C-arm fluoroscopic cone-beam CT for guidance of chemical thoracic sympathectomy
C-arm fluoroscopic cone-beam CT for guidance of chemical thoracic sympathectomy
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C型臂透视锥形束CT指导化学胸交感神经切除术
DOI：
10.1007/s00540-010-1053-8
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发表时间：
2011
期刊：
影响因子：
2.8
通讯作者：
Takeuchi K
中科院分区：
文献类型：
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作者：
Hirose M;Tabata M;Sakai M;Takeuchi K
致编辑：在透视或传统计算机断层扫描（CT）引导下，在深部组织中使用神经溶解剂（例如，乙醇、苯酚）进行神经阻滞。然而，最近发展的C形臂荧光透视锥束CT，使其能够进行实时程序评价（C形臂透视）和三维（3D）图像采集（锥形束CT）在同一房间，而无需移动患者[1-3]。我们对一名46岁的女性患者进行了使用乙醇的胸交感神经切除术，该患者患有右臂复杂区域疼痛综合征，在仔细评估适应症后[4]。她患有自发性烧灼痛，数字评定量表（PI-NRS; 0=无疼痛，10=可想象的最严重疼痛）的平均疼痛强度为7。患者处于俯卧位，我们在X线透视引导下使用DynaCT（Siemens Medical Solutions，Forchheim，德国）沿T2和T3椎体的右侧插入两个10 cm、21号针沿着（图1 a、B），然后注射1 ml碘帕醇（一种溶于1 ml 2%利多卡因的不透射线造影剂）。在技术支持下
To the Editor: Nerve blocks using neurolytic agents (eg, ethanol, phenol) in deep tissues have been performed under fluoroscopic or conventional computed tomography (CT) guidance. The recent development of C-arm fluoroscopic cone-beam CT, however, has made it possible to perform both real-time procedural evaluation (C-arm fluoroscopy) and three-dimensional (3D) image acquisition (cone-beam CT) in the same room without having to move the patient [1–3].We performed thoracic sympathectomy using ethanol in a 46-year-old female patient with complex regional pain syndrome in the right arm, after careful evaluation of the indications [4]. She suffered from spontaneous burning pain with a mean pain intensity of 7 on a numerical rating scale (PI-NRS; 0= no pain, 10= worst pain imaginable). With the patient in the prone position, we introduced two 10-cm, 21-gauge needles along the right lateral sides of the T2 and T3 vertebral bodies under fluoroscopic guidance (Fig. 1 a, b) using DynaCT (Siemens Medical Solutions, Forchheim, Germany), and then injected 1 ml iopamidol, a radiopaque contrast medium, dissolved in 1 ml 2% lidocaine. Under technical support