• Title/Summary/Keyword: 초음파 조직생검

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Availability of Positron Emission Tomography-Computed Tomography for the Diagnosis of the Soft Tissue Tumor through Ultrasound-Guided Biopsy (초음파 유도하 침 생검을 이용한 연부조직 종양의 진단에 있어 양전자방출 컴퓨터 단층촬영술의 유용성)

  • Jun, Se Bin;Kim, Jeung Il;Lee, In Sook;Song, You Seon;Choi, Kyung Un
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.398-403
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    • 2021
  • Purpose: A biopsy is needed to diagnose soft tissue tumors. However, it is extremely difficult to pinpoint the site of a tumor due to the heterogeneity of sarcomas. Thus, even when an open biopsy is conducted, it is difficult to diagnose a soft tissue tumor. In such cases, an ultrasound (US)-guided biopsy is used to improve the diagnostic accuracy. This study evaluated the accuracy of US-guided biopsy for a diagnosis of soft tissue tumors found initially in a magnetic resonance (MR) perfusion and assessed the availability of positron emission tomography-computed tomography (PET-CT) for a diagnosis of soft tissue tumors. Materials and Methods: From January 2014 to December 2018, the US-guided biopsy was performed on 152 patients with a suspected soft tissue tumor found in an MR perfusion and 86 cases were definitively diagnosed with a soft tissue tumor. The accuracy of the US-guided biopsy was assessed retrospectively. Among the 86 cases, only MR perfusion was used before the biopsy in 50 cases, while both MR perfusion and PET-CT was conducted on 36 cases. The accuracy was analyzed to determine if the PET-CT could improve the precision of a biopsy. Results: From 86 cases, 34 out of 50 cases, in which only MR perfusion had been conducted, matched the result of the definitive diagnosis and the US-guided biopsy. 32 out of 36 cases, in which both PET-CT and MR perfusion were conducted, matched the definitive diagnosis and the US-guided biopsy. These results show significant differences in the accuracy of US-guided biopsy. In the case of soft tissue sarcomas, 6 out of 12 cases, in which only MR perfusion had been conducted, matched the result of the definitive diagnosis and the US-guided biopsy. 17 out of 18 cases, in which both PET-CT and MR perfusion were conducted, matched the definitive diagnosis. Moreover US-guided biopsy also showed significant differences in the accuracy of US-guided biopsy. Conclusion: In diagnosing soft tissue tumors, a US-guided biopsy is a well-known tool for its high accuracy. However, the heterogeneity of sarcoma makes it difficult to locate the exact site for a biopsy using only MR perfusion. Thus, the use of PET-CT will meaningfully improve the accuracy of a diagnosis by precisely targeting the site for the US-guided biopsy.

Correlation of hypoechogenic lesions with lactic dehydrogenase isoenzymes, culture and cytological findings of prostatic fluid and bilpsied tissue in dogs (개에서 전립선액과 생검조직에 대한 젖산탈수소 효소치, 배양 및 세포학적 검사와 초음파상의 저에코 영역과의 연관성)

  • Eom, Ki-dong;Yoon, Jung-hee;Sung, Jai-ki
    • Korean Journal of Veterinary Research
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    • v.38 no.3
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    • pp.664-673
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    • 1998
  • 초음파학적 검사에 따라 미만성 저에코 영역, 낭포, 다병소성 낭포 및 비후된 피막 등 비정상적 소견을 보이는 전립선에서 추출한 전립선액과 생검조직에서의 LDH 분획비(LDH I/V)의 평균치는 각각 $0.92{\pm}0.55$, $2.69{\pm}0.82$, 정상군(각각 $0.23{\pm}0.20$, $0.57{\pm}0.36$)에 비하여 유의성(p<0.01) 있게 높았다. 세포병리학적 검사에서 전립선 비대증 및 전립선염으로 나타난 비정상군($2.76{\pm}0.77$의 생검조직 LDH 평균분획비는 정상군($1.38{\pm}1.19$)에 비해 유의성 있게 높았으나 전립선액에서는 분획비의 유의차가 인정되지 않았다. 배양결과에 따른 전립선액 및 조직시료의 LDH 분획비는 정상군과 비정상군 사이에서의 유의성은 인정되지 않았다. 결론적으로 저에코 영역 및 낭포부위는 생검조직과 전립선액의 배양 및 세포병리학적 검사에 따른 비정상성 및 높은 LDH 분획비와 밀접한 연관성을 보였다. 특히 경직장 초음파상에 나타나는 미만성 저에코 영역은 전립선 비대증 및 만성 전립선염 등과 같은 병적 관련성을 내포하고 있는 것으로 사료된다.

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Ultrasound-guided Core Needle Biopsy in Diagnosis of Soft Tissue Masses (연부조직 종물의 진단에서 초음파 유도하 중심부 침생검)

  • Kim, Jeung-Il;Youn, Myung-Soo;Cheon, Sang-Jin;Choi, Gyung-Un;Lee, Tae-Hong
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.113-119
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    • 2004
  • Purpose: To determine the utility of sonographically guided percutaneous core needle biopsy to diagnose musculoskeletal soft tissue masses. Methods: A prospective study was performed in 55 patients referred for image-guided needle biopsy of primary or recurrent soft tissue masses and bone lesion or suspected solitary metastasis with extraosseous masses. Tissue samples were obtained with a 14-gauge or 18-gauge cutting needle coupled to an automated biopsy device under local anesthesia and sonographic guidance. Statistical analysis was based on 49 biopsies confirmed by successful clinical treatment (11 cases) or surgical resection (38 cases). Results: An accurate diagnosis was obtained in 47 (97%) of 49 biopsies; sensitivity was 95%, and specificity was 100%. The method did not yield sufficient tissue to establish a diagnosis in 6 cases. Considering all 55 biopsies, high-quality specimens were obtained in 87%. There were no serious complications. Conclusions: Sonographically guided core needle biopsy is accurate and safe, in soft tissue masses and bone tumors with extraosseous masses in the appendicular skeleton. In such patients, the sonographically guided procedure is the most prompt and effective method for obtaining tissue samples.

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Atypical Ductal Hyperplasia: Risk Factors for Predicting Pathologic Upgrade on Excisional Biopsy (침생검 조직검사에서 진단된 비정형 관상피증식증: 수술적 절제 생검에서 악성으로 진단될 가능성을 예측할 수 있는 위험인자들)

  • Ko Woon Park;Boo-Kyung Han;Sun Jung Rhee;Soo Youn Cho;Eun Young Ko;Eun Sook Ko;Ji Soo Choi
    • Journal of the Korean Society of Radiology
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    • v.83 no.3
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    • pp.632-644
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    • 2022
  • Purpose To determine the incidence of atypical ductal hyperplasia (ADH) in needle biopsy and the upgrade rate to carcinoma, and to evaluate difference in findings between the upgrade and non-upgrade groups. Materials and Methods Among 9660 needle biopsies performed over 48 months, we reviewed the radiologic and histopathologic findings of ADH and compared the differences in imaging findings (mammography and breast US) and biopsy methods between the upgrade and non-upgrade groups. Results The incidence of ADH was 1.7% (169/9660). Of 112 resected cases and 30 cases followed-up for over 2 years, 35 were upgraded to carcinoma (24.6%, 35/142). The upgrade rates were significantly different according to biopsy methods: US-guided core needle biopsy (USCNB) (40.7%, 22/54) vs. stereotactic-vacuum-assisted biopsy (S-VAB) (16.0%, 12/75) vs. USguided VAB (US-VAB) (7.7%, 1/13) (p = 0.002). Multivariable analysis showed that only US-CNB (odds ratio = 5.19, 95% confidence interval: 2.16-13.95, p < 0.001) was an independent predictor for pathologic upgrade. There was no upgrade when a sonographic mass was biopsied by US-VAB (n = 7) Conclusion The incidence of ADH was relatively low (1.7%) and the upgrade rate was 24.6%. Surgical excision should be considered because of the considerable upgrade rate, except in the case of US-VAB.

Clinical Efficacy of the Ultrasonography in the Diagnosis of the Palpable Soft Tissue Masses (촉지되는 연부조직 종괴의 진단에서 초음파 검사의 유용성)

  • Park, Tae Soo;Kim, Hong Sik;Kim, Sungjun;Ryu, Jeong Ah
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.4 no.2
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    • pp.59-65
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    • 2011
  • Purpose: To determine the clinical efficacy of the ultrasonography (US) for the diagnosis of the soft tissue masses comparing to the clinical diagnosis through the physical examination. Materials and Methods: 83 consecutive patients with palpable soft tissue masses were presented retrospectively. On the basis of the pathological diagnosis after the operation, the diagnostic accuracies were evaluated the cases diagnosed by history taking and physical examination, and the cases diagnosed by US before the operation. Results: The diagnostic accuracy of the cases using US was higher(86.7%) than that of the cases using physical examination and history taking. The accuracy of US of the epidermal inclusion cyst was 71.4%, ganglion cyst 85.7%, lipoma 88.6%, respectively. Accurate diagnosis were made 54 cases with 65.1% sensitivity in the cases diagnosed by history taking and physical examination. In this case, its accuracy of the ganglion cyst was 56.0%, and the lipoma was 67.9%. Conclusion: US is a useful diagnostic tool for the diagnosis of the palpable soft tissue masses before the operation.

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Observation of Changes in Indoor Formaldehyde(HCHO) Concentration during Ultrasound Guided Biopsy (초음파 조직생검 시 실내의 포름알데히드(HCHO) 농도 변화 관찰)

  • Lee, Hoon-Jeong;Kang, Sung-Jin
    • Journal of the Korean Society of Radiology
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    • v.15 no.7
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    • pp.1057-1064
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    • 2021
  • This study was conducted by simulating the same environmental conditions as the actual biopsy to observe the change in formaldehyde(HCHO) concentration in the indoor air during ultrasound guided biopsy. Changes in HCHO concentration in the room were measured by successively performing five steps: sealing the ultrasound room, ventilation, opening formalin containers, sealing formalin containers, and re-ventilating. Trends of measured HCHO concentration changes were visualized using graphs. As a result of analyzing the consistency of the concentration change values measured three times using the intra-class correlation coefficient, it was found to be 0.989, which was statistically significant(p<0.05). Based on the results of this study, we hope that medical workers working in the HCHO exposure environment of the field of radiology part will improve their awareness of the necessity of exposure management at work, and actively discuss the establishment of an environment for exposure control and preparation of countermeasures.

Ultrasonographic Features and the Diagnostic Role of Core Needle Biopsy at Metastatic Breast Cancer in the Thyroid gland: A Case Report (갑상선에 생긴 전이성 유방암의 초음파 소견 및 중심부 바늘 생검의 진단적 가치: 증례 보고)

  • Dong Hyun Lee;Ra Gyoung Yoon;Jin Kyung An;Jeong Joo Woo
    • Journal of the Korean Society of Radiology
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    • v.81 no.3
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    • pp.719-725
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    • 2020
  • Metastases to the thyroid gland have rarely been reported in clinical settings, and the thyroid gland is an uncommon site for breast carcinoma metastasis. We report a case of a 64-year-old breast cancer patient diagnosed with metastatic breast carcinoma in the thyroid gland after performing ultrasonography (US)-guided core needle biopsy (CNB) and subsequent total thyroidectomy. On US, the thyroid lesion appeared to be mildly enlarged with multiple internal hypoechoic lines and a few microcalcifications without mass formation. Under US-guidance, CNB was performed by targeting the area with microcalcifications and subsequently diagnosed as metastatic breast carcinoma. Total thyroidectomy revealed that the patient had metastatic invasive ductal carcinoma of the breast with lymphatic spread involving both lobes and the isthmus of the thyroid gland. Although the thyroid gland is an uncommon metastatic site, the unusual features of thyroid metastasis can be observed on US; thus, US-guided CNB effectively aids the diagnosis of thyroid metastasis.

MR-Guided Targeted Prostate Biopsy from Radiologists' Perspective (영상의학과 의사의 시각에서 본 자기공명영상 기반 전립선 표적 생검)

  • So-Yeon Kim;Kye Jin Park
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1220-1232
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    • 2023
  • The prostate cancer diagnosis has traditionally been based on a systematic biopsy method in which tissue samples are randomly obtained from the prostate 10-12 sites. However, there are concerns as the method can fail to diagnose all prostate cancers or lead to over-detection of clinically insignificant cancers. MRI-guided prostate targeted biopsy has been proposed to address these shortcomings. This method involves identifying suspicious lesions using MRI and performing targeted biopsies under ultrasound or MRI guidance. We review the methods of MRI-based targeted biopsy and discuss recent guidelines and trends in prostate cancer diagnosis.

The Study for Results of Complex Cystic Breast Masses by Biopsy on Ultrasound (초음파상 복합성 낭성 유방 종괴의 조직 검사 결과에 관한 연구)

  • Kang, Hye-Kyoung;Dong, Kyung-Rae
    • Journal of radiological science and technology
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    • v.31 no.2
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    • pp.129-134
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    • 2008
  • Purpose: We examined the roles of Ultrasonography conductors by analyzing the results of tissue biopsy of complex cystic masse under the guidance of breast US. Objects and methods: This study was performed to a group of 178 who showed breast US indicating complex cystic masses among 342 patients who were definitely diagnosed by tissue biopsies and operations in our hospital from June 30th, 2003 to June 30th, 2007. The evaluation of tissues around, calcification, the distribution state of blood flow were excluded from the analysis subjects and logic 200 made by GE corporation and gun for core biopsy(Kimal corp., K7/MBD23) were used in this study. Results: The biopsy results of 178 subjects showed FCC (fibrocystic change)(n=56 : 31.4%), Fibrosis (n=41 : 23.0%), Fibroadenoma (n=20 : 11.2%), Epithelial hyperplasia (n=17 : 9.6%), Carcinoma (n=15 : 8.4%), Fibroadipose (n=8 : 4.5%), Sclerosing adenosis (n=7 : 3.9%), Duct ectasia (n=5 : 2.8%), Papiloma (n=5 : 2.8%), and Fat necrosis (n=1 : 0.6%), Hemangioma (n=1 : 0.6%), Abscess (n=1 : 0.6%), Dystrophic calcification(n=1 : 0.6%). Conclusion: The US showed that the results of the tissue biopsy of complex cystic masses were mostly carcinoma(8.4%). Most of them were benign and only 9.6% of epithelial hyperplasia which has high progression rate into malignant tumors epidemically showed malignancy. Most of them were included in the spectrum of fibrous cystic nodule. Even though these results are confirmed, further studies are required. As a result, a nodule which is not certified by US should be right to take the tissue biopsy, but if it's difficult due to patients or another reasons, re-check tests in three months are required. And systemic ultrasonography evaluation should be well recognized to conduct more careful and specific tests.

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