常规超声及超声造影在肝脏占位性病变穿刺活检中的应用价值  

Effectiveness of Conventional US versus CEUS in Biopsies of Hepatic Space-Occupying Lesions

作　　者：战勇[1,2] 于晓玲[1] 梁萍[1] 刘方义[1] 程志刚[1] 韩治宇[1] 房立柱 

机构地区：[1]中国人民解放军总医院介入超声科,北京100853 [2]中国人民解放军第二五二医院超声科,河北保定071000

出　　处：《中国医疗设备》2014年第2期164-167,共4页China Medical Devices

基　　金：国家自然科学基金项目(81171358)

摘　　要：目的探讨常规超声（US）及超声造影（CEUS）在肝脏占位性病变穿刺活检中的应用价值。方法选取2010年1月～2010年3月我科穿刺活检的肝占位病变患者62例，其中行彩超引导下经皮穿刺活检者（US组）55例，超声造影引导下经皮穿刺活检者（CEUS组）7例，以所取组织能够作出明确病理诊断为取材满意，随访≥6个月，以术后病理诊断或随访影像学检查结果为最终临床诊断并随访观察有无并发症。结果两组穿刺病灶共64个，穿刺成功率100％，其中US组中55灶明确了病理学诊断，定性诊断率96．5％（55／57）。穿刺定性诊断符合率100％（55／55）。穿刺患者中有5例出现一过性术中疼痛，1例疑似出现针道少量出血，经对症治疗后症状很快消失。CEUS组中7灶明确了病理学诊断，定性诊断率100％（7／7）。穿刺定性诊断符合率100％（7／7）。结论超声引导下穿刺活检对肝占位性病变的穿刺成功率以及病理诊断准确率高，是获得病理诊断的首选方法。超声造影指导穿刺活检，有助于确认病变的活性、坏死液化区域以及常规超声分辨不清的微小肿瘤，能更准确地定位取材，从而提高穿刺检出阳性率，具有临床指导意义。Objective To assess the effectiveness of conventional US （Ultrasound） versus CEUS （Contrast- Enhanced Ultrasound） in biopsies of hepatic space-occupying lesions. Methods Among 62 patients who had undergone biopsies of hepatic space-occupying lesions from January, 2010 to March, 2010, US-guided biopsies were performed in 55 cases （the US group） versus the CEUS-guided biopsies in 7 cases （the CEUS group）. The up-to-standard tissues taken from patients for biopsies should be able to be well identified for pathological diagnosis. Having been followed up for at least 6-month, all the patients were clinically diagnosed according to their post：operative pathological diagnosis or follow-up imaging examination results, and were observed for any associated complications. Results There were a total of 64 lesions involved in this study as the puncture sites with the 100% puncture success rate. Of the US group, 55 lesions were pathologically diagnosed with the 96.5% （55/57） qualitative diagnosis rate and the 100% （55/55） qualitative diagnosis coincidence rate; 5 patients suffered from transient intraoperative pain and 1 patient was suspected to have slight bleeding in the needle tract, all of which were freed from such symptoms after symptomatic treatment. Of the CEUS group, 7 lesions were diagnosed pathologically with the 100% （7/7） qualitative diagnosis rate and the 100% （7/7） qualitative diagnosis coincidence rate. Conclusion The conventional US-guided biopsy demonstrated great rates of success in biopsies performed in patients with hepatic space-occupying lesions and its excellent ability to give accurate pathological diagnosis of above-mentioned lesions, and was highly recommended as the first alternative for acquisition of pathological diagnosis. The CEUS-guided biopsy was helpful to identify the activity or liquefactive necroses of the lesions and distinguish small lesions that cannot be revealed by conventional US. In comparison with conventional US, CEUS allowed for more accurate pos

关 键 词：超声检查 造影剂 肝肿瘤 活组织检查 针吸 穿刺活检 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]