https://radiopaedia.org/articles/chiba-needle

Tsis pub dhau lub cuab yeej armamentarium ntawm cov tshuaj cuam tshuam,Chiba koobsawv tawm raws li qhov tseem ceeb thoob ntiaj teb sib txawv los ntawm kev sib tw, qhov tseeb ntawm qhov tseeb thiab kev ua haujlwm zoo tshaj plaws rau kev daws cov teeb meem kev kho mob ntau yam. Txawm hais tias muaj ntau yam, lawv qhov kev xa tawm ua raws li kev siv lub cev hnyav, kab mob thiab cov txheej txheem txheej txheem es tsis yog siv arbitrary. Daim ntawv no qhia txog tag nrho cov spectrum ntawm cov tseem ceeb Chiba koob qhia thiab tsim kev txiav txim siab- ua lub hauv paus rau kev xaiv, xa cov lus qhia meej rau kev kho mob.

1. Spectrum of Diagnostic Applications

Kev kuaj mob yog lub luag haujlwm tseem ceeb ntawm Chiba koob, nyob rau hauv qhov tseeb ntawm qhov tau txais cov qauv.

• Histopathological biopsyIb qho ntawm nws cov kev siv ntau tshaj plaws. Raws li CT, ultrasound lossis MRI kev taw qhia, Chiba rab koob nkag mus rau cov nqaij tawv nqaij kom pom cov kab mob sib sib zog nqus visceral, suav nrog cov qog nqaij hlav, cov kab mob siab, cov qog nqaij hlav thiab cov qog nqaij hlav retroperitoneal. Nws qhov ntsuas me me (feem ntau yog 20G–25G) txo qis kev pheej hmoo ntawm hemorrhage thiab koob- kab mob qog nqaij hlav. Nws yog tshwj xeeb tshaj yog haum rau siab - qhov chaw muaj kev pheej hmoo (cov kab mob nyob ib sab ntawm cov hlab ntsha loj) thiab cov xwm txheej uas yuav tsum tau muaj ntau-site, rov ua piv txwv. Nws txoj kev hloov pauv hloov pauv tau ua rau kev zam ntawm lub cev tseem ceeb, txhawb nqa tus kheej txoj hauv kev kho koob.
• Cytology thiab kua dej tsom xamAspiration ntawm Chiba koob retrieves cellular cov ntaub ntawv los yog kua los ntawm qhov txhab. Rau cov kab mob siab / lub raum thiab cov kab mob abscesses, rab koob pab txhawb ob qho tib si decompressive kua thiab cov kua dej sau rau biochemical kuaj, kab lis kev cai kab lis kev cai los yog kev kuaj cytological kom sib txawv sib txawv ntawm cov kab mob neoplastic. Nws kuj yog ib qho kev nyab xeeb, txhim khu kev txheeb xyuas cov cuab yeej rau thoracentesis thiab abdominocentesis ntawm effusions.
• Luminal opacification thiab duabQhov no yog qhov tseem ceeb ntawm daim ntawv thov uas tsim kom muaj Chiba koob lub koob npe nrov. Nyob rau hauv percutaneous transhepatic cholangiography (PTC), koob punctures dilated intrahepatic bile ducts rau qhov sib piv txhaj tshuaj, ua kom pom tseeb pom ntawm biliary anatomy, qhov chaw thaiv thiab qhov txhab. Tib lub hauv paus ntsiab lus siv rau percutaneous pyelography, muab cov txheej txheem kev qhia txog kev kho mob tom ntej.

2. Cov txheej txheem ntawm kev siv tshuaj kho mob

Kev siv tshuaj kho mob yog qhov kev hloov pauv hloov pauv rau Chiba koob, hloov nws los ntawm cov cuab yeej kuaj mob mus rau hauv lub hauv paus nkag mus rau kev kho mob.

• Kev kho dej thiab decompression khoRau cov hlwv, abscesses, hematomas, los yog obstructed bile ducts thiab lub raum pelvicalyceal systems, Chiba koob ua raws li ib tug trailblazer los tsim ib qho kev nkag mus rau thawj zaug. Tom qab ua tiav kev sib tsoo, ib txoj hlua coj tau nce siab los ntawm lub lumen, tom qab ntawd hloov pauv rau cov kav dej loj dua rau kev khiav tawm mus tas li. Cov txheej txheem sawv cev muaj xws li percutaneous ntws ntawm hepatic abscesses thiab thawj koob nkag rau PTCD (percutaneous transhepatic biliary drainage) nyob rau hauv obstructive jaundice, ob qho tib si tso siab rau Chiba koob lub meej lub hom phiaj muaj peev xwm.
• Nerve block thiab tshuaj lom neeg neurolysisRaws li cov duab taw qhia, rab koob tau muab tso rau qhov tseeb nyob ib sab rau lub hom phiaj paj hlwb -xws li celiac plexus, intercostal nerves thiab posterior spinal nerve rami. Kev txhaj tshuaj ntawm cov ethanol, phenol glycerin lossis tshuaj loog hauv zos muab kev tswj xyuas kom tsawg kawg nkaus rau qhov kawg - mob qog noj ntshav thiab mob ntev heev.
• Tsim cov kev pabcuam kho mob nkag mus tau zooLub koob Chiba ua haujlwm raws li qhov tseem ceeb nkag mus rau ntau yam kev ua haujlwm nyuaj. Qhov piv txwv tseem ceeb tshaj plaws yog TIPS (transjugular intrahepatic portosystemic shunt), qhov uas nws ua qhov tseem ceeb ntawm cov hlab ntsha ntawm lub siab mus rau cov hlab ntsha portal los tsim txoj hauv kev shunt. Nws kuj tseem siv tau raws li cov pob txha lesion biopsy los tsim ib txoj hauv kev rau cov pob txha cement lossis tshuaj infusions.

3. Kev txiav txim siab-Ua kom muaj logic rau koob xaiv thiab siv

Kev xaiv ntawm qhov tsim nyog Chiba koob ntsuas thiab npaj daim ntawv thov ua raws li cov qauv hauv qab no:

3.1 Lub Hom Phiaj-Cov Ntsiab Lus Qhia

• Diagnostic hom phiaj: Ua ntej qhov ntsuas zoo (22G–25G); Qhov tseem ceeb tshaj plaws yog qhov kev nyab xeeb siab tshaj plaws thiab kev raug mob tsawg kawg nkaus los sau cov qauv kuaj pom zoo, siv tau.
• Kev tso dej tawm: Cov ntsuas loj me me (18G–20G) tuaj yeem siv los ua ib txoj haujlwm ua haujlwm, los yog cov txheej txheem coaxial (zoo koob hauv zos ua raws li cov sheath loj dua) tuaj yeem siv los tsim kom muaj txoj hauv kev zoo.
• Therapeutic access creation lub hom phiaj: Sib npaug trajectory complexity thiab qhov ntev ntawm cov cuab yeej tom ntej; Cov kev cai tshwj xeeb txawv (xws li, cov koob TIPS puncture koob) yuav tsum tau.

3.2 Trajectory Risk Stratification

Ntsuam xyuas seb cov hlab ntsha tseem ceeb, cov hlab ntsha lossis cov hlab ntsha hauv qhov khoob nyob ntawm txoj kev npaj puncture. Kev pheej hmoo siab dua anatomical mandates finer Chiba koob, uas nws optimized bevel geometry muab blunt ntaub so ntswg dissection, displacing tubular lug es perforating lawv los txhawb txoj kev nyab xeeb.

3.3 Compatibility nrog duab taw qhia Modality

• Ultrasound kev taw qhia: Tiag - lub sij hawm dynamic visualization kom meej meej qhia cov koob taub thiab vasculature, tso cai siv cov finer - ntsuas koob.
• CT kev taw qhia: Muab cov lus piav qhia anatomical nkig tab sis tsis muaj qhov tseeb - lub sij hawm tawm tswv yim, xav tau cov lus qhia muaj zog radiopacity; tob-calibrated cim shafts feem ntau pab tau rau gauging qhov tob.
• MRI kev taw qhia: Yuav tsum tau tshwj xeeb Chiba koob tsim los ntawm MRI- cov ntaub ntawv xwm txheej xws li nitinol alloy.

Xaus

Chiba koob daim ntaub ntawv tsim ib tug nruam spectrum spanning meej diagnostic sampling rau minimally invasive meej txoj kev kho. Kev paub txog lub hauv paus kev txiav txim siab hauv qab- kev ntsuas qhov sib luag ntawm peb qhov tseem ceeb: lub hom phiaj txheej txheem, kev pheej hmoo ntawm lub cev, thiab kev ntsuas kev sib raug zoo- txhawb nqa cov kws kho mob kom siv cov cuab yeej kom nyab xeeb thiab ua tau zoo. Ntau tshaj li ib qho yooj yim cannula, nws embodies lub ntsiab lus tseem ceeb ntawm kev cuam tshuam cov tshuaj: ua kom muaj txiaj ntsig zoo tshaj plaws thiab kho tau zoo thaum txo cov txheej txheem kev raug mob.