CT导向经皮肝穿刺活检的临床应用

Clinical application of percutaneous liver biopsy under CT guidance

目的 :提高CT导向经皮肝穿刺活检的技术水平 ,并评价其临床应用价值。方法 :采用SiemensSOMATOMHiQ S型全身CT扫描仪及自动活检枪 (18G)对 16例肝脏占位性病变患者行CT导向经皮肝穿刺活检术。穿刺部位 :肝右叶 10例 ,肝左叶 5例 ,肝尾叶 1例。病灶直径 1.5～ 11.7cm。结果 :16例患者均一次穿刺成功 ,穿刺成功率为 10 0 %。 15例肝脏占位性病变得到病理学诊断 ,活检确诊率为 93 .75 % (15 /16) ,原发性肝癌 8例 ,转移性腺癌 5例 ,恶性肿瘤 1例 ,炎性假瘤 1例 ,1例未见肿瘤细胞。无 1例发生出血等并发症。结论 :CT导向经皮肝自动活检枪穿刺活检成功率和确诊率高 ,创伤小 ,并发症少 ,是肝脏占位性病变诊断及鉴别诊断的一种操作简便、安全可靠重要手段。

Objective:To improve the technique of percutaneous puncture biopsy of liver under CT guidance and to evaluate its clinical application.Methods:16 cases with hepatic space occupying lesion were performed percutaneous puncture biopsy using 18 gauge automated biopsy devices under CT guidance. Biopsy of right lobe was performed in 10 cases,left lobe in 5 and caudate lobe in 1. The lesions varied in size from 1.5～11.7cm in diameter.Results: The procedures were successful in all of 16 cases. The success rate was 100%.Pathologic diagnosis was obtained in 15 of 16 cases,including hepatocelluilar carcinoma (n=8),metastatic adenocarccinoma (n=5),malignant tumor (n=1) and inflammatory pseudotumor (n=1). No complications such as hemorrhage were encountered in this series.Conclusion: Percutaneous liver biopsy under CT guidance with automated biopsy devices has high success rate and accuracy of diagnosis and less complication. It is a simple,safe and important method for diagnosis and differential diagnosis of liver disease.