1.0T高场开放式磁共振自由手透视技术引导肝顶部结节穿刺活检术  

Percutaneous puncture biopsy of liver nodules at the hepatic dome guided by 1.0T high-field open MR fluoroscopy with free-hand technique

作　　者：王立刚[1] 刘风海 何祥萌 柳明 许玉军 李成利 WANG Ligang;LIU Fenghai;HE Xiangmen;LIU Ming;XU Yujun;LI Chengli(Department of Interventional Therapy,Yuhuangding Hospital,Yantai,Shandong Province 264000,China)

机构地区：[1]烟台毓璜顶医院介入治疗科,山东264000 [2]山东大学附属山东省医学影像学研究所 [3]河北省沧州中心医院

出　　处：《介入放射学杂志》2019年第11期1042-1046,共5页Journal of Interventional Radiology

摘　　要：目的分析及评估1.0T高场开放式MR自由手透视技术引导穿刺肝顶部结节的准确性、安全性及有效性。方法选取57例肝顶部占位患者,病灶最大直径范围为6~38 mm,采用MR自由手透视技术引导病灶穿刺活检。与外科手术病理诊断或临床和影像学随访至少12个月的诊断进行对比,计算穿刺活检诊断的准确度、特异度、灵敏度和平均手术时间。根据结节最大直径分为两组:≤1.5 cm组(n=21)和>1.5 cm组(n=36),两组之间采用Fisher精确检验行相关参数对比。结果 57例患者穿刺成功率达到100%,且均取得了足量的病理组织。MR引导经皮穿刺肝顶病变诊断疾病性质的准确度、灵敏度和特异度分别为98.2%、97.9%、100%。≤1.5 cm病灶的准确度、灵敏度、特异度分别为95.2%、93.8%、100%。>1.5 cm病灶的准确度、灵敏度、特异度均达100%。两组之间没有明显的统计学差异(P>0.05)。穿刺针通过皮肤到病变的平均时间为1.1 min,穿刺手术平均时间为27.7 min。穿刺过程中无严重并发症的发生。结论 1.0 T高场开放式MR自由手透视技术引导穿刺肝顶部病灶是一种准确、安全及有效的技术。Objective To analyze and evaluate the accuracy, safety and effectiveness of 1.0 T highfield open MR fluoroscopy together with free-hand technique in guiding percutaneous biopsy of liver nodules located at the hepatic dome. Methods Fifty-seven patients with space-occupying lesions located at hepatic dome were enrolled in this study. The maximum diameter of lesions was 6-38 mm. Guided by 1.0 T open MR fluoroscopy together with free-hand technique, percutaneous biopsy of the lesions was performed. The diagnostic accuracy, specificity and sensitivity for hepatic lesions determined by MR-guided needle biopsy were compared with those confirmed by surgical pathology or by clinical and imaging follow-up for at least 12 months. The mean time spent for surgery was calculated. According to the maximum diameter of the nodules, the patients were divided into≤1.5 cm group(n=21) and>1.5 cm group(n=36). Fisher’s exact test was used to compare the relevant parameters between the two groups. Results The success rate of puncturing was 100%, and sufficient amount of pathological tissue was obtained in all the 57 patients. The diagnostic accuracy, specificity and sensitivity for hepatic lesions determined by MR-guided needle biopsy were 98.2%,97.9% and 100% respectively. The diagnostic accuracy, specificity and sensitivity for hepatic lesions in≤1.5 cm group were 95.2%, 93.8% and 100% respectively, which were 100%, 100% and 100% respectively in>1.5 cm group. No statistically significant differences in the diagnostic accuracy, specificity and sensitivity existed between the two groups(P >0.05). The mean time spent for needle-puncturing(from skin to the target lesion) was 1.1 min, and the mean time spent for total puncturing procedure was 27.7 min. No serious complications occurred during the puncturing process. Conclusion 1.0 T high-field open MR fluoroscopy with free-hand technique is an accurate, safe and effective method for guiding percutaneous puncture biopsy of liver nodules located at the hepatic dome.

关 键 词：介入放射学 核磁共振 肝脏活检 肝肿瘤 

分 类 号：R735.7[医药卫生—肿瘤]