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BACKGROUND@#Virtual bronchoscopic navigation (VBN) assisted endobronchial ultrasonography with guide sheath (EBUS-GS) has reduced the difficulty and even avoiding radiation exposure during performing transbronchus lung biopsy (TBLB). To evaluate the feasibility and safety of virtual bronchoscopic navigation assisted endobronchial ultrasonography with guide sheath for peripheral pulmonary lesions.@*METHODS@#We performed a retrospective analysis of the patients with PPLs who received VBN assisted EBUS-GS-TBLB in Peking University Cancer Hospital from January 2016 to December 2017. Their clinicopathologic data and complications were assessed.@*RESULTS@#A total of 121 patients were enrolled in the study. The patients included 65 men and 56 women, with a mean age of (58.8±10.3) years. A total of 121 PPLs were examined, and 108 lesions of which could be detected by EBUS. The overall diagnostic yield of EBUS-GS was 73.5%. The diagnostic yield of malignancy was 82.5%. The combination of transbronchial lung biopsy, brush smear and bronchoalveolar lavage fluid provided the greatest diagnostic yield (χ²=6.084, P=0.014). Factors that significantly affected and predicted diagnostic success were EBUS probe within the lesions (χ²=20.372, P=0.000) and PPLs located in the central two-thirds of the lung (χ²=10.810, P=0.001). 1 patient (0.8%) suffered from intraoperative bleeding which could be managed under endoscopy.@*CONCLUSIONS@#VBN assisted EBUS-GS-TBLB for PPLs was an effective and safe procedure.
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Female , Humans , Male , Middle Aged , Bronchoscopy , Methods , Endosonography , Methods , Lung Neoplasms , Diagnostic Imaging , General Surgery , Retrospective Studies , SafetyABSTRACT
Objective To explore the value of high resolution reconstruction for optimization of imaging quality of GE Discovery CT 750 HD based on phantom pilot.Methods CT scanning with large (50 cm) and small (32 cm) scanning field of view (SFOV) was performed for a Catphan 500 phantom with or without high resolution on GE Discovery CT 750 HD.All raw data acquired by volumetric CT scan were reconstructed as the same size of a small DFOV (25 cm) with STAND algorithm.Then the images were divided into four groups,including large SFOV without high resolution (group A),large SFOV with high resolution (group B),small SFOV without high resolution (group C) and small SFOV with high resolution (group D).The spatial-resolution (SR),density-resolution (DR),noise (N),CNR,SNR and CT dose index volumes (CTDI) were measured and compared among 4 groups.Results The overall differences of SR,DR,N,CNR,SNR and CTDI were statistically significant among four groups (all P＜0.05).Compared with group A,the average N increased in group C (P＜0.01),SR increased in group B and the average CNR and SNR decreased in group D,while N increased in group D (all P＜0.01).Conclusion Large SFOV combined with high resolution reconstruction may ensure CNR and SNR,and improve SR.
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Objective To evaluate the clinical value of gemstone spectral imaging (GSI) in preliminary assessment of esophageal carcinoma pathology features.Methods 58 patients were analyzed which were diagnosed with histological pathology as esophageal carcinoma underwent GSI enhanced scans before surgery.The iodine concentrations (IC) in the lesions were measured on the iodine-water based material-decomposition images.The results of IC value were evaluated retrospectively with different pathological grading,locations and pathological morphology according to the final pathologic findings.Results 52 cases patients were squamous cell carcinoma and 6 patients were adenocarcinoma.The IC values were (14.75±4.24) mg/ml and (12.86±5.09) mg/ml.The IC value between the two different pathological types had not statistically difference (P =0.35).The IC of different pathological grading:Well differentiation was (20.08± 4.66)mg/ml,n =19.Medium was (14.13±3.39) mg/ml,n =25.Poor was(11.73±3.21) mg/ml,n =14.The IC values between pathological grading had significant difference(P =0.00).There were four different pathological morphology including m edullar (n =16),m ushroom type (n =21),ulcer (n =13) and narrow type (n =8).Their IC values respectively were (16.34±2.56) mg/ml,(18.70±3.03) mg/ml,(14.31±4.60) mg/ml and (11.18±2.09) mg/ml.The IC value between mushroom and narrow type had statistical difference (P =0.04).The Other types had no statistically difference (P =0.19).Conclusions The results of this study demonstrate that GSI has a certain ability of pathologic stage of esophageal cancer.The GSI has a certain clinical value in guiding treatment and judging prognosis of esophageal carcinoma.
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Objective To explore the imaging and clinical pathological features of extranoda and intranoda lymphoma in head and neck characterized by computed tomography (CT) and magnetic resonance imaging (MRI).Methods 46 malignant lymphoma patients were confirmed by surgery and pathology.The CT and MR images data were reviewed and analyzed in comparison with surgical and pathological results.Diagnostic value of the CT and MRI findings were analyzed. Results The subjects enrolled in this study including 38 cases of non-Hodgkin lymphoma(NHL)and 8 cases of Hodgkin Lymphoma(HL).The pathological sites of extranodal lymphomas (45.65 ％,21/46) included nasal (10 cases),Waldeyer ring (7 cases),throat (2 cases),Thyroid(1 case) and parotid (1 case).The lymph nodes metastases in the neck were observed in 13 cases of Extranodal lymphomas.Intranodal lymphoma in neck (54.35 ％,25/46) involved all district lymph nodes especially Ⅱ-Ⅳ districts. According to the Ann Arbor staging,14 cases were Ⅰ staging, 19 cases Ⅱ staging,none Ⅲ staging,Ⅳ staging 13 cases.According tumor form,21 cases were multinodulars,12 cases mass type, 11 cases diffuse swelling type, 2 cases ulcer or necrotic type. Conclusion CT and MR images might indicate the location, morphology, surrounding tissue and lymph nodes metastases of malignant lymphoma in head and neck.Great value in clinical diagnosis and treatment is observed.
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Objective To investigate the characteristics and value of nasal area-distance curves.Methods Based on data from CT images, nasal cavity cross-sectional areas in 60 volunteers were reconstructed. The size of each nasal airway and the distance from nostril to the corresponding cross-sectional area were measured. Area-distance curves were then established according to data obtained. t test was used to analysis the data. Results Three types of curves were found and categorized according to their shapes.Type Ⅰ consisted of 56 sides (46.7%) ,type Ⅱ 40 sides(33.3%), and type Ⅲ 24 sides (20. 0% ). Forcurves of nasal valve area, smooth type was seen in 86 sides (71.7%), and concave type in 34 sides(28.3%). Curves in area of inferior turbinate head were seen with shallow notch(48 sides,40.0%) ,deep notch (54 sides,45.0%), and no notch( 18 sides,15.0% ). Curves in area of middle turbinate head wereseen with shallow notch (31 sides, 25.8%), deep notch (38 sides, 31.7%), and no notch ( 51 sides,42. 5% ). Nasal minimal cross-sectional area was located at nasal valve area in76 sides (63.3%), head of inferior turbinate in 26 sides ( 21.7% ), region anterior to nasal valve in 15 sides ( 12. 5% ), head ofmiddle turbinate in 1 side, and region anterior to choana in 2 sides. The cross-sectional area at nasal valve in men and women were (197.9 ±41.2) and (151.2 ±35.5) mm2, respectively. The cross-sectional area at choana in men and women were (361.8±97.9) and (296.3 ± 81.8) mm2, respectively. There wassignificant difference between men and women at both sites (t = 4.707 and 0. 007, P ＜ 0.01). The distance from nostril to nasal valve in men and women were (14. 0 ± 2.4) and ( 11.8 ± 2. 9) mm, which presented significant difference, too (t = 3. 232,P ＜ 0. 01). Conclusions CT nasal area-distance curve varied with individual, CT may provide information for evaluating nasal passage on individual basis