超声造影引导肝占位穿刺活检的应用价值  

The value of contrast-enhanced ultrasound in guiding biopsy of hepatic space-occupying lesions

作　　者：闻宝杰[1] 孔文韬[1] 金志斌[1] 张捷[1] 吴敏[1] 

机构地区：[1]南京大学医学院附属鼓楼医院超声科,南京210008

出　　处：《临床肿瘤学杂志》2017年第12期1131-1134,共4页Chinese Clinical Oncology

基　　金：国家自然基金面上资助项目(81671701)

摘　　要：目的探讨超声造影引导穿刺活检在肝占位性病变中的应用价值。方法回顾性分析2016年1月至2017年1月行超声造影引导肝占位穿刺活检患者的临床与影像学资料,共33例患者35个病灶。在超声造影引导下选择穿刺部位和进针路径,并实时引导完成穿刺活检。计算取材成功率和诊断准确率。结果所有病例均顺利完成穿刺,每个病灶穿刺两针,取材成功率为100.0%。33例患者中,恶性28例:肝细胞癌13例,胆管细胞癌10例,神经内分泌癌3例,转移性尿路上皮癌1例,转移性鳞状细胞癌1例;良性5例:炎性病变2例,肝细胞腺瘤1例,异型增生结节2例。诊断准确率为100%。仅1例出现并发症,为肝包膜下少量出血。结论超声造影可更加清晰地显示肝内病灶,实时造影模式下进行穿刺活检,可提高穿刺诊断的阳性率。Objective To evaluate the value of contrast-enhanced ultrasound（CEUS） guided biopsy in hepatic lesions.Methods A total of 33 patients with 35 lesions underwent contrast-enhanced ultrasound guided biopsy from Jan 2016 to Jan 2017 were enrolled in this study.Guided by contrast-enhanced ultrasound,the puncture site and needle path were selected and guided real-time biopsy was performed.Puncture successful rate and diagnostic accuracy were calculated.Results All the patients were performed successfully,and each lesion was punctured twice.The puncture successful rate was 100.0%.Among 33 patients,28 cases were diagnosed with malignancies（13 cases of hepatocellular carcinoma,10 cases of cholangio cellular carcinoma,3 cases of neuroendocrine carcinoma,1 case of metastatic urothelial carcinoma and 1 case of metastatic squamous cell carcinoma）,and 5 cases were benign（2 cases of inflammatory lesions,hepatocellular adenoma in 1 case and dysplasia nodules in 2 cases）.The diagnostic accuracy was 100.0%.Puncture complication was found in 1 case（small amount of bleeding under hepatic capsule）.Conclusion Contrast-enhanced ultrasound can clearly display intrahepatic lesions,and real-time biopsy can improve the positive rate of puncture diagnosis.

关 键 词：肝占位 超声造影 穿刺 活检 

分 类 号：R735.7[医药卫生—肿瘤]