超声内镜引导下Trucut胃周实质脏器活检

Endoscopic ultrasonography guided Trucut biopsy (TCB) of perigastric organs

目的评估超声内镜引导下Trucut穿刺活检技术(EUS-TCB)对胃周实质器官穿刺活检的有效性及安全性。方法以三头30kg食用猪为研究对象,经静脉麻醉后行超声内镜检查及超声内镜引导下肝脏、胰腺及肾脏Trucut穿刺活检,穿刺获取的组织标本通过大体及组织学检查,观察获取组织条块的状态,测量组织条块的长度。检查结束后进行动物解剖并观察腹腔内出血状况。结果共对三头动物进行33次穿刺,其中肝脏穿刺11次,胰腺6次,肾脏16次。9次(81.8%)肝脏穿刺成功获得组织,获得的组织长度2￣4mm,平均(3.00±0.66)mm;6次(100%)胰腺穿刺均获得组织,组织长度1.6￣2.5mm,平均(2.0±0.3)mm;13次(81.25%)肾穿刺成功获得了肾脏组织,组织长度0.95￣7.00mm,平均(3.64±1.73)mm;所有穿刺经组织病理学观察均能清晰判断出其组织来源;大体解剖观察腹腔内未见显著的出血现象。结论超声内镜引导下Trucut穿刺活检可以安全、有效地对胃周实质脏器进行穿刺,并获得满意的组织用于组织病理学观察。

[Objective ] To evaluate the efficiency and safety of endoscopic ultrasound-guided Trucut biopsy （EUS-TCB） of perigastric organs. [Methods] Under general anesthesia, three 30kg swine underwent EUS examination. The biopsy specimens taken from liver, pancreas and left kidney were obtained with use of EUS-TCB and embedded by paraffin followed by hematoxylin and eosin stain and evaluated histopathologically. The length of the tissue core was counted. The animals were sacrificed after EUS-TCB in order to determine overt bleeding in their abdominal cavities. [Results] Thirty-three biopsy specimens were obtained from the 3 target organs with two needles. Median biopsy length was （3_＋0.66） mm （liver）, （3.64_＋1.73） mm （left kidney）, and （2.00_＋0.3） mm （pancreas body）. Of all the specimens acquired, 100% had tissue representative of the target organ. No complications were identified. [Conclusions] Use of the trucut needle under EUS guidance to obtain biopsy specimens of perigastric organs appears safe and yields specimens that are representative of the target organ sampled.