CT引导下经皮胰腺占位病变穿刺活检的诊断准确性  

Diagnostic accuracy of CT-guided percutaneous puncture biopsy of pancreatic space-occupying lesions

作　　者：冯道春[1] 何闯 李良山 李廷源 黄学全 刘丽 FENG Dao-chun;HE Chuang;LI Liang-shan;LI Ting-yuan;HUANG Xue-quan;LIU Li(Department of Cardiac Vascular Surgery,the First People's Hospital of Zunyi,Zunyi 563000,Guizhou;Department of Nuclear Medicine,the First Affiliated Hospital of Army Medical University,Chongqing 400038,China)

机构地区：[1]遵义市第一人民医院心脏血管外科,贵州遵义563000 [2]陆军军医大学第一附属医院核医学科,重庆400038

出　　处：《川北医学院学报》2023年第7期944-948,共5页Journal of North Sichuan Medical College

基　　金：重庆市技术创新与应用发展项目(cstc2019jscx-kjfpx0005);重庆市技术创新与应用发展专项(2019ZDXM027)。

摘　　要：目的:探讨CT引导下经皮胰腺占位病变穿刺活检病理诊断的方法及准确性,对比分析16G半自动针切割活检和18G全自动针切割活检的诊断效能。方法:选取155例胰腺占位病变患者为研究对象,按照使用穿刺针的不同分为半自动针组(n=102)与全自动针组(n=53)。半自动针组使用16G半自动切割活检针进行取材;全自动针组使用18G全自动切割活检针进行取材。比较两组患者手术成功率、病理诊断结果及活检并发症发生情况等。结果:两组患者手术成功率均为100.00%;活检病理诊断准确率半自动针组为98.04%,全自动针组为98.11%;术后总体并发症发生率半自动针组为14.71%,全自动针组为15.09%,均无严重并发症发生;两组病理诊断准确率、总并发症发生率比较,差异均无统计学意义(P>0.05);两组穿刺入路包括经脏器、经间隙(胃肠间隙、血管间隙、脾胃间隙、肾周间隙)或椎体,充分运用经脏器、经间隙、经椎体、钝性分离、盐水拓宽路径等方法实施穿刺。结论:CT引导下经皮胰腺占位病变16G半自动针和18G全自动针切割活检诊断准确性相当,合理入路及穿刺方法的使用,手术成功率高,并发症可控,临床上可根据胰腺占位病变的位置、大小、病灶与周围结构的关系等选择合适的穿刺针。Objective:To explore the accuracy of pathological diagnosis and methods of CT-guided percutaneous needle biopsy for pancreatic space-occupying lesions,and compare the diagnostic efficacy of 16G semi-automatic needle biopsy and 18G automatic needle biopsy.Methods:155 patients with pancreatic space occupying lesions were divided into the semi-automatic needle group(n=102)and the automatic needle group(n=53)according to the different puncture needles used.The semi-automatic needle group used 16G semi-automatic cutting biopsy needle for sampling,and the automatic needle group used 18G automatic cutting biopsy needle for sampling.The surgical success rate,pathological diagnosis results,and biopsy complications were compared between the two groups.Results:The surgical success rate of the two groups was 100%.The diagnostic accuracy of biopsy pathology was 98.04%in the semi-automatic needle group and 98.11%in the automatic needle group.The overall incidence of postoperative complications was 14.71%in the semi-automatic acupuncture group and 15.09%in the automatic acupuncture group,no serious complications occurred.There was no statistical significance in the accuracy pathological diagnosis and the incidence of total complications between the two groups(P>0.05).The puncture approaches included the transorgan,transspace(gastrointestinal space,vascular space,spleen and stomach space,perirenal space)or the vertebral body of the two groups,and full use of the cavity organs,space,vertebral body,blunt separation,saline widening path and other methods for puncture.Conclusion:The diagnostic accuracy of 16G semi-automatic needle biopsy for CT-guided percutaneous pancreatic space occupying lesions is comparable to that of 18G automatic needle biopsy.The reasonable use of approach and puncture method has a high success rate of surgery and controllable complications.In clinical practice,appropriate puncture needles can be selected according to the location and size of pancreatic space occupying lesions,the relationship between lesion

关 键 词：胰腺占位 经皮 CT引导 穿刺活检 切割活检针 

分 类 号：R445[医药卫生—影像医学与核医学]