超声引导及重复活检在CT/MR LR-4/5类肝局灶性小病变穿刺活检的应用价值  

Application Value of Ultrasound Guidance and Repeated Biopsy in Small Focal Hepatic Lesions of CT/MR LR-4/5

作　　者：蔡清源 吴晓敏 李凤霞 李尤佳 丁英瑜 Cai Qingyuan;Wu Xiaomin;Li Fengxia;Li Youjia;Ding Yingyu(Department of Ultrasound,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou Fujian 362000,China)

机构地区：[1]福建医科大学附属泉州第一医院超声科,福建省泉州市362000

出　　处：《中国超声医学杂志》2020年第3期221-224,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨超声引导及重复活检在CT/MR LR-4/5类肝局灶性小病变穿刺活检中的应用价值。方法收集<2 cm且CT/MR LR-4/5类的251个病灶行超声引导下肝局灶性病变活检,共241例患者。分为US和CEUS引导下穿刺活检,每次活检穿1~2针。恶性病变经活检或手术切除后病理确诊。良性病变的最终诊断是依靠重复活检或至少6个月的影像学检查无变化。结果超声引导下穿刺活检成功率100%;218个灶病变最终确诊为恶性。CT/MR LR-4/5类与超声引导下穿刺活检的定性诊断率为86.85%和98.01%。US组及CEUS组引导下首次活检定性诊断率为78.10%和90.35%;40个灶首次活检病理未明确病变性质的病变经重复活检后定性诊断率100%;重复穿刺后,两组穿刺活检定性诊断率为96.35%和100%。首次活检及重复活检的定性诊断率为83.67%和100%。结论超声引导下穿刺活检能提高CT/MR LR-4/5对肝内局灶性小病变的诊断效能,重复活检能提高常规超声引导下穿刺活检定性诊断率的临床价值。Objective To study the application value of ultrasound guidance and repeated biopsy in small focal hepatic lesions of CT/MR LR-4/5. Methods All lesions were classified as CT/MR LR-4/5 from. It is divided into US-guided and CEUS-guided biopsies, with 1-2 needles per biopsy. Malignant lesions are diagnosed by pathology after biopsy or surgical removal. The final diagnosis of benign lesions is based on repeated biopsy or no change in imaging for at least 6 months. Results The puncture success rate by ultrasound-guided biopsy was 100%, and 218 lesions were finally diagnosed as malignant. The qualitative diagnosis rate of CT/MR LR-4/5 and ultrasound-guided biopsy was 86.85% and 98.01%. The qualitative diagnosis rate of the first percutaneous transhepatic biopsy guided by US and CEUS was 78.10% and 90.35%. The qualitative diagnosis rate was 100% after repeated biopsies for 40 lesions whose pathological was not clear in the first biopsy. After repeated biopsy, the qualitative diagnosis rate of the two groups was 96.35% and 100%. The qualitative diagnosis rate of the first biopsy and repeated biopsy was 83.67% and 100%. Conclusions Ultrasound guided biopsy can improve the diagnosis value of CT/MR LR-4/5 for small focal hepatic lesions. Repeated biopsy can improve the clinical value of the qualitative diagnosis rate of ultrasound-guided biopsy.

关 键 词：超声造影 经皮肝穿活检 肝局灶性病变 重复活检 LI-RADS 

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]