scholarly journals Computed Tomography-Guided Bronchoscopy With an Ultrathin Fiberscope

1996 ◽  
Vol 2 (4) ◽  
pp. 229-232 ◽  
Author(s):  
Toshiaki Kobayashi ◽  
Kayako Shimamura ◽  
Kohzoh Hanai ◽  
Masahiro Kaneko
Keyword(s):  
Computed Tomography ◽  
Pulmonary Function ◽  
Endoscopic Examination ◽  
Open Lung Biopsy ◽  
Ct Guidance ◽  
Ct Guided ◽  
Open Lung ◽  
Examination Method ◽  
The Right ◽  
Poor Pulmonary Function

Bronchoscopy was performed under computed tomography (CT) guidance using an ultrathin fiberscope in a patient with a fluoroscopically invisible lesion that was visualized by CT in the right S8 and with poor pulmonary function. Under local anesthesia, the ultrathin fiberscope (3 mm in diameter) was inserted close to the lesion (1.5 mm in diameter) under direct visual guidance, and a brush was inserted into the lesion under CT guidance. Cytologic specimens obtained by the brush and washing revealed adenocarcinoma. This is the first report of CT-guided bronchoscopy, which is a new examination method for peripheral small lung lesions and is a less invasive examination than either endoscopic examination with a conventional bronchoscope or open lung biopsy, especially for those with poor pulmonary function.

Diagnostic Open Lung Biopsy in the Critically Ill Child

PEDIATRICS ◽  
1973 ◽  
Vol 52 (4) ◽  
pp. 605-608
Author(s):  
Stacy A. Roback ◽  
William H. Weintraub ◽  
Mark Nesbit ◽  
Panayiotis K. Spanos ◽  
Barbara Burke ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Critically Ill ◽  
Lung Tissue ◽  
Lung Biopsy ◽  
Open Lung Biopsy ◽  
University Of Minnesota ◽  
Biopsy Technique ◽  
Open Lung ◽  
Critically Ill Child ◽  
The University

Forty-six open biopsies in 40 acutely ill children with rapidly decreasing pulmonary reserve were performed at the University of Minnesota Hospitals between January 1, 1970, and January 1, 1972. Tissue obtained was adequate in all patients and no serious complications ensued. Information obtained resulted in the change in treatment in 30 patients. This procedure is recommended over closed biopsy when the magnitude of the patient's illness and degree of pulmonary function do not allow acceptance of the risks known to occur with a closed biopsy technique and when histologic examination of lung tissue is required.

scholarly journals A mysterious clavicular swelling

2021 ◽  
Vol 16 (3) ◽  
pp. 97-100
Author(s):  
Nur Saadah Mohamad ◽  
Mohd Jazman Che Rahim ◽  
Azliana Aziz
Keyword(s):  
Computed Tomography ◽  
Lung Carcinoma ◽  
Primary Tumour ◽  
Musculoskeletal Ultrasound ◽  
Atypical Presentation ◽  
Intermittent Fever ◽  
Ct Guided ◽  
Tumour Metastasis ◽  
The Right ◽  
Lung Ct

The clavicle or collarbone is a horizontal-axis bony structure located between the neck and thoracic area. Tumour metastasis at the clavicle is very rare. Due to its location at the border of the neck and chest area, a primary tumour could originate from both areas. We report the case of a 39-year-old man who presented with a painful right sternal-end clavicular mass and intermittent fever. Chest radiography was normal. Musculoskeletal ultrasound of the clavicle revealed a mass. Computed tomography (CT) thorax further identified a mass at the upper lobe of the right lung. CT-guided tissue biopsy confirmed that it was a lung adenocarcinoma. This case shows an atypical presentation of lung carcinoma and how musculoskeletal ultrasound helped in the diagnosis when other features and investigations were inconclusive.

Computed Tomography Guidance for Percutaneous Glycerol Rhizotomy for Trigeminal Neuralgia

2019 ◽  
Vol 19 (2) ◽  
pp. E117-E121
Author(s):  
Bradley T Schmidt ◽  
Conrad D Pun ◽  
Wendell B Lake ◽  
Daniel K Resnick
Keyword(s):  
Computed Tomography ◽  
Trigeminal Neuralgia ◽  
Radiation Exposure ◽  
Skull Base ◽  
Ct Guidance ◽  
Foramen Ovale ◽  
Ct Scanner ◽  
Ct Guided ◽  
Needle Position ◽  
Scout Image

Abstract Background Percutaneous glycerol rhizotomy (PGR) is a well-described treatment for trigeminal neuralgia; however, the technique in using surface landmarks and fluoroscopy has not drastically changed since being first introduced. In this paper, we describe a protocol for PGR using computed tomography (CT) guidance based on an experience of over 7 yr and 200 patients. Objective To introduce an approach for PGR using CT guidance and, in doing so, demonstrate possible benefits over the traditional fluoroscopic technique. Methods Using a standard CT scanner, patients are placed supine with head in extension. Barium paste and a CT scout image are used to identify and plan a trajectory to the foramen ovale. A laser localization system built into the CT scanner helps to guide placement of the spinal needle into the foramen ovale. The needle position in the foramen is confirmed with a short-sequence CT scan. Results CT-guided PGR provides multiple benefits over standard fluoroscopy, including improved visualization of the skull base and significant reduction in radiation exposure to the surgeon and staff. Side benefits include improved procedure efficiency, definitive imaging evidence of correct needle placement, and potentially increased patient safety. We have had no significant complications in over 200 patients. CONCLUSION CT-guided PGR is a useful technique for treating trigeminal neuralgia based on better imaging of the skull base, better efficiency of the procedure, and elimination of radiation exposure for the surgeon and staff compared to traditional fluoroscopic based techniques.

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

Image-Guided Right T10 Costotransverse Joint Resection for Costotransversitis: Operative Technique and Nuances: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Gaetano De Biase ◽  
Kelly Gassie ◽  
Kingsley Abode-Iyamah ◽  
Eric Nottmeier
Keyword(s):  
Computed Tomography ◽  
Single Photon ◽  
Preoperative Evaluation ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
X Rays ◽  
Ct Guided ◽  
Image Guided ◽  
Spect Scan ◽  
The Right

Abstract We describe the operative approach and management for costotransverse joint inflammation in a 49-yr-old man with worsening midthoracic pain radiating to the right paraspinal area. He underwent physical therapy with no relief of his symptoms. Thoracic spine magnetic resonance imaging (MRI) revealed severe arthritic changes involving the right T10 costotransverse joint. Scoliosis X-rays showed a dextroconvex curvature in the midthoracic spine, without any significant imbalance. Single-photon emission computed tomography (SPECT) scan revealed focal increased uptake of the right T10 costotransverse joint. T10 costotransverse joint lidocaine injection did not provide any relief. We performed a computed tomography (CT)-guided biopsy, which was negative for malignancy and also cultures were negative. MRI revealed a significant enhancement in this area and the patient's C-reactive Protein was elevated. Decision was made to perform open biopsy and costotransverse joint resection. We present a case of minimally invasive, image-guided costotransverse joint resection, which has not been described in the literature. The right T10 costotransverse joint was dissected out with the image-guided dilator, and tubular retractors were inserted. Under the microscope, using the image-guided drill, the right T10 costotransverse joint was drilled out. The lateral aspect of the right T10 process was drilled out as well as the medial-dorsal aspect of the right T10 rib. The patient recovered from surgery well with abatement of his preoperative thoracic pain, which remained abated at 6-mo follow-up. This case highlights the complex technical nuances of this procedure, and the importance of a thorough preoperative evaluation with a bone SPECT scan to help localize the pain generator. Patient consented for the procedures and for the publication of the video.

scholarly journals Role of percutaneous computed tomography-guided radiofrequency ablation in treatment of osteoid osteoma

2017 ◽  
Vol 06 (04) ◽  
pp. 139-140 ◽  
Author(s):  
Ajay R. Upadhyay ◽  
Nikunj Chandrakant Desai ◽  
Digish U. Vaghela
Keyword(s):  
Computed Tomography ◽  
Radiofrequency Ablation ◽  
Success Rate ◽  
Osteoid Osteoma ◽  
Clinical Success ◽  
Tertiary Care ◽  
Ct Guidance ◽  
Western India ◽  
Ct Guided

Abstract Aim: The aim of the study was to evaluate efficacy of percutaneous computed tomography (CT)-guided radiofrequency ablation (RFA) of nidus in osteoid osteoma (OO). Materials and Methods: RFA was performed on fifty patients with clinically and radiologically diagnosed OO. RFA was done in the department of radio-diagnosis in our institute (a tertiary care providing institute in Ahmedabad, Western India). Ablation was performed by putting at an electrode tip (3–5 mm) into nidus under CT guidance with targeted temperature of 90°C for 3 min. Results: All procedures were technically successful. No immediate major or minor complications were observed. Complete clinical success was achieved in 46 patients. Only four patients required second intervention. Conclusion: Our experience indicates a 98% success rate. No major complications were noted.

Cervical Transforaminal/Nerve Root Injections: Computed Tomography

2016 ◽  
Author(s):  
Tilman Wolter
Keyword(s):  
Computed Tomography ◽  
Nerve Root ◽  
Ct Guidance ◽  
Complication Rates ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Ct Guided ◽  
Real Time Visualization ◽  
Nerve Root Blocks ◽  
Sensitivity Specificity

Computed tomography (CT)–guided selective cervical nerve root blocks, particularly in the dorsal/posterior access, are sensitive, specific, efficacious, and safe. If performed with a lateral/anterolateral access, the CT-fluoroscopic technique with real-time visualization should be chosen. In comparison to fluoroscopy-guided nerve root blocks, CT guidance offers a more precise visualization of the contrast agent. While the advantages of CT guidance seem to outweigh the slightly higher exposure to radiation, this specific topic is debatable and requires additional scientific inquiry. Comparative studies are needed to address the sensitivity, specificity, efficacy, complication rates, and radiation exposure of CT- and fluoroscopy-guided cervical nerve root blocks.

scholarly journals Primary Pleural Angiosarcoma in a 63-Year-Old Gentleman

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Ahmed Abu-Zaid ◽  
Shamayel Mohammed
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Histopathological Examination ◽  
Case Reports ◽  
Immunohistochemical Analysis ◽  
Whole Body ◽  
Cytologic Examination ◽  
Ct Guided ◽  
Positron Emission ◽  
The Right

Primary pleural angiosarcomas are extremely rare. As of 2010, only around 50 case reports have been documented in the literature. Herein, we report the case of a 63-year-old gentleman who presented with a 3-month history of right-sided chest pain, dyspnea, and hemoptysis. Chest X-ray showed bilateral pleural effusion with partial bibasilar atelectasis. Ultrasound-guided thoracocentesis showed bloody and exudative pleural fluid. Cytologic examination was negative for malignant cells. An abdominal contrast-enhanced computed tomography (CT) scan showed two right diaphragmatic pleural masses. Whole-body positron emission tomography/computed tomography (PET/CT) scan showed two hypermetabolic fluorodeoxyglucose- (FDG-) avid lesions involving the right diaphragmatic pleura. CT-guided needle-core biopsy was performed and histopathological examination showed neoplastic cells growing mainly in sheets with focal areas suggestive of vascular spaces lined by cytologically malignant epithelioid cells. Immunohistochemical analysis showed strong positivity for vimentin, CD31, CD68, and Fli-1 markers. The overall pathological and immunohistochemical features supported the diagnosis of epithelioid angiosarcoma. The patient was scheduled for surgery in three weeks. Unfortunately, the patient died after one week after discharge secondary to pulseless ventricular tachycardia arrest followed by asystole. Moreover, we also present a brief literature review on pleural angiosarcoma.

Sign in / Sign up

Export Citation Format

Share Document