Diagnostic performance of percutaneous lung biopsy using automated biopsy needles under CT-fluoroscopic guidance for ground-glass opacity lesions.

OBJECTIVE: The goal of our study was to evaluate the diagnostic performance of percutaneous lung biopsy under CT-fluoroscopic guidance for ground-glass opacity (GGO) lesions. METHODS: 85 percutaneous needle lung biopsies were performed in 73 patients. Specimens were obtained by core biopsy utilising an automated cutting needle and were evaluated histologically. Final diagnosis was confirmed by independent surgical pathology, independent culture results or clinical follow-up. RESULTS: Rates of adequate specimens obtained and of precise diagnosis by needle biopsy were 92.9% (79/85) and 90.6% (77/85) of evaluated lung lesions, respectively. Precise diagnosis was achieved in 87.1% (27/31) of lesions ≤10 mm in diameter, 90.0% (36/40) of lesions >10 mm to ≤20 mm and 100.0% (14/14) of lesions >20 mm. Precision in diagnosing GGO lesions according to the GGO component was 73.9% (17/23) for pure GGO lesions and 96.8% (60/62) for part-solid GGO lesions. Obtaining a precise diagnosis did not differ significantly according to the lesion size (p=0.3840), but differences were significant according to the GGO component (p=0.0047). Malignancy was accurately diagnosed in 35 of 36 malignant lesions for which surgery was later performed. The specific cell type determined from specimens obtained by needle biopsy was exactly the same as the final histological diagnosis obtained after surgery in 20 lesions. CONCLUSION: Tissue-core lung biopsy under CT-fluoroscopic guidance for a GGO lesion provides a high degree of diagnostic accuracy but is less reliable for determining the specific cell type. ADVANCES IN KNOWLEDGE: Percutaneous lung biopsy under CT-fluoroscopic guidance for GGO is useful in differentiating malignancy.

MR imaging of ventral thalamic nuclei.

BACKGROUND AND PURPOSE: The Vim and VPL are important target regions of the thalamus for DBS. Our aim was to clarify the anatomic locations of the ventral thalamic nuclei, including the Vim and VPL, on MR imaging. MATERIALS AND METHODS: Ten healthy adult volunteers underwent MR imaging by using a 1.5T whole-body scanner. The subjects included 5 men and 5 women, ranging in age from 23 to 38 years, with a mean age of 28 years. The subjects were imaged with STIR sequences (TR/TE/TI = 3200 ms/15 ms/120 ms) and DTI with a single-shot echo-planar imaging technique (TR/TE = 6000 ms/88 ms, b-value = 2000 s/mm(2)). Tractography of the CTC and spinothalamic pathway was used to identify the thalamic nuclei. Tractography of the PT was used as a reference, and the results were superimposed on the STIR image, FA map, and color-coded vector map. RESULTS: The Vim, VPL, and PT were all in close contact at the level through the ventral thalamus. The Vim was bounded laterally by the PT and medially by the IML. The VPL was bounded anteriorly by the Vim, laterally by the internal capsule, and medially by the IML. The posterior boundary of the VPL was defined by a band of low FA that divided the VPL from the pulvinar. CONCLUSIONS: The ventral thalamic nuclei can be identified on MR imaging by using reference structures such as the PT and the IML.

Plicae palmatae of the cervical canal visualized on MRI.

We report a case in which plicae palmatae (a normal anatomical structure of the cervix) was demonstrated on MRI. A 33-year-old woman with endometrial cancer underwent a pre-operative MRI examination before total abdominal hysterectomy. Axial T2 weighted images through the cervix demonstrated a longitudinal line of distinct hypointensity confined to the cervical canal. Gross examination of the surgical specimen revealed a relatively large median longitudinal ridge, as well as shorter folds fanning out laterally and upward, which were clearly identifiable on the endocervical wall. The midline longitudinal ridge was considered to represent a portion of the plicae palmatae, which are folds on the anterior and posterior walls of the uterine cervical canal. On MRI, one should avoid misdiagnosing this line of hypointensity as a septate uterus.