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OBJECTIVE@#To explore the efficacy of ultrasound-guided needle-knife with precise three-dimensional stereotactic localization of points for stenosing tenosynovitis of flexor tendon (trigger finger).@*METHODS@#A total of 74 patients were randomly divided into an observation group and a control group, 37 cases in each group. The patients in the observation group were treated with ultrasound-guided intrathecal injection and releasing method of needle-knife, while the patients in the control group were treated with ultrasound-guided intrathecal injection. The self-made 9-score scale of trigger finger was recorded before treatment, immediately after treatment, 1 month and 3 months after treatment; the curative effect of the two groups was evaluated.@*RESULTS@#The results of self-made 9-score scale in the observation group immediately after treatment, 1 month and 3 months after treatment were lower than that before treatment (all <0.01); the scores in the observation group were lower than those in the control group at each time point after treatment (all <0.01). The excellent and good rate immediately after treatment was 100.0% (37/37) in the observation group, which was superior to 8.1% (3/37) in the control group (<0.05); the cured rates in the observation group were 100.0% (37/37) 1 month after treatment and 97.3% (36/37) 3 months after treatment, which were superior to 13.5% (5/37) and 10.8% (4/37) in the control group, respectively (<0.05).@*CONCLUSION@#The needle-knife with three-dimensional stereotaxic location of point could significantly improve the symptoms of trigger finger, with superior immediate and long-term efficacy.
Subject(s)
Humans , Needles , Tendons , Trigger Finger Disorder , Therapeutics , UltrasonographyABSTRACT
Objective To explore the clinical application value of core needle biopsy guided by fully digital mammography three-dimensional positioning system in the diagnosis of breast lesions.Methods A retrospective analysis of 21 patients who underwent guided core needle biopsy in a fully digital mammography system was performed.2 1 patients had 2 1 lesions,which included mass (4 cases),suspected calcification (15 cases)and glandular collection (2 cases)based on X-ray examination before biopsy.The needle depth was manually calculated according to the mammogram (0°and 90°),and automatically calculated with the full digital mammography three-dimensional positioning system. The needle depth was adjusted according to the combination of above two values with the patient’s skin elasticity and gland structure. After putting a small incision into the needle with local anesthesia,X-ray radiography was taken to observe the position of the puncture needle, and then the puncture gun was excited to take out the tissue at different positions of the lesion.Finally,X-ray radiography of the tissue was performed.Results 21 patients underwent biopsy with the average operation time of 45 minutes and puncture time of 25 minutes.The needle depth adjustment range was 3－5 mm,using 14G puncture needle and 4－8 pieces of tissue were pierced according to the lesions. X-ray radiographywas performed on the removed tissue strips. For all the cases of suspected calcification,the calcified lesions were found in the removed tissue strips.No serious adverse reactions occurred in 21 patients with lateral position (1 9 cases)and sitting position (2 cases).2 patients with sitting position developed dizziness, nausea,and palpitation,and recovered quickly after rest and psychological comfort.Puncture pathology confirmed 6 cases of breast cancer (1 case of intraductal papillary carcinoma,2 cases of ductal carcinoma in situ,3 cases of invasive breast cancer),and 1 5 cases of benign lesions,with no obvious changes after one year follow-up.Conclusion In the core needle biopsy guided by the fully digital mammography three-dimensional positioning system for breast lesions,the patient should be placed in the lateral position, which can effectively reduce the occurrence of adverse reactions.A 14G puncture needle and ≥4 tissue strips can achieve a higher pos-itive rate.The technology is simple and easy to perform with a high puncture accuracy,and has important application value.
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Objective To evaluate the clinical value of full-field digital mammography three-dimensional (3D) positioning system for localization and excision of nonpalpable breast lesions.Methods 106 patients with nonpalpable breast lesions and underwent preoperative localization were analyzed retrospectively.They underwent wire-localization operation guided by mammography 3D positioning system (GE Senogrphe DS).The depth of wire insertion was calculated manually and automatically.Combined with the manual measurement, systematic measurement, skin elasticity and breast parenchyma structure, the positioning wire was placed.Then, the clinical resection was performed according to the wire localization.Results The localization accuracy of mammography 3D positioning system was 100%.11 patients appearedsyncope.With the rest, psychological comfort and fluid infusion, patients recovered quickly.Conclusion Full-field digital mammography 3D positioning system can improve the accuracy of clinical resection of nonpalpable breast lesion.
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Objective To discuss the feasibility of using three-dimensional simulation positioning of puncture route that is sketched according to the transversal and sagittal CT images to design percutaneous vertebroplasty (PVP) plan. Methods A total of 58 patients with 63 diseased vertebral bodies were enrolled in this study. Before PVP, the simulation puncture route was delineated according to the transversal and sagittal CT images, and the simulation puncture parameters were determined by using the software of PACS, in this way the three-dimensional simulation puncturing route was established , and the skin needle entry point as well as the puncture angle were calculated. Unilateral transpedicular approach was used when the simulation puncture route could meet the requirements of unilateral approach. Otherwise , bilateral transpedicular approach would be employed. Three months after PVP visual analogue score (VAS) was used to evaluate the degree of pain relief, and the result was compared with that determined before PVP. SPSS 13.0 software was used for statistical analysis. The estimating data were statistically analyzed with paired t-test and the results were expressed in the form of (x ± s). Results The measurement results showed that significant differences in the puncture angles and skin needle entry points existed between different vertebral bodies. Guided by the preoperatively determined simulation puncture route , PVP was successfully accomplished in all patients. The success rate of single puncturing was 100% (63 vertebral bodies in total). Among 63 vertebral bodies, unilateral transpedicular approach was adopted in 55 and the operation time was (28.5 ± 5.5) minutes, while bilateral transpedicular approach was carried out in 8 and the operation time was (37.5 ± 5.5) minutes. After PVP, complete pain relief was achieved in all patients. No serious complications occurred during the follow-up period. Conclusion Three-dimensional simulation positioning of puncture route that is sketched according to preoperative transversal and sagittal CT images is very useful in precisely determining the puncturing route before PVP, which is very helpful to increase the success rate of single puncture and to improve the procedural safety.