CT引导下经皮穿刺活检胃肠道占位性病变的有效性及安全性  

Efficacy and safety of CT-guided percutaneous biopsy of gastrointestinal space-occupying lesions

作　　者：张豪杰 杜可朴[1] 王猛[1] 高飞[1] 周志刚[1] ZHANG Haojie;DU Kepu;WANG Meng;GAO Fei;ZHOU Zhigang(Department of Radiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院放射科,河南郑州450052

出　　处：《中国介入影像与治疗学》2024年第7期398-402,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的观察CT引导下经皮穿刺活检胃肠道占位性病变的有效性及安全性。方法回顾性分析116例接受CT引导下经皮穿刺活检的胃、小肠或结直肠占位性病变患者(共116个病变),统计穿刺取材成功率,以手术病理或随访结果为标准评估活检有效性,包括敏感度、特异度、准确率及假阴性率,并观察病变腔壁厚度(<1 cm与≥1 cm)、穿刺进针深度(<5 cm或≥5 cm)、穿刺针有无经胃肠道的影响,记录相关并发症。结果对所有病变均取材成功。穿刺活检诊断敏感度为88.07%(96/109),特异度为100%(7/7),准确率为88.79%(103/116),假阴性率为11.93%(13/109)。腔壁厚度≥1 cm及进针深度<5 cm时活检敏感度及准确率较高(P均<0.05),而穿刺针有无经胃肠道的敏感度及准确率差异均无统计学意义(P均>0.05)。12例(12/116,10.34%)病变周围少量出血;未见其他并发症。结论CT引导下经皮穿刺活检胃肠道占位性病变有效且安全。Objective To observe the efficacy and safety of CT-guided percutaneous biopsy of gastrointestinal space-occupying lesions.Methods Data of 116 patients with gastric,small intestinal or colorectal space-occupying lesions(totally 116 lesions)who underwent CT-guided percutaneous biopsy were retrospectively analyzed.The success rate of sampling was recorded.According to surgical pathology or follow-up results,the effectiveness of percutaneous biopsy,including the diagnostic sensitivity,specificity,accuracy and false negative rate were calculated.The impact of cavity wall thickness of the lesion(<1 cm and≥1 cm),needle insertion depth(<5 cm and≥5 cm)and puncture needle through gastrointestinal tract or not were observed and the related complications were recorded.Results All lesions were successfully sampled.The diagnostic sensitivity of percutaneous biopsy was 88.07%(96/109),with specificity of 100%(7/7),accuracy of 88.79%(103/116)and false negative rate of 11.93%(13/109).For lesions with cavity wall thickness≥1 cm and puncture needle insertion depth<5 cm,the sensitivity and accuracy of puncture biopsy were higher(all P<0.05),while the sensitivity and accuracy of puncture needle through gastrointestinal tract or not were not different(both P>0.05).Slight bleeding around the lesions occurred in 12 cases(12/116,10.34%),but no other complications happened.Conclusion CT-guided percutaneous biopsy of gastrointestinal space-occupying lesions was effective and safe.

关 键 词：胃肠肿瘤 穿刺术 活组织检查 体层摄影术 X线计算机 

分 类 号：R735.3[医药卫生—肿瘤] R815[医药卫生—临床医学]