CT 유도하 대동맥 주변 임파절 흡입과 생검에 대한 고찰

Technical Aspect of CT-guided para-aortic LN Aspiration and Biopsy (Focused Preoperative staging of stomach cancer)

Purpose Stomach cancer is the most widely-found cancer in korea, accounts for about 24%(1st) for men, 15.3%(2nd) for women of the whole of the cancer patients, with development of MDCT, isotropic image and 3D image got available CT-guided para-aortic LN Aspiration/Biopsy is the early detection and accurate preoperative staging is critical. Materials and methods 16 slice MDCT used were studied on 33 patients with para-aortic LN enlargement during the period of Feb.2004- Dec.2006 AGC:7, Liver cancer:7, Pancreatic cancer:4, Lymphoma:3, Inflammation:2, MUO:1, Others:4, Unknown:5 The method used was coaxial technique. It was guided by 19G-needle and aspiration with 20G-aspiration needle is done 2 or 3 times. the advantage of this technique is the fact that we can raise the accuracy of targeting at smaller lesion. at the same time, it is helpful for multiple biopsy and aspiration. also less complication is reported. back approach was made for less complication. because mesentery, small bowel, peritoneum could not be passed through Results 2 patients showed negative results without F/U sensitivity:88.9%(16/18), specificity: 100%(13/13), accuracy:93.5%(29/31) CT-guided para-aortic LN aspiration in AGC 7 patients With suspected LN metastasis sex: 6 men, 1 woman, Age:40-72(mean 57), Size of enlarged LN :10-18mm(mean 13.3) Mean procedure time: 30mins, Confirmed by surgery or pathology, 2 true positive, 4 true negative, 1 false negative, Accuracy: 85.7%(6/7), No post procedural complication. Conclusion The advantage of CT-guided para-aortic LN aspiration/biopsy is as following: range of procedure is less invasive than surgery. also it shows relatively high accuracy. on the other band, the disadvantage of it is consumption of time. and the limitation of it is the fact that it can be performed on only a small number of patients. Also it is unable to biopsy to anatomical location of enlarged LN. But, development of CT equipment technology with CT-guided para-aortic LN aspiration and biopsy Technic’ s will keep increasing.