Abstract：
OBJECTIVE: The study aims to show how the \"Puncture Cube\" (PC) (Medical Templates, Egg, Switzerland) compares to the freehand method (FHM) for CT-guided punctures.
METHODS: The PC is a patient-mounted disassemblable cube consisting of an upper and lower template with multiple holes each to predefine puncture trajectory. A total of 80 punctures (FHM in-plane, FHM off-plane, PC in-plane, PC off-plane) was performed by 4 radiologists on a target 9.1 cm below surface level of a neoprene covered elliptical cylinder gelatin phantom. The PC was never disassembled. Evaluated parameters were procedure time, number of CT-scans, euclidean distance (ED) and normal distance (ND). Respective parameters of FHM and PC were compared using the Wilcoxon signed-rank test and Levene test with significance levels of 5%.
RESULTS: PC achieved smaller ED and ND values after initial needle insertion without corrections for both in-plane and off-plane punctures (P > 0.05). Variance of initial NDs was off-plane significantly larger for FHM. Final ED after needle path corrections was smaller for FHM both in- and off-plane (P < 0.05). Final off-plane ND was significantly lower for FHM with no significant difference in final in-plane ND. FHM off-plane punctures were significantly faster. There was no significant difference in CT-scans between both methods.
CONCLUSIONS: Utilizing the PC may improve initial needle positioning and safety especially off-plane. However, better final needle positioning after correction with the greater freedom of movement method may suggest need for disassembly of the cube.
METHODS: The PC is a patient-mounted disassemblable cube consisting of an upper and lower template with multiple holes each to predefine puncture trajectory. A total of 80 punctures (FHM in-plane, FHM off-plane, PC in-plane, PC off-plane) was performed by 4 radiologists on a target 9.1 cm below surface level of a neoprene covered elliptical cylinder gelatin phantom. The PC was never disassembled. Evaluated parameters were procedure time, number of CT-scans, euclidean distance (ED) and normal distance (ND). Respective parameters of FHM and PC were compared using the Wilcoxon signed-rank test and Levene test with significance levels of 5%.
RESULTS: PC achieved smaller ED and ND values after initial needle insertion without corrections for both in-plane and off-plane punctures (P > 0.05). Variance of initial NDs was off-plane significantly larger for FHM. Final ED after needle path corrections was smaller for FHM both in- and off-plane (P < 0.05). Final off-plane ND was significantly lower for FHM with no significant difference in final in-plane ND. FHM off-plane punctures were significantly faster. There was no significant difference in CT-scans between both methods.
CONCLUSIONS: Utilizing the PC may improve initial needle positioning and safety especially off-plane. However, better final needle positioning after correction with the greater freedom of movement method may suggest need for disassembly of the cube.
摘要：
目的：该研究旨在展示“穿刺立方体”(PC)(医学模板，鸡蛋，瑞士）与CT引导穿刺的徒手法（FHM）进行比较。
方法：PC是患者安装的可拆装立方体，由上下模板组成，每个模板都有多个孔，以预定义穿刺轨迹。总共80次穿刺(FHM平面内，FHM飞机下，PC在平面上，PC脱离平面）由4位放射科医师在氯丁橡胶覆盖的椭圆柱明胶体模表面以下9.1cm的目标上进行。PC从未被拆解。评估参数为手术时间，CT扫描次数,欧氏距离(ED)和正常距离(ND)。使用Wilcoxon符号秩检验和Levene检验比较FHM和PC的各自参数，显著性水平为5％。
结果：PC在初次插入针后获得了较小的ED和ND值，而平面内和平面外穿刺均未校正（P>0.05）。对于FHM，初始ND的方差在平面外明显更大。对于平面内和平面外的FHM，针路校正后的最终ED较小（P<0.05）。FHM的最终平面外ND显着降低，最终平面内ND无显着差异。FHM的平面外穿刺明显更快。两种方法之间的CT扫描没有显着差异。
结论：使用PC可以改善初始针头定位和安全性，尤其是离平面。然而,校正后更好的最终针定位与更大的运动自由度方法可能建议需要拆卸立方体。
方法：PC是患者安装的可拆装立方体，由上下模板组成，每个模板都有多个孔，以预定义穿刺轨迹。总共80次穿刺(FHM平面内，FHM飞机下，PC在平面上，PC脱离平面）由4位放射科医师在氯丁橡胶覆盖的椭圆柱明胶体模表面以下9.1cm的目标上进行。PC从未被拆解。评估参数为手术时间，CT扫描次数,欧氏距离(ED)和正常距离(ND)。使用Wilcoxon符号秩检验和Levene检验比较FHM和PC的各自参数，显著性水平为5％。
结果：PC在初次插入针后获得了较小的ED和ND值，而平面内和平面外穿刺均未校正（P>0.05）。对于FHM，初始ND的方差在平面外明显更大。对于平面内和平面外的FHM，针路校正后的最终ED较小（P<0.05）。FHM的最终平面外ND显着降低，最终平面内ND无显着差异。FHM的平面外穿刺明显更快。两种方法之间的CT扫描没有显着差异。
结论：使用PC可以改善初始针头定位和安全性，尤其是离平面。然而,校正后更好的最终针定位与更大的运动自由度方法可能建议需要拆卸立方体。
