超声内镜引导下细针穿刺抽吸/活检术(endoscopic ultrasound-guided fine needle aspiration/biopsy,EUS-FNA/B)已广泛用于消化道及其邻近器官病变的标本获取,其诊断效果受多个因素的影响,如何提高穿刺标本的质量以减少假阴性诊断的发生...超声内镜引导下细针穿刺抽吸/活检术(endoscopic ultrasound-guided fine needle aspiration/biopsy,EUS-FNA/B)已广泛用于消化道及其邻近器官病变的标本获取,其诊断效果受多个因素的影响,如何提高穿刺标本的质量以减少假阴性诊断的发生,提高FNA/B阳性率是穿刺过程中面临的重要问题,本文主要围绕FNA/B相关辅助技术的研究进展进行阐述。展开更多
为提高超声内镜引导细针穿刺抽吸/活检术(endoscopic ultrasound-guided fine-needle aspiration/biopsy,EUS-FNA/B)诊断准确率,快速现场评估(rapid on site evaluation,ROSE)被应用于该操作中,通过细胞病理医师现场评估标本取材满意度...为提高超声内镜引导细针穿刺抽吸/活检术(endoscopic ultrasound-guided fine-needle aspiration/biopsy,EUS-FNA/B)诊断准确率,快速现场评估(rapid on site evaluation,ROSE)被应用于该操作中,通过细胞病理医师现场评估标本取材满意度及标本的良恶性,让内镜医师及时获得反馈,以提高诊断准确率、减少不必要的穿刺。由于许多内镜中心无法实现细胞病理医师进行ROSE,目前逐渐出现内镜医师进行ROSE。内镜医师能否胜任ROSE,其诊断效能能否与细胞病理医师相媲美值得探讨。文中结合近年来文献进展,对内镜医师在胰腺实性占位EUS-FNA/B标本快速评估中的作用进行了综述。展开更多
Background: In patients with thickened esophagogastric wall on CT but without evidence of malignancy on endoscopic mucosal biopsies, obtaining adequate histology from the gut wall is difficult. We examined whether it ...Background: In patients with thickened esophagogastric wall on CT but without evidence of malignancy on endoscopic mucosal biopsies, obtaining adequate histology from the gut wall is difficult. We examined whether it is feasible to obtain diagnostic tissue core from the gut wall by using EUS-guided Trucut biopsy technique in this group of patients. Methods: Ten patients were included in this study. Under EUS guidance, mucosa was penetrated by using a 19-gauge Trucut needle, and a 18-mm tissue tray was advanced obliquely through the wall layers to avoid penetration of the serosa. Then, the cutting sheath was fired over the tray. Observations: Biopsies were performed without complications. Diagnoses of carcinoma were made in 5 patients. Four other patients had benign histology, and, during follow-up, all these diagnoses have been proven to be true negatives. One Trucut biopsy specimen was considered false negative. Conclusions: The EUS guided Trucut mural biopsy technique could yield diagnostic tissue cores in patients with unexplained thickening of the esophagogastric wall.展开更多
Background: EUS-guided FNA (EUS-FNA) is an accurate technique for sampling extraintestinal masses and lymph nodes. The use of a Trucut needle to perform EUS-guided biopsy (EUS-TCB) may improve the results or simplify ...Background: EUS-guided FNA (EUS-FNA) is an accurate technique for sampling extraintestinal masses and lymph nodes. The use of a Trucut needle to perform EUS-guided biopsy (EUS-TCB) may improve the results or simplify the procedure. To date, few studies have prospectively assessed the performance and the safety of EUS-TCB. Methods: Patients with a known or a suspected malignancy referred for a diagnostic and/or staging EUS examination were enrolled in a prospective study. EUS-guided biopsy was performed first with a 19-gauge Trucut needle. If the Trucut failed to obtain an adequate sample orwhen the “ in room" touch preparation was benign, EUS-FNA was performed with a standard 22-gauge FNA needle. The objective of the study was to assess the yield of detection of malignancy and the safety of EUS-TCB in patients with known or suspected malignancies and to investigate if EUS-FNA has a role for rescue in cases of Trucut failure. Observations: Thirty-nine lesions underwent EUS-TCB in 30 patients. Sufficient follow-up was available for all patients. By using EUS-TCB, we were able to obtain a sample for diagnosis in all but 3 patients (one pancreatic mass and two lymph nodes) in which technical problems arose. In these patients, the diagnosis was obtained in two cases by EUS-FNA and in the other one by EUS-TCB from the primary pancreatic tumor. The yield of detection of malignancy for EUS-TCB was 84% . No complications were recorded in any patients at 1 and 7 days of follow-up. The sample size is limited to generalize conclusions. Conclusions: EUS-TCB is a safe and an accurate procedure to obtain a histologic diagnosis in patients with known or suspected malignancies. EUS-FNA can serve as a rescue technique in cases of Trucut failure.展开更多
我院自1995年开展肾穿刺活检,曾采用18 G Menghi-ni穿刺针负压抽吸式术（双人操作）,近年来,实时超声的引导和自动活检枪的应用使经皮肾穿刺活检更准确有效,我院自2005年底开展使用Tru-cut型活检针在B超引导下行经皮肾穿刺活检术,成功...我院自1995年开展肾穿刺活检,曾采用18 G Menghi-ni穿刺针负压抽吸式术（双人操作）,近年来,实时超声的引导和自动活检枪的应用使经皮肾穿刺活检更准确有效,我院自2005年底开展使用Tru-cut型活检针在B超引导下行经皮肾穿刺活检术,成功率高。作为1种有创性检查,仍会出现一定的并发症,现将2种取材方法、质量及并发症报告如下。展开更多
胆囊癌侵袭性强,进展速度快,早期诊断胆囊癌是提升预后的关键。本综述回顾了以胆囊为靶点的超声内镜引导细针穿刺抽吸/活检术(endoscopic ultrasound-guided fine needle aspiration/biopsy,EUS-FNA/B)诊断胆囊癌的研究,总结了EUS-FNA/...胆囊癌侵袭性强,进展速度快,早期诊断胆囊癌是提升预后的关键。本综述回顾了以胆囊为靶点的超声内镜引导细针穿刺抽吸/活检术(endoscopic ultrasound-guided fine needle aspiration/biopsy,EUS-FNA/B)诊断胆囊癌的研究,总结了EUS-FNA/B对胆囊癌的诊断效能、可能影响诊断率的因素以及不良事件。展开更多
文摘超声内镜引导下细针穿刺抽吸/活检术(endoscopic ultrasound-guided fine needle aspiration/biopsy,EUS-FNA/B)已广泛用于消化道及其邻近器官病变的标本获取,其诊断效果受多个因素的影响,如何提高穿刺标本的质量以减少假阴性诊断的发生,提高FNA/B阳性率是穿刺过程中面临的重要问题,本文主要围绕FNA/B相关辅助技术的研究进展进行阐述。
文摘为提高超声内镜引导细针穿刺抽吸/活检术(endoscopic ultrasound-guided fine-needle aspiration/biopsy,EUS-FNA/B)诊断准确率,快速现场评估(rapid on site evaluation,ROSE)被应用于该操作中,通过细胞病理医师现场评估标本取材满意度及标本的良恶性,让内镜医师及时获得反馈,以提高诊断准确率、减少不必要的穿刺。由于许多内镜中心无法实现细胞病理医师进行ROSE,目前逐渐出现内镜医师进行ROSE。内镜医师能否胜任ROSE,其诊断效能能否与细胞病理医师相媲美值得探讨。文中结合近年来文献进展,对内镜医师在胰腺实性占位EUS-FNA/B标本快速评估中的作用进行了综述。
文摘Background: In patients with thickened esophagogastric wall on CT but without evidence of malignancy on endoscopic mucosal biopsies, obtaining adequate histology from the gut wall is difficult. We examined whether it is feasible to obtain diagnostic tissue core from the gut wall by using EUS-guided Trucut biopsy technique in this group of patients. Methods: Ten patients were included in this study. Under EUS guidance, mucosa was penetrated by using a 19-gauge Trucut needle, and a 18-mm tissue tray was advanced obliquely through the wall layers to avoid penetration of the serosa. Then, the cutting sheath was fired over the tray. Observations: Biopsies were performed without complications. Diagnoses of carcinoma were made in 5 patients. Four other patients had benign histology, and, during follow-up, all these diagnoses have been proven to be true negatives. One Trucut biopsy specimen was considered false negative. Conclusions: The EUS guided Trucut mural biopsy technique could yield diagnostic tissue cores in patients with unexplained thickening of the esophagogastric wall.
文摘Background: EUS-guided FNA (EUS-FNA) is an accurate technique for sampling extraintestinal masses and lymph nodes. The use of a Trucut needle to perform EUS-guided biopsy (EUS-TCB) may improve the results or simplify the procedure. To date, few studies have prospectively assessed the performance and the safety of EUS-TCB. Methods: Patients with a known or a suspected malignancy referred for a diagnostic and/or staging EUS examination were enrolled in a prospective study. EUS-guided biopsy was performed first with a 19-gauge Trucut needle. If the Trucut failed to obtain an adequate sample orwhen the “ in room" touch preparation was benign, EUS-FNA was performed with a standard 22-gauge FNA needle. The objective of the study was to assess the yield of detection of malignancy and the safety of EUS-TCB in patients with known or suspected malignancies and to investigate if EUS-FNA has a role for rescue in cases of Trucut failure. Observations: Thirty-nine lesions underwent EUS-TCB in 30 patients. Sufficient follow-up was available for all patients. By using EUS-TCB, we were able to obtain a sample for diagnosis in all but 3 patients (one pancreatic mass and two lymph nodes) in which technical problems arose. In these patients, the diagnosis was obtained in two cases by EUS-FNA and in the other one by EUS-TCB from the primary pancreatic tumor. The yield of detection of malignancy for EUS-TCB was 84% . No complications were recorded in any patients at 1 and 7 days of follow-up. The sample size is limited to generalize conclusions. Conclusions: EUS-TCB is a safe and an accurate procedure to obtain a histologic diagnosis in patients with known or suspected malignancies. EUS-FNA can serve as a rescue technique in cases of Trucut failure.
文摘我院自1995年开展肾穿刺活检,曾采用18 G Menghi-ni穿刺针负压抽吸式术（双人操作）,近年来,实时超声的引导和自动活检枪的应用使经皮肾穿刺活检更准确有效,我院自2005年底开展使用Tru-cut型活检针在B超引导下行经皮肾穿刺活检术,成功率高。作为1种有创性检查,仍会出现一定的并发症,现将2种取材方法、质量及并发症报告如下。
文摘胆囊癌侵袭性强,进展速度快,早期诊断胆囊癌是提升预后的关键。本综述回顾了以胆囊为靶点的超声内镜引导细针穿刺抽吸/活检术(endoscopic ultrasound-guided fine needle aspiration/biopsy,EUS-FNA/B)诊断胆囊癌的研究,总结了EUS-FNA/B对胆囊癌的诊断效能、可能影响诊断率的因素以及不良事件。
