超声引导下的抽吸和活检
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• Glass slides ready 准备玻片 • Biopsy sample containers
保存样品的容器
• Minimum number of samples 最少的样品量
• Needles for teasing samples off biopsy device
准备细针用于把样品从活检装置上取下来
FNA – fine needle aspirate
Site Localization 穿刺点定位
• As close to transducer as possible 尽可能接近探头
• No critical structures in between transducer and target 探头和被穿刺物间没有重要器官结构
一旦固定针头就直刺入目标物
Move probe to find needle 移动探头来定位针头
FNA techniques 细针抽吸技术
• Peck (sewing needle) method 啄（缝纫机式）方法
• Suction method 吸的方法
• Second person often helpful 这时助手往往很有帮助
•suction method 抽吸方法
Biopsy Devices 活检所需设备
• Guns 枪
• Throw inset into tissue (12-20 mm) and then advance cutting sleeve 将头伸入组织（12-20mm）然后用切削轴套
• Advance then fire 伸入和采样
Preparation 准备工作
• Clip hair over site
穿刺点剃毛
• Clean site
穿刺点清洁
• Remove ultrasound gel as this can affect certain stains
将耦合剂清洁干净因为耦合剂会影响染 色
• Locate target 被ຫໍສະໝຸດ Baidu刺物定位
• Start needle ~45 to transducer
针头从探头的45°进针
• Enter skin in front or behind transducer in the plane of the ultrasound beam
从探头的前或后入针
• Do not enter skin from the side of the transducer
Ultrasound-Guided Aspirates and Biopsies
超声引导下的抽吸和活检
Pre FNA/Biopsy Considerations 细针穿刺/活检前的考虑
• Coagulopathies 凝血
• Anemia
贫血
• Physical Status 机体状态
• Sedation / Panting 镇静/气喘
不要从探头的旁边入针
• Move transducer to find location of needle
移动探头来确定针头的位置
• Beware of moving needle if not seen in ultrasound plane
在屏幕上看不到针头时最好不要移动针头
• Once tip of needle located, advance into target
• On-screen needle guide 屏幕上显现细针
• Make sure needle long enough to reach target 细针要足够长
Lesion in Near Field 病变部位接近探头
Lesion Too Deep? 病变部位太深？
Avoid Structures 回避重要器官结构
FNA Equipment 细针穿刺设备
• 22 – 25 gauge needles
22-25号针头
• 1.5 – 2.5 inches
1.5—2.5 英寸
• Spinal needle (with stylet) on occasion 有时要用脊髓针（带管芯）
• 6 – 12 ml syringe with extension set 6-12ml 注射器
• The throw is advanced into the tissue and then the cutting sleeve fires around the advanced throw to cut the tissue 伸入组织开动切削轴套采样
Preparing for Sample 采样准备
Target in Sight 目标在视野中
Renal Biopsy 肾脏穿刺
Free Hand Technique 徒手穿刺技术
• For biopsies, make sure device is spring loaded before starting this step
在开始这步前要确保装置是固定好的
Peck Method 啄式
Practice 练习
• Make a Jello phantom 做一个果胶
• Targets are fruit, pasta, pickles 穿刺的目标是水果、面条、酱菜
Thank You
保存样品的容器
• Minimum number of samples 最少的样品量
• Needles for teasing samples off biopsy device
准备细针用于把样品从活检装置上取下来
FNA – fine needle aspirate
Site Localization 穿刺点定位
• As close to transducer as possible 尽可能接近探头
• No critical structures in between transducer and target 探头和被穿刺物间没有重要器官结构
一旦固定针头就直刺入目标物
Move probe to find needle 移动探头来定位针头
FNA techniques 细针抽吸技术
• Peck (sewing needle) method 啄（缝纫机式）方法
• Suction method 吸的方法
• Second person often helpful 这时助手往往很有帮助
•suction method 抽吸方法
Biopsy Devices 活检所需设备
• Guns 枪
• Throw inset into tissue (12-20 mm) and then advance cutting sleeve 将头伸入组织（12-20mm）然后用切削轴套
• Advance then fire 伸入和采样
Preparation 准备工作
• Clip hair over site
穿刺点剃毛
• Clean site
穿刺点清洁
• Remove ultrasound gel as this can affect certain stains
将耦合剂清洁干净因为耦合剂会影响染 色
• Locate target 被ຫໍສະໝຸດ Baidu刺物定位
• Start needle ~45 to transducer
针头从探头的45°进针
• Enter skin in front or behind transducer in the plane of the ultrasound beam
从探头的前或后入针
• Do not enter skin from the side of the transducer
Ultrasound-Guided Aspirates and Biopsies
超声引导下的抽吸和活检
Pre FNA/Biopsy Considerations 细针穿刺/活检前的考虑
• Coagulopathies 凝血
• Anemia
贫血
• Physical Status 机体状态
• Sedation / Panting 镇静/气喘
不要从探头的旁边入针
• Move transducer to find location of needle
移动探头来确定针头的位置
• Beware of moving needle if not seen in ultrasound plane
在屏幕上看不到针头时最好不要移动针头
• Once tip of needle located, advance into target
• On-screen needle guide 屏幕上显现细针
• Make sure needle long enough to reach target 细针要足够长
Lesion in Near Field 病变部位接近探头
Lesion Too Deep? 病变部位太深？
Avoid Structures 回避重要器官结构
FNA Equipment 细针穿刺设备
• 22 – 25 gauge needles
22-25号针头
• 1.5 – 2.5 inches
1.5—2.5 英寸
• Spinal needle (with stylet) on occasion 有时要用脊髓针（带管芯）
• 6 – 12 ml syringe with extension set 6-12ml 注射器
• The throw is advanced into the tissue and then the cutting sleeve fires around the advanced throw to cut the tissue 伸入组织开动切削轴套采样
Preparing for Sample 采样准备
Target in Sight 目标在视野中
Renal Biopsy 肾脏穿刺
Free Hand Technique 徒手穿刺技术
• For biopsies, make sure device is spring loaded before starting this step
在开始这步前要确保装置是固定好的
Peck Method 啄式
Practice 练习
• Make a Jello phantom 做一个果胶
• Targets are fruit, pasta, pickles 穿刺的目标是水果、面条、酱菜
Thank You