CT引导下经皮同轴细针穿刺活检术诊断胰腺占位性病变

CT-guided percutaneous coaxial fine needle biopsy for the diagnosis of space-occupying lesions of the pancreas

目的评价CT引导下经皮同轴细针穿刺活检术对胰腺占位性病变诊断的技术成功率、诊断正确性及安全性。方法在CT引导下采用18 G带芯穿刺针穿刺15例患者胰腺占位病变,然后经18 G穿刺针的外套针同轴引入20 G切割活检细针对胰腺占位性病变行经皮同轴穿刺活检。结果 15例患者共接受16次胰腺占位性病变活检,其中1例患者接受2次活检。CT证实16次经皮穿刺的穿刺针皆位于胰腺病灶内,15次活检病理结果与临床最终诊断相一致,1例患者第1次活检结果可疑阳性,后行第2次活检明确诊断为淋巴瘤。本组穿刺技术成功率100%,活检诊断与病理结果符合93.8%。所有病例无穿刺相关的严重并发症发生。结论 CT引导下经皮同轴细针穿刺活检术诊断胰腺占位性病变是安全、准确、微创的介入诊断技术。

Objective To assess the technical success rate, diagnostic accuracy and clinical safety of CT-guided pereutaneous coaxial fine needle biopsy for space- occupying lesions of the pancreas. Methods During the period from Dec. 2006 to Sep. 2012, CT-guided percutaneous coaxial fine needle biopsy was carried out in 15 patients with space-occupying lesions at pancreatic area. Using an 18 G trocar needle the pancreatic lesion was punctured, then through its cannula a 20 G fine biopsy needle was coaxially inserted into the lesion to make the biopsy. The pathological findings and the clinical results were analyzed. Results A total of 16 percutaneous coaxial fine needle biopsies were perfomled in 15 patients with pace- occupying lesions of the pancreas. One patient received twice puncture procedures. CT scanning proved that the biopsy needle was fight within the pancreatic lesion in all 16 biopsy procedures. The pathologic findings were consistent with the final clinical diagnosis in 15 needle biopsies, with a diagnostic accuracy of 93.8%. In one patient, as the initial biopsy showed that the lesion was questionably positive the second biopsy had to be employed, which turned out that the lesion was lymphoma. Technical success in this series was 100%. The diagnostic accuracy was 93.8%. No severe puncture- related complications occurred. Conclusion For the diagnosis of space-occupying lesions of the pancreas CT-guided percutaneous coaxial fine needle biopsy is a safe, proper and minimally-invasive interventional technique.