高分辨率微细血流成像引导术前经皮穿刺活检

High definition micro flow imaging for guiding percutaneous puncture biopsy

目的分析高分辨率微细血流成像(HDMFI)引导穿刺活检的临床价值。方法回顾性分析46例经手术切除病灶并明确病理诊断的单发占位病变患者,病灶位于浅表31例、腹腔8例、盆腔7例;术前接受超声引导下穿刺活检,最大径<1 cm者接受细针穿刺,≥1 cm者接受粗针活检,其中25例以常规CDFI(CDFI组)、21例以HDMFI靶向引导穿刺(HDMFI组);对比2组取材成功率、诊断符合率及穿刺并发症。结果对CDFI组共行细针活检16例、粗针活检9例,穿刺61次,其中52次取材成功,22例获得明确病理诊断;HDMFI组细针活检15例、粗针活检6例,穿刺48次,46次取材成功,20例获得明确病理诊断。CDFI组穿刺活检取材成功率、诊断符合率分别为85.25%(52/61)、88.00%(22/25),HDMFI组分别为95.83%(46/48)、95.24%(20/21),HDMFI组均高于CDFI组(P均<0.01)。术中及术后均未见穿刺并发症。结论HDMFI可清晰显示病灶内部微细血流灌注,用于精准引导穿刺效果较CDFI更佳。

Objective To explore the clinical application value of high definition micro flow imaging(HDMFI)for guiding percutaneous puncture biopsy.Methods Data of 46 patients with single space-occupying lesions who underwent surgical resection and postoperative pathological examinations were retrospectively analyzed,including 31 cases with superficial lesions,8 with lesions in abdominal cavity and 7 with lesions in pelvic cavity.All patients underwent ultrasound-guided percutaneous puncture biopsy before operation.Fine needle puncture was performed for lesions with the maximum diameter<1 cm,while coarse needle biopsy was used for lesions≥1 cm.Among 46 patients,25 underwent conventional CDFI guided puncture(CDFI group)and 21 underwent HDMFI guided targeted puncture(HDMFI group).The success rate of sampling,diagnostic coincidence rate and puncture complications were compared between the two groups.Results In CDFI group,16 cases underwent fine needle biopsy and 9 cases underwent coarse needle biopsy,and totally 61 times of puncture were performed,including 52 times with successful sampling,and 22 cases were definitely pathologically diagnosed.In HDMFI group,there were 15 cases of fine needle biopsy and 6 cases of coarse needle biopsy,totally 48 times of puncture were performed,including 46 times with successful sampling,and 20 cases were definitely pathologically diagnosed.The success rate of sampling and diagnostic coincidence rate was 85.25%(52/61)and 88.00%(22/25)in CDFI group,which was 95.83%(46/48)and 95.24%(20/21)in HDMFI group,the latter were higher the former(both P<0.01).No puncture complication occurred.Conclusion HDMFI could clearly display microscopic blood perfusion inside the lesions,being conducive to accurately guiding percutaneous puncture biopsy of lesions with effect better than CDFI.