Roman Andrei, Achimas-Cadariu Patriciu, Fetica Bogdan, Gata Vlad, Seicean Andrada
Radiology Department, "Prof. Dr. Ion Chiricuţă" Oncology Institute, Cluj-Napoca, Romania.
Surgery Department, "Prof. Dr. Ion Chiricuţă" Oncology Institute, Cluj-Napoca, Romania.
Clujul Med. 2018 Oct;91(4):427-434. doi: 10.15386/cjmed-1145. Epub 2018 Oct 30.
Despite their usefulness, CT-guided procedures have a low profile in Romania. The current study has the purpose of describing a first experience in performing these procedures.
Tumors and fluid collections that were inaccessible for biopsy or drainage by ultrasound or endoscopic guidance were included. The procedures were performed using a 64-slice GE Optima CT660 CT scanner. The biopsies were carried out using the coaxial technique with an 18 G semiautomatic needle. The drainages were performed using 10 F pig-tail drains that were inserted using the Seldinger technique. Data regarding the size and location of the target lesion, puncture technique, success and complication rates were recorded.
Between May 2017 and April 2018, 30 procedures were performed, of which 26 biopsies and 4 drainage insertions. Of the biopsies 3 were mediastinal, 8 pulmonary, 6 retroperitoneal, 4 pelvic, and 5 of the bone. The drainages were performed for pelvic lymphoceles. The average lesion size was 3.2 cm (0.7-9 cm), with a depth from the skin of 9.1 cm (0.6-15.2 cm). The average procedure duration was 58 minutes (31-93 minutes). A conclusive histopathological diagnosis was set after 92.3% of biopsies. Three procedures resulted in complications, two being minor (hemothorax, soft tissue hematoma) and one severe (tension pneumothorax requiring drainage).
CT guidance offers safe access to lesions that cannot be biopsied or drained under ultrasound or endoscopic guidance.
尽管CT引导下的操作很有用，但在罗马尼亚并不常见。本研究旨在描述开展这些操作的首次经验。
纳入那些无法通过超声或内镜引导进行活检或引流的肿瘤和液体积聚。操作使用64排GE Optima CT660 CT扫描仪进行。活检采用同轴技术，使用18G半自动穿刺针。引流采用10F猪尾引流管，通过Seldinger技术插入。记录有关目标病变的大小和位置、穿刺技术、成功率和并发症发生率的数据。
2017年5月至2018年4月期间，共进行了30例操作，其中26例活检和4例引流置入。活检中，3例为纵隔病变，8例为肺部病变，6例为腹膜后病变，4例为盆腔病变，5例为骨病变。引流针对盆腔淋巴管囊肿进行。病变平均大小为3.2 cm（0.7 - 9 cm），距皮肤深度为9.1 cm（0.6 - 15.2 cm）。平均操作时间为58分钟（31 - 93分钟）。92.3%的活检后获得了确定性的组织病理学诊断。3例操作出现并发症，2例为轻微并发症（血胸、软组织血肿），1例为严重并发症（张力性气胸需引流）。
CT引导为无法在超声或内镜引导下进行活检或引流的病变提供了安全的入路。
