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EUS引导的trucut细针穿刺活检与EUS引导FNA进行活检补救:一项前瞻性研究

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世界核心医学期刊文摘（胃肠病学分册） 2006年第2期2卷 44-45页

作者： Ginè s A. Wiersema M.J. Clain J.E. M.J. Levy 陈瑜 Mayo Clinic Division of Gastroenterology and Hepatology 200 First St. SW Rochester MN 55905 United States Dr.

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.

关键词：细针穿刺活检 EUS FNA trucut 针吸组织学诊断胰腺肿瘤抽吸术简化过程本项

EUS引导下的trucut针吸活检:确定自身免疫性胰腺炎是否为梗阻性黄疽的病因

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世界核心医学期刊文摘（胃肠病学分册） 2005年第8期1卷 37-37页

作者： Levy M.J Reddy R.P Wiersema M.J 陈云茹 Mayo Clinic Div. of Gastroenterol. and Hepatol. 200 First Street SW Rochester MN 55905 United St atesDr

Background: The diagnosis of autoimmune pancreatitis can be difficult and ofte n requires a larger specimen than can be provided by FNA alone to determine if t he tissue sample obtained with EUS trucut biopsy (TCB) is sufficient to allow ad equate histologic review to establish the diagnosis of autoimmune pancreatitis. Methods: EUS TCB was performed in patients presenting with obstructive jaundice who were suspected of having autoimmune pancreatitis based on their clinical, la boratory and imaging studies. The charts were retrospectively reviewed to determ ine the feasibility of TCB. Results: Between August 2002 and June 2004, 3 patien ts with obstructive jaundice and suspected autoimmune pancreatitis (AIP) underwe nt EUS TCB. In each case, a diagnosis of pancreatic cancer also was considered, and surgical resection was the planned therapy before the patient underwent EUS TCB. Histologic review of the TCB specimens established the diagnosis of AIP in two patients and identified nonspecific changes of chronic pancreatitis in the t hird patient. EUS-guided FNA was performed in two of the 3 patients and failed to establish the diagnosis in either patient. Other than mild transient abdomina l pain (n = 1), no complications were identified. Conclusions: This preliminary study suggests that EUS TCB can safely establish the diagnosis of AIP. Doing so helps guide management and may help to avoid unnecessary surgery. Prosp- ective studies are needed to verify these findings and to more clearly define the role of EUS TCB in these patients.

关键词： EUS trucut 针吸活检阻性黄疽慢性胰腺炎黄疸者梗阻型影像学检查疑似患者

针道双极射频消融的trucut活检针:测试实验

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国际医学放射学杂志 2010年第5期 508-508页

作者： P.Bruners T.Penzkofer P.Isfort J.Pfeffer T.Schmitz-Rode R.W.Gunther 肖运平 Applied Medical Engineering Helmholtz Institute for Biomedical EngineeringRWTH Aachen University

关键词：活组织检查射频消融 trucut 岀血肿瘤细胞种植

EUS引导的trucut细针抽吸活检研究不明原因的食管壁增厚

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世界核心医学期刊文摘（胃肠病学分册） 2006年第2期2卷 46-46页

作者： Aithal G.P. Anagnostopoulos G.K. Kaye P. 陈瑜 Queen's Medical Centre University Hospital South Block Nottingham NG72UH United Kingdom Dr.

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.

关键词： EUS trucut 细针抽吸活检管壁增厚活检标本电烙止血细针穿刺黏膜活检真阴性抽吸术