the lipiodol spots, including the target lesions, with ring-shaped forceps and resected them. RESULTS Of 1182 lesions, 1181 (99.9%) were successfully marked. In 1 case, the injected lipiodol diffused, and no spot was created. Of the 1181 lesions, 1179 (99.8%) were successfully resected with intraoperative fluoroscopy. Two lipiodol spots were not detected because of the lipiodol distribution during the division of pleural adhesions. The mean lesion size was 9.1 mm (range 1–48 mm). The mean distance from the pleural surface was 10.2 mm (range 0–43 mm). Lipiodol marking-induced pneumothorax occurred in 495 (57.1%) of 867 cases. Of these, chest drainage was required in 59 patients (6.8%). The other complications were 19 (2.2%) cases of bloody sputum, 3 (0.35%) cases of intravascular air, 1 (0.12%) case of pneumonia and 1 (0.12%) case of cerebral infarction. There were no lipiodol marking-induced deaths or sequelae. CONCLUSIONS Preoperative CT-guided lipiodol marking followed by VATS resection was shown to be a safe and reliable procedure with a high success rate and acceptably low severe complication rate.

Computed tomography–based prediction of the straight antegrade humeral nail's entry point and exposure of “critical types”: truth or fiction?

2017 ◽  
Vol 26 (5) ◽  
pp. 902-908 ◽  
Author(s):  
Simon A. Euler ◽  
Clemens Hengg ◽  
Matthias Boos ◽  
Grant J. Dornan ◽  
Travis Lee Turnbull ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Entry Point
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