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T Tikkakoski

Publications and source records attributed to T Tikkakoski.

At least 55 records · Page 3Linked to original sources
PubMed1994

Diagnosis of diffuse lung disease by cutting needle biopsy.

The results of 15 consecutive automated cutting needle (1.2 mm, n = 14; 2.0 mm, n = 1) biopsies of diffuse lung manifestations are presented. Sufficient material for histologic analysis was obtained in 13 of 15 specimens (87%) and a specific diagnosis was obtained in 11 of 14 patients (79%). The tissue specimen confirmed the clinically probable lung disease in 6 patients, gave a new, unsuspected, diagnosis in 2, and resolved a differential diagnostic problem in 3 patients. One pneumothorax after a 2.0-mm needle biopsy necessitated catheter drainage. We conclude that percutaneous lung biopsy with the automated biopsy device mounted with a 1.2-mm needle yields a histologic diagnosis with high accuracy in interstitial and alveolar lung changes, reducing the need for more invasive methods such as open lung biopsy.

Adult↗
PubMed1994

Diffuse renal disease. Diagnosis by ultrasound-guided cutting needle biopsy.

The results of ultrasound (US)-guided renal parenchymal cutting needle biopsies in 101 consecutive patients were reviewed. The biopsies were done with the automated Biopty device mounted with a 2.0-mm needle. One or 2 needle passes yielded sufficient material for histologic analysis in 94% (95/101). Three or more passes were required in 6% (6/101) to obtain an adequate specimen. Mesangioproliferative glomerulonephritis, IgA-nephropathy, nephrosclerosis, diabetic nephropathy, secondary amyloidosis, lupus nephritis, minimal change glomerulonephritis and interstitial nephritis accounted for 79% of the final histologic diagnoses. The high quality and quantity of the tissue specimens yielded a definitive histologic diagnosis in renal parenchymal diseases of unknown etiology. Four major complications occurred, but no deaths or loss of kidney function were recorded. US proved useful as a guide to suitable biopsy site and in the detection of clinically significant complications. Prebiopsy screening of coagulation variables did not seem to prevent complications. Special attention should be paid to post-biopsy clinical observation.

Adolescent↗
PubMed1993

Ultrasound-guided percutaneous galactography.

We present a new percutaneous ultrasound-guided galactography technique that may be used in patients in whom the conventional technique fails and breast ultrasonography show dilated ducts.

Aged↗
PubMed1993

Radiological findings in cases of gallbladder carcinoma.

Radiological findings in 80 cases of gallbladder carcinoma are analysed retrospectively. Seventy-nine of the patients had been examined by US (ultrasonography), 37 by CT (computed tomography), 26 by PTC (percutaneous transhepatic cholangiography), 17 by ERCP (endoscopic retrograde cholangio-pancreaticography), nine by angiography and 27 by US-guided FNB (fine needle biopsy). US showed the primary tumour in 68% and CT in 57%. In 67 cases the tumour had spread outside the gallbladder area, causing bile duct obstruction in 41. US showed the bile duct obstruction in 39 of these cases and CT in 20 out of 22 cases. US showed 73% of the cases that had spread to the liver; the sensitivity being 68% for direct invasion and 88% for peripheral liver metastases. The corresponding percentages for CT were 68, 67 and 75%, respectively. In lymph node enlargement, US showed the nodes in 70% of cases and CT in 52%. PTC showed either stenosis or total obstruction in 25 cases and failed in one case. ERCP showed a tumour in 76% and failed in 24%. Angiography failed to show the primary tumour in two instances out of nine. The results indicate that current imaging methods are insufficient for the accurate staging of gallbladder carcinoma.

Adult↗
PubMed1993

Parathyroid adenomas: pre-operative localization with ultrasound combined with fine-needle biopsy.

Sixteen patients with biochemically proven primary hyperparathyroidism (PHPT) underwent ultrasonography (US), fine-needle aspiration (FNA) for cytologic sampling (n = 9), or intact parathormone assay (n = 3) before operation (n = 15) in order to determine the accuracy of the methods. Pre-operative US was found sensitive (100 per cent), but two thyroid lesions were initially diagnosed as parathyroid tumours by US (i.e. false positives). Parathyroid cells were detected in six cytologic specimens, one sample was insufficient and another inconclusive, while one was diagnosed as thyroid tissue. Parathormone assay revealed a high hormone content in all three patients who underwent the procedure. We conclude that US is sufficiently sensitive to detect enlarged parathyroid tumours. Specificity can be improved by US-guided FNA for cytology or parathormone assay prior to neck exploration.

Adenoma↗
PubMed1993

Radiological findings in bile duct carcinoma.

Radiological findings in 58 cases of pathologically proven bile duct carcinoma were analysed retrospectively. 11 patients had peripheral intrahepatic cholangiocarcinoma, 30 either hepatic duct or choledochal carcinoma and 17 carcinoma of the papilla of Vater. The tumour was local abdominally in 41 and spread abdominally in 17 cases. All cases but one were examined by US, 27 by CT, 19 by PTC, 28 by ERCP and 11 by angiography. US showed bile duct obstruction in all the cases in which it was present and CT in 94%. US showed the primary tumour in 63% and CT in 44%, while the figures for showing abdominal spread were 56 and 17% respectively. No tumour mass was found at US in 28% of cases or at CT in 52%. ERCP failed in 3 out of 28 cases, showed a tumour in 24 (86%) and showed ambiguous narrowing of the bile duct in one. PTC showed obstruction or narrowing of the bile duct caused by a tumour in all cases, while angiography detected all the intrahepatic cholangiocarcinomas but was abnormal in only 2 out of 6 cases of extrahepatic bile duct carcinoma.

Adult↗
PubMed1993

Thoracic lesions: diagnosis by ultrasound-guided biopsy.

We reviewed the results of US-guided fine-needle biopsies of peripheral pulmonary, pleural, mediastinal and chest wall lesions in 200 patients. Sufficient material for cytological analysis was obtained in 95%, 92%, 96% and 100%, respectively. Sensitivity was 88%, 94%, 96%, 100% and specificity 89%, 100% and 100%, respectively. The ratio of false-negative results was 7%. A cutting needle biopsy was additionally performed in 24 patients. All but two of the histological samples (92%) were adequate for diagnostic purposes and a correct diagnosis was established in 86% (19/22) of these. 8 patients (4%) with pleural or pulmonary targets had minor complications (5 pneumothorax, 3 haemoptysis), which did not require treatment. Cutting needle biopsies and biopsy of mediastinal lesions proved safe. Due to the many advantages US may be considered for guidance in peripheral larger-sized pulmonary lesions, particularly those abutting the pleura, and also in pleural, thoracic wall and mediastinal masses.

Adolescent↗
PubMed1993

[Radiologic findings in renal metastases].

US and CT findings in 41 cases of renal metastasis with known primary malignancy, mostly lymphoma and pulmonary carcinoma, are analysed retrospectively. All of them were examined with US and 22 with CT. The renal metastases were bilateral in 20 cases and multiple in 21. The echo structure was "infiltrative" in 20, non-infiltrative in 21, homogeneous in 11 and non-homogeneous in 30. 33 metastases were echo-poor, 5 were hyperechoic, two iso-echoic and one of mixed echogenicity. The lymphomas were usually homogeneous, infiltrative and echo-poor, whereas the metastases of pulmonary primaries were usually nonhomogeneous, non-infiltrative, echo-poor and some hyperechoic. None of hyperechoic metastases were lymphomas. One case out of 22 examined with CT indicated a false negative US finding, while 4 US examinations showed only some of the lesions detected with CT. The lesions were hypodense and non-homogeneous in plain CT and gave non-homogeneous enhancement in all cases except for 4 with homogeneous lesions. CT showed smaller and more numerous lesions than US.

Adult↗
PubMed1993

Carpet-layer's knee. An ultrasonographic study.

In order to reveal abnormalities in the soft tissue of the anterior part of the knee, caused by protracted mechanical stress, we performed ultrasound studies of both knees of 95 male workers in the carpet-laying and parquet floor trade (group 1). Seventy-three painters (group 2) served as controls. In group 1, an anechoic fluid collection was detected in 10 knees, localized in the superficial infrapatellar bursa and in one patient in the prepatellar bursa, whereas there were no cases of fluid accumulation in the controls. A hypoechoic, oval subcutaneous thickening in the anterior wall of the superficial infrapatellar bursa was detected in 35 (18.4%) and 4 (2.7%) knees, respectively. Prepatellar subcutaneous thickening was detected in 45 knees (23.7%) in group 1, but in only 2 knees (1.4%) in group 2. Two knees in group 1 had thickened and inhomogeneous patellar tendons, while one in group 2 had a thickened and 2 both thickened and hypoechoic patellar tendons. We conclude that ultrasonography is a useful method for the detection of bursitis and soft tissue changes in carpet-layers. Detection of a fluid collection in a bursa does not necessarily denote bursitis of clinical importance, but does signify irritation due to work stress. Patellar tendon pathology is rare among carpet-layers and is probably unrelated to the occupation.

Adult↗
PubMed1993

Superselective intra-arterial chemotherapy with mitomycin C in hepatic neoplasms.

The results of superselective intra-arterial chemotherapy with Mitomycin C (SIAC) in cases of hepatic neoplasms continue to be poor. Survival time was related to the percentage of hepatic replacement (PHR) but only 19% of the patients with Stage I tumours (PHR < 25%) survived for over 5 years and all the others died within 4 years. The patients with hepatic metastases from colorectal cancer achieved a significantly better cumulative 5-year survival figure than those with hepatocellular cancer (P < 0.05). The median survival times for patients with hepatic metastases from colorectal cancer, hepatocellular cancer and gallbladder cancer were 15 months, 6 months and 13 months, respectively. The overall response rate was only 27% (26/97), that for primary liver cancer 20% (7/35), that for hepatic metastases from colorectal cancer 22% (8/37) and that for gallbladder cancer 44% (11/25) and the patients who responded to SIAC (n = 27) had a significantly better cumulative 5-year survival rate (P < 0.005). Cessation of SIAC was necessary in 74% (72/97) of the cases, because of tumour progression in 53% (51/97), major complications in 19% (18/97) and patient refusal in 3% (3/97). The results of this trial may be regarded as disappointing, and we are going to use SIAC for Stage I tumours only. Resection of the tumour continues to provide the only chance of a permanent cure with these patients.

Aged↗
PubMed1993

Percutaneous ultrasound-guided biopsy. Fine needle biopsy, cutting needle biopsy, or both?

The results of 155 US-guided cutting needle biopsies, mainly of abdominal and transthoracic lesions, were reviewed to assess the diagnostic accuracy of the method. A fine needle biopsy (FNB) was additionally performed in 99 of the patients. Sufficient material for histologic and cytologic analysis was obtained in 88% (137/155) and 98% (97/99), and a correct benign or malignant diagnosis was made in 87% and 88%, respectively. Among the 99 combined biopsies the corresponding figures were 100% and 97%, respectively. The proportions of inconclusive and false-negative results among histologic samples were 0% and 4% (2/57), in FNBs 7% (7/99) and 5% (3/56), and in combined examinations 3% (3/99) and 0%. One major complication, Streptococcus faecalis sepsis, occurred. The combined use of FNB and histologic biopsy increases the proportion of correct diagnoses about 10% without increasing the complications.

Abdominal Neoplasms↗
PubMed1992

Diagnostic accuracy of ultrasound-guided fine-needle pancreatic biopsy.

We reviewed the results of 187 consecutive ultrasound-guided fine-needle biopsies of the pancreas in 171 patients to assess the diagnostic accuracy of the method. The final diagnosis obtained at operation, autopsy or follow-up were: adenocarcinoma (n = 83), metastatic cancer (n = 11), cystadenocarcinoma (n = 2), lymphoma (n = 2), malignant gastrinoma (n = 1), pseudocyst (n = 25), cyst (n = 13), chronic pancreatitis (n = 9), normal pancreas (n = 10), abscess (n = 7), benign islet-cell tumour (n = 5), cystadenoma (n = 3). Sufficient cytologic material was obtained in 95.3% of biopsies and the overall accuracy in distinguishing benign from malignant disease was 85.4%. False negative results were obtained in 12 patients (13.1%). Inconclusive results (CIII) were found in aspirates from one cyst and two islet cell tumours. There were no false-positive results. The only complication was a post-biopsy haematoma around the head of pancreas, which resolved spontaneously. Ultrasound-guided pancreatic fine-needle biopsy is a safe method and allows of a high degree of diagnostic accuracy. It has a high specificity. Its sensitivity in the detection of malignancy improves if biopsies are repeated in doubtful cases. It further permits tumours to be graded and allows complications of pancreatitis to be diagnosed.

Adolescent↗