RESUMEN
AIM: To report the early results of the Intact lesion excision system (LES) regarding feasibility, tolerance and efficiency in obtaining soft-tissue tumour samples under ultrasound guidance. MATERIALS AND METHODS: The feasibility and tolerance of Intact LES procedures under ultrasound guidance were studied prospectively in 15 patients. The procedure was performed on an outpatient basis under local anaesthesia by a single interventional radiologist with 6 years of experience and lasted around 30 min. RESULTS: The feasibility of the Intact LES for soft-tissue masses was good except when lesions were hard and calcified. Tolerance was good, with median pain experienced during the procedure evaluated at 4.5/10 (SD 2.2) and median post-procedural pain at day 1 evaluated at 1.8/10 (SD 2.5). No major complications were observed; however, for vascularised lesions, one case of acute wound bleeding and two post-procedural haematomas led to delayed pain. CONCLUSION: Percutaneous biopsy of suspected soft-tissue sarcoma using the LES device under ultrasound guidance is well tolerated and feasible. After a first non-contributing core biopsy, and especially, in the case of lipomatous lesions, it is a valuable option to consider, as is surgical incision biopsy.
Asunto(s)
Sarcoma/diagnóstico por imagen , Sarcoma/patología , Neoplasias de los Tejidos Blandos/diagnóstico por imagen , Neoplasias de los Tejidos Blandos/patología , Ultrasonografía Intervencional/métodos , Adulto , Anciano , Biopsia con Aguja Gruesa , Estudios de Factibilidad , Femenino , Humanos , Biopsia Guiada por Imagen , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Adulto JovenAsunto(s)
Neoplasias Óseas/secundario , Neoplasias Óseas/cirugía , Diseño de Equipo , Ultrasonido Enfocado de Alta Intensidad de Ablación/instrumentación , Imagen por Resonancia Magnética Intervencional/instrumentación , Imagen por Resonancia Magnética/instrumentación , Cirugía Asistida por Computador/instrumentación , Ultrasonografía Intervencional/instrumentación , Neoplasias Óseas/patología , Humanos , Cuidados Paliativos , Diseño de Software , TransductoresAsunto(s)
Diseño de Equipo , Reconocimiento de Normas Patrones Automatizadas , Radiología Intervencionista/instrumentación , Diseño de Software , Cirugía Asistida por Computador/instrumentación , Equipo Quirúrgico , Tomografía Computarizada por Rayos X/instrumentación , Interfaz Usuario-Computador , Estudios de Factibilidad , Humanos , QuirófanosAsunto(s)
Trastornos de Deglución/etiología , Quiste Dermoide/diagnóstico , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Suelo de la Boca/patología , Neoplasias de la Boca/diagnóstico , Ronquido/etiología , Tomografía Computarizada por Rayos X , Ultrasonografía , Anciano , Medios de Contraste , Diagnóstico Diferencial , Humanos , MasculinoRESUMEN
PURPOSE: The current gold standard treatment of localized painful bone lesion is radiotherapy but this technique has limitations. Our study aims to demonstrate that cementoplasty is an efficient alternative for these palliatives indications when lesions involve extraspinal bones. We prospectively followed 20 patients who received a percutaneous cementoplasty on painful lytic bone lesions between May 2008 and May 2010. MATERIALS: Seventeen patients also had difficulty walking in relation to the pain experienced. The clinical indication for treatment was severe pain (≥4 on the numeric scale) due to bone lesion on CT or MRI. All procedures (except one) were performed under local anesthesia. RESULTS: Feasibility was 100% without immediate complications. The patients experienced a significant and rapid decrease of their pain (4.1 points, P<000.1) and this effect was sustained over the long term (7.75 months of follow-up on average). Sixty-four percent of patients treated on the lower limbs and pelvis improved mobility. CONCLUSION: In our experience, percutaneous cementoplasty may be a safe and effective palliative treatment for localized painful lytic lesion. Combining CT and fluoroscopic guidance seems to be the safer option because of extravertebral localization. Smart fill of the bone and careful selection of patient determine the effectiveness of the procedure. Diffuse painful lesions and long bone diaphysis should not be good indications.
Asunto(s)
Neoplasias Óseas/secundario , Neoplasias Óseas/cirugía , Cementoplastia/métodos , Interpretación de Imagen Asistida por Computador , Imagen por Resonancia Magnética , Osteólisis/cirugía , Cuidados Paliativos/métodos , Cirugía Asistida por Computador/métodos , Tomografía Computarizada por Rayos X , Acetábulo/patología , Acetábulo/cirugía , Anciano , Anciano de 80 o más Años , Estudios de Factibilidad , Femenino , Neoplasias Femorales/diagnóstico por imagen , Neoplasias Femorales/cirugía , Humanos , Húmero/diagnóstico por imagen , Húmero/cirugía , Ilion/diagnóstico por imagen , Ilion/cirugía , Masculino , Persona de Mediana Edad , Limitación de la Movilidad , Osteólisis/diagnóstico , Estudios Prospectivos , Sacro/diagnóstico por imagen , Sacro/cirugía , Neoplasias de la Columna Vertebral/diagnóstico por imagen , Neoplasias de la Columna Vertebral/secundario , Neoplasias de la Columna Vertebral/cirugíaAsunto(s)
Procesamiento de Imagen Asistido por Computador/métodos , Tomografía Computarizada Espiral/métodos , Enfermedades de la Médula Ósea/diagnóstico por imagen , Enfermedades de la Médula Ósea/genética , Medios de Contraste/administración & dosificación , Análisis Mutacional de ADN , Diagnóstico Diferencial , Insuficiencia Pancreática Exocrina/diagnóstico por imagen , Insuficiencia Pancreática Exocrina/genética , Pruebas Genéticas , Humanos , Lipomatosis , Masculino , Páncreas/diagnóstico por imagen , Síndrome de Shwachman-Diamond , Adulto JovenRESUMEN
Chest radiographs and CT are especially useful for the follow-up of patients after lung resection. The purpose of this paper is to illustrate normal postsurgical imaging findings that differ according to the type of surgery (pneumonectomy, lobectomy, segmentectomy and wedge resection). Anatomic changes induced by surgery affect the remaining lung, pleura and chest wall, mediastinum and diaphragm. After pneumonectomy, there is accumulation of fluid in the post pneumonectomy space, progressive chest retraction with mediastinal shift toward the operated side and elevation of the ipsilateral hemidiaphragm. After lobectomy, there is hyperexpansion of the remaining lung, mediastinal shift and intercostal space narrowing. Theses findings are different according to the delay after surgery. Knowledge of the variable imaging features is necessary to detect complications and to provide appropriate follow-up of the primary disease.