Chiba koob nyob rau hauv lub ntsws, siab, pancreas & Retroperitoneal qog nqaij hlav - Nrog rau kev tiv thaiv teeb meem

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Lung Nodule CT-FNAB

Nyias-slice CT localizes nodule → kos daim tawv nqaij nkag (shortest trans-pleural path; zam fissures & hlab ntsha).

Lidocaine mus rau theem pleural (txo hnoos reflex ntawm puncture).

21G/22G Chiba → ua ntej → paub meej cov lus qhia tsis pub dhau -necrotic qog ntawm CT.

Kev nqus tau zoo + ntxuam → thim tawm → smear / qhov chaw hauv CytoLyt®.

Tshaj tawm - txheej txheem CXR:txwv tsis pub pneumothorax / pulmonary hemorrhage.

Pneumothorax & Hemoptysis

• Pneumothorax: 3-15% tshwm sim; feem ntau<30% resolve spontaneously; larger / symptomatic → needle aspiration or chest tube
• Tiv thaiv: luv tshaj plaws pleural traverse, ua tsis taus pa - tuav ntawm qhov ntxig, txo qhov hla
• Hemoptysis: feem ntau nws tus kheej- txwv hauv 24-48 teev; persistent → rule out AVM

Abdominal (Liver / Pancreas / raum / Retroperitoneum)

• Lub siab:Tsis txhob muaj cov kab mob loj thiab cov kab mob siab; ua pa- tuav kev sib koom tes
• Pancreas:Tsis txhob gastric / duodenal gas; tuaj yeem ua rau lub plab nrog dej kom tshem tau cov hnyuv; 22G txo qis cov kua txiv kab mob pancreatic
• Retroperitoneal:20-22 cm ntev; zam aorta, IVC, raum cov hlab ntsha
• Lub raum:22G rau localization; feem ntau ua raws li coaxial core biopsy

• Chiba (FNA) vs Core Biopsy (CNB)

• Sib:Cytology, siab rhiab heev rau malignancy, tsawg heev raug mob
• Core (Tru-Txiav):Histology + IHC + kuaj molecular (lymphoma, sarcoma, subtyped carcinoma)
• Kev xyaum: Chiba localizes → coaxial sheath → core los ntawm sheath (txo pleural / serosal passes)

Needle Tract Seeding

Tsawg heev (<0.01%) with FNA; minimize by using shortest path, record tract if subsequent resection planned, avoid excessive manipulation of necrotic/unencapsulated hypervascular tumors

With proper respiratory coordination, CT confirmation of tip position, and micro-coaxial techniques, Chiba needle CT-guided biopsy achieves >90% diagnostic tus nqi nrog kev lees paub morbidity.