| 摘要: |
| 目的 旨在评估超声造影引导下经皮肝穿刺活检对于肝脏局灶性病变的诊断价值。方法 回顾性分析2017年6月到2020年5月鼓楼医院肝穿刺活检354例患者共401个病灶。354例患者分为两组，A组为超声引导下经皮肝穿刺65患者77个病灶，B组为超声造影引导下经皮肝穿刺289例患者324个病灶。通过对比分析两组不同诊断准确率来评价穿刺前超声造影的价值。结果 超声造影穿刺组总的诊断准确性优于超声穿刺组（95.1% vs85.7%, P=0.003）,对于恶性诊断性超声造影穿刺优于未造影穿刺组（95.3% vs 84.7%, P =0.008）。超声造影穿刺组的特异性和阳性预测值强于未造影穿刺组（83.8%和64.0%，P=0.036；95.3%vs 84.7%，P=0.008）。特别对于小于2厘米的病灶，超声造影穿刺组（96.3%，52/54）诊断精确性明显优于A组(74.1% ,20/27)，X2=6.891,P=0.009。结论 超声造影引导下穿刺肝脏局灶性病变是一种风险低、操作方便且能明显提高诊断率的诊断技术，特别对于小于2厘米的病灶更具诊断优势。 |
| 关键词: 超声造影 经皮肝穿刺活检术 肝脏局灶性病变 病理诊断 |
| DOI： |
| 投稿时间：2021-02-02修订日期：2021-12-19 |
| 基金项目: |
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| Diagnostic value of contrast-enhanced ultrasound-guided percutaneous transhepatic biopsy for focal liver lesions |
| wen jing jing |
| (Nanjing Brain hospital) |
| Abstract: |
| Objective To evaluate the diagnostic value of contrast-enhanced ultrasound-guided percutaneous liver biopsy for focal liver lesions. Methods 354 patients with 401 lesions were retrospectively analyzed from May 2015 to may 2019 in Gulou hospital. 354 patients with 401 lesions were divided into two groups: Group A (contrast-enhanced ultrasound-guided percutaneous liver puncture, n = 65 patients with 77 lesions ) and Group B (ultrasound-guided percutaneous liver puncture, n = 289 patients with 324 lesions). The difference in diagnostic accuracy between the two groups was analyzed to evaluate the value of performing contrast-enhanced sonography before biopsy. Results The overall diagnostic accuracy of contrast-enhanced ultrasound-guided percutaneous liver puncture group was better than that of ultrasound-guided percutaneous liver puncture group (95.1% vs 85.7%, P = 0.003), and the diagnostic accuracy of malignant lesions was better than that of ultrasound-guided percutaneous liver puncture group (95.3% vs 84.7%, P = 0.008).
The specificity and positive predictive value of contrast-enhanced ultrasound-guided percutaneous liver puncture group were higher than those of ultrasound-guided percutaneous group (83.8% and 64.0%, P = 0.036; 95.3% vs 84.7%, P = 0.008). Especially for lesions less than 2 cm, the diagnostic accuracy of contrast-enhanced ultrasound-guided percutaneous liver puncture group (96.3%, 52 / 54) was significantly better than that of ultrasound-guided percutaneous liver puncture (74.1%, 20 / 270), X2 = 6.891, P = 0.009. Conclusions Contrast-enhanced ultrasound-guided percutaneous liver biopsy for focal liver lesions is easy to operate with a low risk, and can significantly improve the diagnostic raccuracy, especially for lesions less than 2 cm in size. |
| Key words: Contrast-enhanced ultrasound Percutaneous liver biopsy Local liver lesions Pathologic diagnosis |
