Dose pulmonary puncture biopsy increase the risk of pleural recurrence and air space spread of tumor in patients with stage Ⅰ non-small cell lung cancer? / 介入放射学杂志

In recent years,with the increasing proportion of pulmonary nodules,preoperative percutaneous lung puncture biopsy and bronchoscopic biopsy have received more and more attention.A large amount of clinical evidences indicate that lung puncture biopsy of stageⅠnon-small cell lung cancer(NSCLC)is safe and feasible.However,due to the histological characteristics of pulmonary ground-glass nodule(GGN),puncture biopsy of GGNs is more likely to cause bleeding and cough,and the tumor cells may be implanted along the alveolar wall or needle tract under the impact of blood flow or airflow,leading to the pleural recurrence and tumor spread through air spaces(STAS),when compared with puncture biopsy of solid nodules.Therefore,percutaneous lung puncture biopsy should be carefully adopted,especially for the patients who have subpleural nodules with visceral pleura invasion and lymphocyte infiltration.(J Intervent Radiol,2024,32:7-11)

Application of gelatin sponge-hemocoagulase plugging agent in patients with pulmonary puncture bleeding / 介入放射学杂志

Objective To discuss the application of gelatin sponge-hemocoagulase plugging agent in patients with pulmonary puncture bleeding.Methods The clinical data of 43 patients with hemorrhage caused by DSA-guided lung puncture biopsy,who received gelatin sponge-hemocoagulase plugging agent treatment at the Jining Municipal First People's Hospital of China between September 2021 and May 2023,were collected,and the hemostatic effect of gelatin sponge-hemocoagulase plugging agent was analyzed.Results Successful lung puncture needle biopsy was achieved in all the 43 patients.The puncture needle channel occlusion was accomplished by using gelatin sponge-hemocoagulase plugging agent.Five minutes after occlusion treatment,in one patient,whose moderate hemoptysis with moderate bleeding shadow before puncture needle biopsy changed to bloody sputum,the intrapulmonary bleeding shadow displayed on image became slightly enlarged when compared the size five minutes ago,while in all the remaining patients successful hemostasis was achieved,the hemoptysis disappeared and the pulmonary hemorrhage shadow was similar to that five minutes ago.No occlusion-related complications occurred in all patients.Conclusion For the treatment of pulmonary hemorrhage caused by DSA-guided lung puncture biopsy,gelatin sponge-hemocoagulase plugging agent is clinically safe and effective.

Application of value contrast-enhanced ultrasound microangiography, elastography and conventional ultrasound-guided prostate cancer puncture biopsy in the diagnosis of prostate diseases / 现代泌尿外科杂志

【Objective】 To explore the application value of transrectal contrast-enhanced ultrasound (CEUS) microangiography, elastography and conventional ultrasound-guided prostate cancer puncture biopsy in the diagnosis of prostate diseases, so as to provide reference for the early diagnosis of prostate cancer. 【Methods】 A total of 156 patients suspected of prostate cancer treated in our hospital during Jan.2021 and Dec.2022 were selected.The patients were divided into group A (n=52, conventional ultrasound), group B (n=49, elastography) and group C (n=55, CEUS microangiography) according to the puncture methods.The positive rate of puncture and diagnostic value of the three methods were analyzed. 【Results】 The positive rate of puncture was 24.18% in group B and 25.71% in group C, which was significantly higher than that in group A (13.15%, P<0.05).The diagnostic accuracy of prostate cancer was 93.88% in group B and 94.55% in group C, higher than that in group A (75.00%, P=0.002).In group B, the Emax and Emean of malignant lesions were (65.56±14.43) kPa and (59.59±11.02) kPa, respectively, which were higher than those of benign lesions (P<0.001).The difference in blood flow grade detected by CEUS microangiography was statistically significant between benign and malignant lesions, and grade 3 blood flow accounted for 95.65% of malignant lesions.The area under the receiver operating characteristic (ROC) curve (AUC) of Emean in elastography in the diagnosis of prostate cancer was 0.810 (95%CI: 0.690-0.930, P<0.05).The AUC of CEUS microangiography in the diagnosis of prostate cancer was 0.965 (95%CI: 0.913-1.000, P<0.05). 【Conclusion】 Compared with conventional ultrasound-guided prostate cancer puncture biopsy, CEUS microangiography and elastography guided prostate cancer puncture biopsy have better application value in the diagnosis of prostate diseases, which can provide semi-quantitative/quantitative parameter basis for the diagnosis of prostate diseases.

Study of the malignant potential of histopathological category B3 and B5a lesions from percutaneous core needle biopsy process under the guidance of ultrasonography / 中华超声影像学杂志

Objective:To investigate the malignant potential of histopathological class B3 and B5a lesions by ultrasound-guided core needle biopsy (CNB).Methods:Retrospective analysis of the histopathological results of 712 breast lesions that successively underwent CNB process and surgical resection in the Shanghai General Hospital from January 2018 to December 2022, of which 47 lesions were reported as class B3 and 70 lesions as class B5a.Results:CNB identified 47 category B3 lesions, comprising 19 cases of atypical ductal hyperplasia, 17 papillary lesions, 8 phyllodes tumors, and 3 complex sclerosing lesions. Of these cases, surgical pathology was in full agreement with CNB pathology in 27 instances, indicating a concordance rate of 57.4% (27/47) and an inconsistency rate of 42.6% (20/47). Out of the 20 inconsistent cases, 70.0% (14/20) were upgraded based on the findings from the surgical pathology.Specifically, 4 cases of atypical ductal hyperplasia and 2 cases of intraductal papilloma were upgraded to invasive breast cancer (B5b) after surgery. Among the 4 cases with puncture pathology indicating atypical ductal hyperplasia and one complex sclerosing lesion, these five lesions were upgraded to ductal carcinoma in situ (B5a) after surgery. Two puncture pathologies were diagnosed as atypical ductal hyperplasia, and these were upgraded to ductal carcinoma in situ with microinvasion (B5b) after surgery. One puncture pathology indicated a borderline phyllodes tumor, and this was upgraded to malignant phyllodes tumor (B5b) after surgery. And 30.0% (6/20) resulted in downgrade after surgery, specifically 4 cases of atypical ductal hyperplasia, which were downgraded to breast adenopathy (B2). Of these, 1 puncture pathology was identified as atypical ductal hyperplasia and one as a borderline phyllodes tumor, which were both downgraded to fibroadenoma (B2). Seventy lesions were diagnosed as B5a lesions by CNB pathology, with 28 of them showing complete concurrence with the surgical pathology, a concordance rate of 40.0% (28/70), and an inconsistency rate of 60.0% (42/70). Of the 42 cases with discrepancies, all 42 were upgraded, yielding an upgrading rate of 100% (42/42). Of these, 21 were upgraded to ductal carcinoma in situ with microinvasion (B5b) and 21 to invasive breast cancer (B5b).Conclusions:Lesions with CNB pathology in categories B3 and B5a have a high rate of postoperative escalation. B3 and B5a lesions should be treated with considerable care, especially atypical ductal hyperplasia, which should be surgically resected, and CNB examination should be performed twice if necessary.

The factors influencing the effect of periprostatic nerve block anesthesia and the establishment of a predictive model and efficacy verification / 中华泌尿外科杂志

Objective:To investigate the factors affecting the effect of periprostatic nerve block (PNB), establish a prediction model of pain degree, and verify the prediction efficiency.Methods:The clinical data of 314 patients who underwent transperineal prostate biopsy in our hospital from June 2022 to January 2023 were retrospectively analyzed. The median age was 71 (65, 76) years, the median prostate-specific antigen (PSA) was 14.6 (10.70, 24.65) ng/ml, and the median puncture needle number was 21 (19, 23) needles, median prostate volume 45.86 (31.52, 67.96) ml, median body mass index (BMI)24.02(22.97, 25.33)kg/m 2, including 109 patients with a history of diabetes, 90 patients with a history of surgery, and 57 patients with a history of severe trauma. The patients were divided into mild pain group (1-3 points), moderate pain group (4-6 points) and severe pain group (7-10 points) according to the intraoperative visual analogue scale (VAS). According to the clinical characteristics, the factors affecting the effect of PNB were analyzed by univariate analysis and multiple ordered logistic regression method. R language was used to construct a nomogram model for predicting PNB effect, receiver operating characteristic (ROC) curve and calibration curve were drawn, and Hosmer-Lemeshow test was carried out to verify the prediction efficiency of the model. Results:The results of univariate analysis showed that 171 patients in the mild pain group had a median age of 71 (65, 75) years, a median PSA14.5 (9.6, 24.6) ng/ml, a median number of puncture needles of 20 (18, 22), and a median prostate volume of 34.94 (26.36, 45.12) ml, median BMI24.17(23.14, 25.79)kg/m 2, including 74 patients with a history of diabetes, 51 patients with a history of surgery, and 40 patients with a history of severe trauma; There were 110 patients in the moderate pain group, the median age was 71 (65, 76) years, the median PSA14.8 (11.03, 24.27) ng/ml, the median number of puncture needles was 23 (20, 24) needles, median prostatic volume 63.24 (49.14, 78.72) ml, median BMI23.91(22.58, 24.88)kg/m 2, including 26 patients with a history of diabetes, 29 patients with a history of surgery, and 10 patients with a history of severe trauma; In the severe pain group, 33 patients had a median age of 73 (67, 78) years, a median PSA14.6 (10.85, 34.80) ng/ml, and a median puncture needle number of 23 (22.5, 24) needles, median prostate volume 70.64 (61.50, 104.51) ml, median BMI24.32(23.00, 26.06)kg/m 2, including 9 patients with a history of diabetes, 10 patients with a history of surgery, and 7 patients with a history of severe trauma. The results of univariate analysis showed that the number of puncture needles ( P<0.01), prostate volume ( P<0.01), history of diabetes ( P=0.002) and history of major trauma ( P= 0.009) were the factors affecting the effect of PNB. Multiple logistic regression analysis showed that puncture needle number ( P=0.009), prostate volume ( P<0.01) and diabetes history ( P=0.041) were independent risk factors for PNB effect. The area under ROC curve (AUC) of the moderate and above pain prediction model was 0.872, P<0.01; the area under ROC curve of the severe pain prediction model was 0.817, P<0.01; the result of Hosmer-Lemeshow test of the moderate and above pain prediction model was χ2=5.001, P=0.757. The results of the severe pain prediction model were χ2=4.452 and P=0.814. The calibration curve was established, which showed that the prediction probability of pain degree was in good agreement with the actual risk. Conclusions:The number of puncture needles, prostate volume and history of diabetes are the risk factors affecting the effect of PNB. The prediction model of PNB effect based on this model can be used to predict the pain degree of patients undergoing prostate biopsy after PNB.

Analysis of the relationship between PI-RADS scores and the pathological results of targeted biopsy based on MRI / 中华肿瘤杂志

Objective: To analyze the relationship between Prostate Imaging Reporting and Data System (PI-RADS) scores and the pathological results of transperineal magnetic resonance-ultrasound fusion guided biopsy. Methods: The clinical data, magnetic resonance imaging (MRI) results and prostate puncture biopsies of 517 patients who were assigned to PI-RADS score of 4 or 5 and underwent transperineal magnetic resonance-ultrasound fusion guided biopsy at The First Affiliated Hospital of Nanjing Medical University from June 2019 to March 2022 were retrospectively analyzed. Patients were divided into the PI-RADS 4 and PI-RADS 5 groups according to their PI-RADS scores and were stratified by their prostate specific antigen (PSA) values (PSA<10 ng/ml vs. PSA 10-20 ng/ml). The pathological negative rates from the biopsy, the distribution of the grade groups according to the grading system by World Health Organization/International Society of Urological Pathology (WHO/ISUP), the detection rates of prostate cancer (PCa) and clinically significant prostate cancer (CsPCa)between the groups were compared. Results: 369 patients with a PI-RADS score of 4 and 148 patients with a PI-RADS score of 5 were included in our research. The overall detection rates of PCa and CsPCa were 77.8% (402/517) and 66.7% (345/517), respectively. In the PI-RADS 4 group, patients with prostate negative biopsies or in WHO/ISUP 1, 2, 3, 4, or 5 grade groups accounted for 28.2%, 12.7%, 20.1%, 17.1%, 18.4% and 3.5%, respectively, whereas in the PI-RADS 5 group the rates were 7.4%, 6.8%, 22.3%, 22.3%, 26.4%, and 14.9%, respectively. The difference was statistically significant (P<0.001). The detection rates of PCa and CsPCa in the PI-RADS 4 group [71.8% (265/369) vs. 59.1% (218/369), P<0.001] were lower than those of the PI-RADS 5 group [92.6% (137/148) vs. 85.8% (127/148), P<0.001]. In the PI-RADS 4 group, the proportion of patients classified into WHO/ISUP 4-5 grade groups was lower than that of patients in the PI-RADS 5 group [22.0% (81/369) vs 41.2% (61/148) (P<0.001)]. The detection rates of PCa and CsPCa in the PSA<10 ng/ml stratification were less than that in the PSA 10-20 ng/ml stratification[74.1% (281/379) vs. 87.7% (121/138), P=0.001], and [60.9% (231/379) vs. 82.6% (114/138), P<0.001]. For patients with PSA<10 ng/ml, the detection rates of PCa and CsPCa in the PI-RADS 4 group were less than those in the PI-RADS5 group [70.9% (217/306) vs. 87.7% (64/73), P=0.003], and [56.2% (172/306) vs. 80.8% (59/73), P<0.001]. For those with a PSA value of 10-20 ng/ml, the detection rates of PCa and CsPCa in the PI-RADS 4 group were less than those in the PI-RADS 5 group [76.2% (48/63) vs. 97.3% (73/75), P<0.001], and [73.0% (46/63) vs. 90.7% (68/75), P=0.006]. There were statistically significant differences in the proportions of patients with prostate negative biopsy and those falling into WHO/ISUP grade groups 1, 2, 3, 4, or 5 (P<0.001) between the PI-RADS 4 group and the PI-RADS 5 group in both stratifications. Conclusions: In this study, the detection rates of CsPCa and PCa in the PI-RADS 4 group were less than those in the PI-RADS 5 group. With the increase of PI-RADS scores, the detection rate of high-grade PCa increased. The same results held for patients with PSA<10 ng/ml or with PSA 10-20 ng/ml.

Analysis of the relationship between PI-RADS scores and the pathological results of targeted biopsy based on MRI / 中华肿瘤杂志

Objective: To analyze the relationship between Prostate Imaging Reporting and Data System (PI-RADS) scores and the pathological results of transperineal magnetic resonance-ultrasound fusion guided biopsy. Methods: The clinical data, magnetic resonance imaging (MRI) results and prostate puncture biopsies of 517 patients who were assigned to PI-RADS score of 4 or 5 and underwent transperineal magnetic resonance-ultrasound fusion guided biopsy at The First Affiliated Hospital of Nanjing Medical University from June 2019 to March 2022 were retrospectively analyzed. Patients were divided into the PI-RADS 4 and PI-RADS 5 groups according to their PI-RADS scores and were stratified by their prostate specific antigen (PSA) values (PSA<10 ng/ml vs. PSA 10-20 ng/ml). The pathological negative rates from the biopsy, the distribution of the grade groups according to the grading system by World Health Organization/International Society of Urological Pathology (WHO/ISUP), the detection rates of prostate cancer (PCa) and clinically significant prostate cancer (CsPCa)between the groups were compared. Results: 369 patients with a PI-RADS score of 4 and 148 patients with a PI-RADS score of 5 were included in our research. The overall detection rates of PCa and CsPCa were 77.8% (402/517) and 66.7% (345/517), respectively. In the PI-RADS 4 group, patients with prostate negative biopsies or in WHO/ISUP 1, 2, 3, 4, or 5 grade groups accounted for 28.2%, 12.7%, 20.1%, 17.1%, 18.4% and 3.5%, respectively, whereas in the PI-RADS 5 group the rates were 7.4%, 6.8%, 22.3%, 22.3%, 26.4%, and 14.9%, respectively. The difference was statistically significant (P<0.001). The detection rates of PCa and CsPCa in the PI-RADS 4 group [71.8% (265/369) vs. 59.1% (218/369), P<0.001] were lower than those of the PI-RADS 5 group [92.6% (137/148) vs. 85.8% (127/148), P<0.001]. In the PI-RADS 4 group, the proportion of patients classified into WHO/ISUP 4-5 grade groups was lower than that of patients in the PI-RADS 5 group [22.0% (81/369) vs 41.2% (61/148) (P<0.001)]. The detection rates of PCa and CsPCa in the PSA<10 ng/ml stratification were less than that in the PSA 10-20 ng/ml stratification[74.1% (281/379) vs. 87.7% (121/138), P=0.001], and [60.9% (231/379) vs. 82.6% (114/138), P<0.001]. For patients with PSA<10 ng/ml, the detection rates of PCa and CsPCa in the PI-RADS 4 group were less than those in the PI-RADS5 group [70.9% (217/306) vs. 87.7% (64/73), P=0.003], and [56.2% (172/306) vs. 80.8% (59/73), P<0.001]. For those with a PSA value of 10-20 ng/ml, the detection rates of PCa and CsPCa in the PI-RADS 4 group were less than those in the PI-RADS 5 group [76.2% (48/63) vs. 97.3% (73/75), P<0.001], and [73.0% (46/63) vs. 90.7% (68/75), P=0.006]. There were statistically significant differences in the proportions of patients with prostate negative biopsy and those falling into WHO/ISUP grade groups 1, 2, 3, 4, or 5 (P<0.001) between the PI-RADS 4 group and the PI-RADS 5 group in both stratifications. Conclusions: In this study, the detection rates of CsPCa and PCa in the PI-RADS 4 group were less than those in the PI-RADS 5 group. With the increase of PI-RADS scores, the detection rate of high-grade PCa increased. The same results held for patients with PSA<10 ng/ml or with PSA 10-20 ng/ml.

Application of modified closed biopsy in rabbit model of VX2 transplanted bone tumor / 解放军医学杂志

Objective To explore the application value of modified closed biopsy technique in puncture biopsy of rabbit model of VX2 transplanted bone tumor. Methods VX2 tumor tissue was cut from rabbit with VX2 tumor and transplanted into the bilateral tibia of 30 rabbits through the tibial plateau to make the model of VX2 transplanted bone tumor. Seven days after modeling, the proximal tibia puncture biopsy was performed under the guidance of X-ray, and the biopsy specimen was examined pathologically. The left leg was biopsied with modified closed biopsy technique (experimental group), and the right leg was biopsied with hollow needle (control group). On the 14th day after modeling, all rabbits were executed after X-ray examination around the puncture hole, and the soft tissue around the puncture hole was taken for pathological examination. Results By the end of the experiment, a total of 3 rabbits died, and finally 27 rabbits were included in the study. Tumor cells were detected in all the intramedullary specimens obtained by puncture biopsy. On the 14th day after modeling, X-ray examination showed that, compared with control group, the incidence of periosteal reaction and extraosseous high density shadow around the puncture hole, and the tumor cell metastasis rate were lower [14.81%(4/27) vs. 40.74%(11/27); 29.63%(8/27) vs. 100.00%(27/27)], the differences were statistically significant (P<0.05). Conclusions Both the modified closed biopsy technique and puncture needle aspiration biopsy can provide sufficient biopsy tissue for diagnosis of VX2 transplanted bone tumor in rabbits. Meanwhile, the improved closed biopsy technique can prevent local metastasis of tumor cells along the puncture channel to some extent.

The clinical research of high‐frequency contrast‐enhanced ultrasound in guiding peripheral lung consolidation biopsy / 中华超声影像学杂志

To explore the clinical application value of high‐frequency contrast‐enhanced ultrasound in guiding peripheral lung consolidation biopsy . Methods Clinical data of 33 patients with peripheral pulmonary w ho underwent high‐frequency contrast‐enhanced ultrasound biopsy were retrospectively analyzed . According to the pathological results as the gold standard ,the puncture path , needle tip display ,puncture complications and the diagnostic rate of pathological results were described . Results Among the 33 patients ,32 patients had pathological findings ,including 18 malignant lesions ,14 benign lesions ,and 1 non‐effective tissue . ①T he difference between lesion enhancement and peripheral lung tissue enhancement time within 2 .5 s were in 20 patients ( 12 benign ,8 malignant) ,12 patients ( 2 benign ,10 malignant) showed difference greater than 2 .5 s . T here were 19 cases with uniform enhancement ,including 9 benign cases ( 28 .1% ) ,10 malignancy cases ( 31 .3% ) ; 13 cases with uneven enhancement ,including 5 cases with benign ( 15 .6% ) ,8 cases with malignancy ( 25 .0% ) . T he rate of relatively uneven enhancement of malignant lesions was higher ,but the difference was not statistically significant ( P ＝0 .618 ) . ② High‐frequency contrast‐enhanced images were scored at 2 points or more in 28 cases ( 87 .5% ) ,and the high‐frequency contrast‐enhanced ultrasound images were satisfactory . ③Interventional puncture path score was 2 points or more in 29 cases ( 90 .6% ) . ④Puncture needle tip display were scored at 1 point or more in 28 cases ( 87 .5% ) . ⑤A total of 87 needles were punctured ,and 32 cases obtained pathological diagnosis of puncture ( 97 .0% ,32/33) . Conclusions Due to its high spatial resolution ,high‐frequency ultrasound can avoid adjacent tissues and blood vessels by showing the position of the needle tip in real time without the need of puncture frame and multi‐angle needle insertion during operation ,and accurately locate the target with good safety .

Relationship between Renalase Expression and Kidney Disease: an Observational Study in 72 Patients Undergoing Renal Biopsy / 华中科技大学学报（医学）（英德文版）

The relationship between the levels of renalase and changes in proteinuria,hypertension,renal function,renal tubular epithelial cell apoptosis and B-cell lymphoma-2 (Bcl-2) expression was investigated in patients (chronic nephritis,primary nephrotic syndrome or other kidney disease) that underwent renal biopsy.The study group comprised 72 patients undergoing renal biopsy.Patient profiles and renal function were collected.Concentrations of renalase and Bcl-2 were measured by immunohistochemistry.Tubular injury was detected by periodic acid Schiff staining (PAS) and renal tubular epithelial cell apoptosis was assessed by TUNEL assay.The expression of renalase was significantly lower in renal biopsy specimens than in normal kidney tissues.There was a positive linear relationship between renalase and some serum and cardiac indices;a negative correlation was found between age,eGFR,Ccr and 24-h urinary protein.Renal tubule injury index and tubular epithelial cell apoptosis index showed a negative linear correlation with renalase.The results showed that renalase probably increased the expression of Bcl-2.By two independent samples t-test,renalase levels were significantly increased in the non-hypertension group than in the hypertension group.One-way ANOVA showed that renalase expression was higher in samples with Lee's grade Ⅲ than in those with Lee's grade V.The expression of renalase was significantly decreased in patients who underwent renal biopsy,and was also associated with blood and renal function.The research proved that renalase may reduce renal tubular injury and apoptosis of renal tubular epithelial cells through the mitochondrial apoptosis pathway,finally achieving the purpose of delaying the progress of renal failure.

Relationship between Renalase Expression and Kidney Disease: an Observational Study in 72 Patients Undergoing Renal Biopsy / 华中科技大学学报（医学）（英德文版）

The relationship between the levels of renalase and changes in proteinuria,hypertension,renal function,renal tubular epithelial cell apoptosis and B-cell lymphoma-2 (Bcl-2) expression was investigated in patients (chronic nephritis,primary nephrotic syndrome or other kidney disease) that underwent renal biopsy.The study group comprised 72 patients undergoing renal biopsy.Patient profiles and renal function were collected.Concentrations of renalase and Bcl-2 were measured by immunohistochemistry.Tubular injury was detected by periodic acid Schiff staining (PAS) and renal tubular epithelial cell apoptosis was assessed by TUNEL assay.The expression of renalase was significantly lower in renal biopsy specimens than in normal kidney tissues.There was a positive linear relationship between renalase and some serum and cardiac indices;a negative correlation was found between age,eGFR,Ccr and 24-h urinary protein.Renal tubule injury index and tubular epithelial cell apoptosis index showed a negative linear correlation with renalase.The results showed that renalase probably increased the expression of Bcl-2.By two independent samples t-test,renalase levels were significantly increased in the non-hypertension group than in the hypertension group.One-way ANOVA showed that renalase expression was higher in samples with Lee's grade Ⅲ than in those with Lee's grade V.The expression of renalase was significantly decreased in patients who underwent renal biopsy,and was also associated with blood and renal function.The research proved that renalase may reduce renal tubular injury and apoptosis of renal tubular epithelial cells through the mitochondrial apoptosis pathway,finally achieving the purpose of delaying the progress of renal failure.

CT-guided percutaneous transthoracic needle biopsy for the diagnosis of non-small cell lung cancer: a retrospective analysis of its diagnostic accuracy / 介入放射学杂志

Objective To investigate the diagnostic accuracy of CT-guided percutaneous transthoracic needle biopsy (PTNB) for non - small cell lung cancer (NSCLC), and to discuss the factors affecting the diagnostic accuracy of puncture biopsy. Methods The clinical data of a total of 203 patients with pathologically-proved NSCLC, who received CT-guided PTNB during the period from January 1, 2010 to November 1, 2016, were retrospectively analyzed. CT - guided PTNB was performed in all patients before surgery, and tissue specimens were collected for pathological study. The diagnostic accuracy of needle biopsy was calculated, and the factors that might affect the diagnostic accuracy of needle biopsy were analyzed. Results (l)The coincidence rate of pathological results of CT-guided PTNB (small specimens) with surgical specimens (large specimens) was 92. 6％ (188/203). The squamous cell carcinoma and adenocarcinoma had the highest coincidence rates, which were 100％ and 97. 5％ respectively. The coincidence rate of large cell carcinoma type was 20％. No statistically significant differences in the coincidence rate of adenocarcinoma and squamous cell carcinoma existed between small specimens and large specimens (κ=0. 872, P=0. 250). (2)Chi square test showed that only the lesion size was an important factor that affected the diagnostic accuracy of needle biopsy (P=0. 008). Conclusion In diagnosing commonly seen NSCLC, CT - guided PTNB has high coincidence rate with surgical specimens, therefore, CT-guided PTNB is worth popularizing widely in clinical practice. The lesion size is an important factor that affected the diagnostic accuracy of needle biopsy. (J Intervent Radiol, 2018, 27:274-277)

Contrast Researches of Liver Biopsy and Ultrasound in the Diagnosis of Fatty Liver / 昆明医科大学学报

Objective To evaluate the significance of liver biopsy and B ultrasonograpgy in the diagnosis of fatty liver. Methods The results of 62 patients with liver steatosis diagnosed by liver puncture biopsy but not by B-ultrasonograpgy were contrastively analyzed and combined with liver function, blood lipids, blood glucose, and body mass index. Results The 62 cases which were not diagnosed as fatty liver by B-ultrasonograpgy were proved to be 5％-33％liver steatosis after liver puncture biopsy. Among the 62 cases, 23 cases were indicated by the B-ultrasonograpgy that the liver parenchyma echo did not see abnormalities, 18 cases showed the liver parenchyma echo slightly was enlarged, 17 cases showed the liver parenchyma echo density was a bit enhanced and 4 cases were diffuse liver damage,which respectively were 37.01％、29.03％、27.42％and 6.45％. Pathologically it indicated that 45 cases were 5％≤liver steatosis≤19％. Among the 45 cases, 18 cases were indicated by the B-ultrasonograpgy that the liver parenchyma echo was not seen abnormalities, 8 cases showed the liver parenchyma echo slightly was enlarged, 17 cases showed the liver parenchyma echo density was a bit enhanced, and 2 cases were diffuse liver damage, and the change of ultrasound was mainly showed by the liver parenchyma echo not seen abnormalities and the enhanced liver parenchyma echo density. Pathologically it indicated that 17 cases were 20％≤liver steatosis≤33％, 6 cases were indicated by the B-ultrasonograpgy that the liver parenchyma echo did not see abnormalities, 5 cases showed the liver parenchyma echo slightly was enlarged, 5 cases showed the liver parenchyma echo density was a bit enhanced, and 1 case was diffuse liver damage, and the change of ultrasound was mainly showed by the liver parenchyma echo not seen abnormalities, the slightly enlarged liver parenchyma echo and the enhanced liver parenchyma echo density. By analyzing the influence to the ultrasound changes by patients' liver function, body mass index, blood fat and blood sugar, and with logistic regression analysis through a disorderly classification, it was found that the larger value of the glutamine transferase, alkaline phosphatase, body mass index, triglyceride and low density lipoprotein cholesterol, the higher possibility of diffuse liver damage, and the higher level of fatty degeneration, the higher possibility of diffuse liver damage. Conclusion In the diagnosis of fatty liver, when the fatty degeneration is below 1/3, B-ultrasonic examination can't show characteristic changes of fatty liver. It should be closely observed or take liver puncture biopsy to make a definite diagnosis of fatty liver.

Application of MSCT three-dimensional digital navigated biopsy in subcarinal lesions / 实用放射学杂志

Objective To investigate the application of MSCT three-dimensional digital navigated biopsy in subcarinal lesions.Methods 82 patients were enrolled.Study subjects were randomly divided into control group and research group.Three-dimensional positioning and three-dimensional navigation needle biopsy were used in research groups, while CT cross-sectional image positioning with conventional puncture needle was used in control group.Puncture accuracy, one-time success rate of puncture, complications, diagnosis accuracy and operation time were compared between the two groups.Results Puncture success rate, definite diagnosis rate were 87.80%(36/41) and 97.56%(40/41) for the research group,and 60.97%(24/41) and 80.49% (33/41) for the control group, respectively,which on the research group were higher than that on the control group(χ2=8.945, 6.116;P<0.05).Complication rate and operating time were 14.63% (6/41) and (11.64±2.76) min for the research group, and 41.45% (17/41) and (22.22±6.31) min for the control group, respectively, which were lower on the research group than that on the control group (χ2=7.31,t=-11.70,P<0.05).Conclusion MSCT three-dimensional digital navigated biopsy technique could promote the efficiency of subcarinal space puncture biopsy significantly,which is a novel, convenient, precise and safe method.

Ultrasound-guided versus CT-guided percutaneous biopsy for the qualitative diagnosis of ultrasonic-visual chest lesions: a comparison study / 介入放射学杂志

Objective To compare the puncturing hit rate,positive rate of pathological diagnosis and the incidence of complications between color Doppler ultrasound-guided and CT-guided percutaneous biopsy for the qualitative diagnosis of ultrasonic-visual chest lesions.Methods A total of 112 patients,who were encountered from January 2015 to June 2016 in authors' hospital and whose imaging materials suggested the presence of ultrasonic-visual chest lesions,were enrolled in this study.There were no bones or lung air between the thoracic skin and chest lesion to hinder imaging observation.Ultrasound-guided puncturing was employed in 52 patients (ultrasound-guided group) and CT-guided puncturing was adopted in 60 patients (CT-guided group).The puncturing hit rate,positive rate of pathological diagnosis and the incidence of complications were compared between the two groups.Results The puncturing hit rate in ultrasound-guided group was 100％ (52/52),which was higher than 91.7％ (55/60) in CT-guided group.The positive rate of pathological diagnosis in ultrasound-guided group was 96.2％ (50/52),which was higher than 80.0％ (48/60)in CT-guided group.The incidence of complications in ultrasound-guided group was 3.8％ (2/52),which was lower than 18.3％(11/60) in CT-guided group.Conclusion For the qualitative diagnosis of ultrasonic-visual chest lesions,ultrasound-guided percutaneous biopsy is more reliable than CT-guided percutaneous biopsy.

Preliminary application of MRI-navigation system in assisting the performance of percutaneous biopsy / 介入放射学杂志

Objective To evaluate the effectiveness and safety of MRI-navigation system EMT-100 in assisting the performance of precise percutaneous puncture biopsy.Methods With the help of MRI-navigation system EMT-100,percutaneous puncture biopsy of thoracic and abdominal lesions was performed in 42 patients.The puncture success rate was used as the main index to evaluate the effectiveness of MRI-navigation system EMT-100.The success rate of puncture biopsy,the total time used for procedure,the average number of puncturing,the average number of scanning,and the incidence of complications were recorded.Results In the 42 patients,the success rates with single and twice puncturing were 86％ (36/42) and 14％ (6/42) respectively.The success rate of puncture biopsy was 100％.The mean time used for locating puncture site was (11.5±5.5) min;the average number of puncturing was (1.4±0.5) times,and the average number of scanningwas(4.2±0.8) times.Among the 32 patients with pulmonary lesions,bloody sputum occurred in 2 patients (6.2％) and small amount pneumothorax in one patient (3.1％),and no serious complications occurred in other patients.Conclusion In performing percutaneous puncture biopsy of thoracic and abdominal lesions,the use of MRI-navigation system is safe.This technique has certain advantages,such as accurate positioning,high puncture success rate,wide range of application,radiationless,etc.It can help precisely obtain the lesion tissue and get pathological diagnosis.Therefore,it is really a valuable guiding technology.(J Intervent Radiol,2017,26:263-265)

Diagnosis value of ultrasound-guided core-needle biopsy in breast masses under BI-RADS categories 4A to 4C / 中国肿瘤临床

Objective:To evaluate the clinical value of ultrasound-guided core-needle biopsy (US-CNB) in the diagnosis of breast lesions under categories 4A to 4C of the second edition of the Breast Imaging Reporting and Data System (BI-RADS) ultrasound lexicon. Meth-ods:The pathological characteristics of 355 patients with breast masses who underwent US-CNB in the Tianjin Medical University Can-cer Institute and Hospital from March 2015 to October 2015 were retrospectively analyzed. Each patient was subjected to postopera-tive pathological examination to confirm diagnosis. Results:According to the US-CNB results, of the 355 patients, 235 were diagnosed with breast cancer, and 120 had benign lesions. Through postoperative pathological examination, 41 of the patients with benign le-sions were confirmed to have breast cancer. The specificity of the US-CNB was 100%in all the categories of breast masses. The sensibil-ities of breast masses under BI-RADS categories 4A, 4B, and 4C were 62.50%, 82.46%, and 89.73%, respectively. The accuracies of the US-CNB in 4A, 4B, and 4C were 84.62%, 87.01%, and 90.74%, correspondingly. Of the 41 patients with false-negative results, 14 had in-traductal carcinoma, 5 had intraductal papillary carcinoma, 3 had mucinous carcinoma, and 19 had invasive ductal carcinoma. Conclu-sion:US-CNB is a safe, reliable, and accurate early diagnostic method for breast masses under the 4B and 4C categories. However, the sensibility of US-CNB was extremely low in patients with breast masses under the 4A category. Thus, final diagnosis should be accom-plished by combining US-CNB with mammography, MRI, or other testing methods. Meanwhile, US-CNB is not recommended for pa-tients with intraductal papillary neoplasms diagnosed through ultrasonography.

Effect of puncture needles with different diameter on percutaneous biopsy for transplant kidney under ultrasound guidance / 器官移植

Objective To compare the effect of puncture needles with different diameter on percutaneous biopsy for transplant kidney under ultrasound guidance. Methods A total of 82 cases underwent percutaneous renal biopsy for transplant kidney under ultrasound guidance,and were divided into two groups based on the diameters of puncture needles, Group 18 G (n =31)and Group 16 G (n =51).The effect of biopsy and complications were compared between the two groups. Results Compared with Group18 G,Group16 G used less puncture needles and obtained more glomeruli (both P <0.01).The qualified rate of renal specimens in Group 16 G was significantly higher than that of Group 18 G(P <0.05). There was no significant difference in postoperative complications between the two groups (P >0.05 ).Further stratified comparison was conducted,and the results showed that complications of the two groups were not statistically significant in case of puncture with 2 needles or 3 needles (both P >0.05). Conclusions There is similar safety of 16 G puncture needle and 18 G puncture needle to perform renal biopsies under ultrasound guidance.Under the allowable condition of patients,16 G puncture needle is superior to 18 G puncture needle and realizes high quality of renal specimens.

Analysis of risk factors of hemorrhage after ultrasound-guided liver graft biopsy / 器官移植

Objective To investigate the risk factors of hemorrhage after ultrasound-guided liver graft biopsy.Methods Clinical data of 51 liver transplant patients undergoing ultrasound-guided liver graft biopsy in the Third Affiliated Hospital,Sun Yat-sen University between February 201 3 and April 201 4 were retrospectively studied.Hemorrhage after biopsy was taken the dependent variable.Age,gender,coagulation, duration of biopsy,frequency of biopsy,number of biopsy tissues,medication of anticoagulant or not and cooperation in breathing and breath holding or not were taken as the independent variables.Multivariate non-conditional Logistic regression analysis was performed for all independent variables to screen out the risk factors associated with hemorrhage after ultrasound-guided liver graft biopsy.Results Fifty-one patients underwent 84 biopsies in total and 5 cases (6%)had hemorrhage after biopsy.The multivariate non-conditional Logistic regression analysis showed that obvious hemorrhagic tendency,medication of anticoagulant and poor cooperation in breathing were independent risk factors of hemorrhage after liver graft biopsy (OR was respectively 8.71 , 3.1 6 and 2.03,all in P <0.05).Conclusions Obvious hemorrhagic tendency,medication of anticoagulant and poor cooperation in breathing are independent risk factors of hemorrhage after ultrasound-guided liver graft biopsy.

The clinical application of CT-guided craniocerebral puncture biopsy：initial experience in 23 cases / 介入放射学杂志

Objective To investigate the diagnostic value of CT-guided craniocerebral puncture biopsy, and to discuss its clinical safety. Methods During the period from April 2013 to June 2014 at authors’ hospital CT-guided craniocerebral puncture biopsy was carried out in 23 patients. All patients had clinical symptoms or signs of nervous system. Imaging examination revealed that all patients had intracranial space-occupying lesions. CT-guided craniocerebral puncture biopsy was performed to make pathological or bacteriological examinations. The results were statistically analyzed. Results In this group of patients, definite pathological diagnosis was made in 19 cases, biopsy positive diagnosis rate of biopsy was 82.6% (19/23), among them oncology-pathological diagnosis was obtained in 14 cases (60.9%), mainly including glioma, non-Hodgkin lymphoma, dysembryoplastic neuroepithelial tumor, choroid plexus papillary tumor, epidermoid cyst, etc. Non-neoplastic lesion was confirmed in 5 cases (21.7%), including suppurated meningitis, cerebral gliosis hyperplasia, cerebral telangiectasis, etc. Small amount of subdural hemorrhage was observed in one case (4.3%). No severe complications, such as intracranial infection or epilepsy, occurred in all patients. Conclusion CT-guided craniocerebral puncture biopsy is minimally-invasive with fewer complications, it can provide definite diagnosis for intracranial lesions, therefore, this technique has a broad development prospect in clinical practice.