超声造影引导肝脏局灶性病变穿刺活检的临床应用价值  

Clinical application of percutaneous transhepatic biopsy of hepatic focal lesions guided by contrast-enhanced ultrasound

作　　者：周平安[1] 林礼务[2] 薛恩生[2] 何以敉[2] 高上达[2] 林晓东[2] 

机构地区：[1]延安大学附属医院第二超声诊断科,陕西延安716000 [2]福建医科大学附属协和医院超声科,福建福州350001

出　　处：《中国介入影像与治疗学》2009年第2期159-163,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨超声造影引导肝脏局灶性病变穿刺活检的临床应用价值。方法共200例因肝脏局灶性病变行穿刺活检患者,随机分为实验组和对照组各100例,实验组行超声造影后常规超声引导下肝穿活检,对照组行常规超声引导下肝穿活检,比较两组总体及不同性质病变之间的一次取材满意率和诊断准确率。结果实验组总体一次取材满意率、诊断准确率分别为100%和98%,高于对照组的94%、91%(P<0.05)。对直径≥5cm的病灶,实验组一次取材满意率100%,对照组97.56%(P>0.05),但实验组诊断准确率(100%)高于对照组(85.36%,P<0.05)。对直径<5cm的病灶,实验组一次取材满意率与诊断准确率(100%、96.42%)与对照组(93.22%、93.22%)比较均无明显差异(P>0.05)。对肝癌(HCC)PEI治疗后穿刺,实验组一次取材满意率(100%)和对照组(89.74%)比较无明显差异(P>0.05),诊断准确率(100%)高于对照组(84.61%,P<0.05)。实验组的平均穿刺次数[(1.0±0)次]低于照组[(1.12±0.41)次]。P<0.05)。结论超声造影有助于提高肝脏局灶性病变穿刺活检的取材满意率及诊断准确率,减少穿刺次数,可提高较大病灶和PEI治疗后HCC穿刺活检的诊断准确率,减少假阴性结果。Objective To assess the clinical value of percutaneous transhepatic biopsy of focal hepatic lesions guided by contrast-enhanced ultrasound. Methods Two hundred patients with focal hepatic lesions were randomly divided into two groups. All patients underwent pereutaneous transhepatic biopsy. One group underwent biopsy indirectly guided by contrast- enhanced ultrasound （experiment-group, one hundred eases）, another group underwent biopsy guided by conventional ul- trasound（control-group, one hundred cases）. The biopsy achievement ratio, puncture times and accurate diagnosis ratio of different character nodules were compared between two groups. Results The biopsy achievement ratio of experiment group was 100%, higher than that of control group respectively （94%, P〈0.05）. The average times of puncture of experiment group was 1.00±0, lower than that of control-group （1.12±0.41, P（0. 05）. The biopsy achievement ratio of lesions di- ameter more than 5 cm of experiment group and control group was 100%, 97.56% respectively （P〉0.05）, accurate diag- nosis ratio was 100% and 87.80% respectively （P〈0.05）, while the biopsy achievement ratio of lesions diameter smaller than 5 em was 100% and 93.22%, respectively （P〉0.05）, accurate diagnosis ratio was 96.42% and 93. 22% respectively （P〉0.05）. The biopsy achievement ratio of HCC nodules after PEI of experiment group and control group was 100%, 89.74% （P〉0.05）, accurate diagnosis ratio was 100% and 84.61%, respectively （P〈0.05）. Conclusion Contrast-en- hanced ultrasound can improve the biopsy achievement ratio, accurate diagnosis ratio of pereutaneous transhepatic biopsy, Especially for the lesions diameter more than 5 cm and HCC nodules after nonoperative therapy, contrast-enhanced ultra- sound is helpful to decrease the false negative results of biopsy and the average times of puncture.

关 键 词：超声检查 造影剂 经皮肝穿活检 肝局灶性病变 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575[医药卫生—诊断学]