Effect of puncture sites on pneumothorax after lung CT-guided biopsy.

To determine the influence of puncture site on aspiration in dealing with pneumothorax following CT-guided lung biopsy.Two hundred thirty-six pneumothorax patients after CT guided lung biopsies were retrospective analyzed from January 2013 to December 2018. Patients with minor asymptomatic pneumothorax were treated conservatively with monitoring of vital signs and follow-up CT to confirm stability. Ninety of the 236 pneumothorax patients, who underwent manual aspiration, were included in this analysis. In first manual aspiration, the needle from the lesion was retracted back into the pleural space after biopsy, and then aspiration treatment was performed. If the treatment is of unsatisfied result, a second attempt aspiration treatment, which puncture site away from initial biopsy one, was conducted. The efficacy of simple manual aspiration and the new method, changing puncture site for re-aspiration was observed.Immediate success was obtained in 62 out of the 90 patients in the first attempt. The effective rate and failure rate were 68.9% (62/90) and 31.1% (28/90), respectively. Twenty-eight patients in whom first attempt simple aspiration were unsuccessful underwent a second attempt aspiration, which puncture site away from initial biopsy one, was successful in 13 patients with 15 patients undergoing chest tube placement. The effective rate and failure rate were 46.4% (13/28) and 53.6% (15/28), respectively. Applying the modified procedure, total effective rate of aspiration elevated significantly from 68.9% (62/90) to 83.3% (75/90) (P < .05). No serious side effects were detected in the period of aspiration procedure.Manual aspiration with puncture site away from initial biopsy one is worth trying to deal with post-biopsy pneumothorax. This modified procedure improved the efficiency of treatment significantly, and reduced the rate of pneumothorax requiring chest tube placement.

Manual aspiration in the biopsy-side down position to deal with delayed pneumothorax after lung biopsy.

BACKGROUND: To assess the effect of aspiration in the biopsy-side down position to deal with delayed pneumothorax after computed tomography (CT)-guided lung biopsy. METHODS: A retrospective review was performed of the 236 delayed pneumothorax patients who underwent CT-guided transthoracic needle biopsies (TTNBs). Asymptomatic minimal pneumothorax patients were managed conservatively. Manual aspirations were applied for symptomatic cases with minimal pneumothorax and all cases with moderate to large pneumothorax. Patients were included into two groups: in group A (35 patients), aspiration was performed in the same position as the biopsy, while in group B (54 patients), patients were turned to the biopsy-side down position (from supine to prone or vice versa), and aspiration was conducted. The efficacy of two approaches was evaluated. RESULTS: One hundred forty-seven (62.3%) asymptomatic cases resolved without treatment. Distance between parietal and visceral pleura before and after aspiration were 4.24±1.87 and 1.93±2.33 cm for group A, 3.92±1.31 and 0.98±1.50 cm for group B, respectively. Volume of aspirated air in group A and group B were 735.4±231.8 and 434.8±320.3 mL, respectively. Complete lung expansion was detected in 28.6% (10/35) and 38.9% (21/54) for group A and group B, respectively. The overall effective rate and failure rate were 74.3% (26/35) and 25.7%(9/35) for group A, 92.6% (50/54) and 7.4%((4/54))for group B, respectively, which have significant statistic difference (P<0.05). CONCLUSIONS: Manual aspiration in biopsy-side down position demonstrates the safety and efficacy in treating delayed pneumothorax after CT-guided TTNBs. Thus reduce the rate of pneumothorax requiring drainage catheter placement.

Meta-analysis of quantitative diffusion-weighted MR imaging in differentiating benign and malignant pancreatic masses.

There have been numerous studies done to explore the diagnostic performance of quantitative diffusion-weighted (DW) MR imaging to differentiate between benign and malignant pancreatic masses. However, the results have been inconsistent. We performed a meta-analysis to investigate whether DW-MR imaging can differentiate between these two diseases. Databases including MEDLINE, EMBASE and Cochrane Library were utilized to find relevant articles published between January 2001 and January 2014. A Stata version 12.0 and a Meta-Disc version 1.4 were used to describe primary results. Twelve studies with 594 patients, which fulfilled the inclusion criteria, were enrolled for the analysis. The pooled sensitivity and specificity of DW imaging was 0.91 (95% CI: 0.84, 0.95) and 0.86 (95% CI: 0.76, 0.93) respectively. The area under the curve of the summary receiver operating characteristic was 0.95 (95% CI: 0.93, 0.96). The results indicated that DW imaging might be a valuable tool for differentiating benign and malignant pancreatic masses.

Magnetic resonance imaging correlates of bee sting induced multiple organ dysfunction syndrome: A case report.

Occasionally systemic complications with high risk of death, such as multiple organ dysfunction syndrome (MODS), can occur following multiple bee stings. This case study reports a patient who presented with MODS, i.e., acute kidney injury, hepatic and cardiac dysfunction, after multiple bee stings. The standard clinical findings were then correlated with magnetic resonance imaging (MRI) findings, which demonstrates that MRI may be utilized as a simpler tool to use than other multiple diagnostics.