超声造影引导下穿刺活检在肝脏占位性病变中的应用效果

Application effect of contrast-enhanced ultrasound guided needle biopsy in hepatic space occupying lesions

目的探讨超声造影(CEUS)引导下穿刺活检在肝脏占位性病变中的应用效果。方法回顾性分析于我院行CEUS引导下穿刺活检的53例肝占位性病变患者的临床资料。在CEUS引导下选择患者肝脏占位有强化的位置为靶目标,并实时引导完成经皮肝穿刺活检。计算取材成功率和诊断准确率。结果CEUS引导下,选取强化活性区进行穿刺活检取材,穿刺次数2~3次,平均(2.56±0.24)次。53例肝脏占位性病变患者穿刺活检病理结果:肝细胞肝癌39例,胆管细胞肝癌1例,转移性肝癌6例,结节性肝硬化3例,海绵状血管瘤1例,炎性病变1例,局灶性结节增生2例。CEUS引导下穿刺活检取材成功率为100%(53/53),诊断准确率为100%(53/53)。患者均无肝周或腹腔出血、气胸、胆漏、大血管损伤等并发症发生。结论CEUS可更清晰显示肝脏病灶,准确判断病灶的坏死与血供区域,可提高穿刺诊断的成功率、准确率。

Objective To explore the application effect of contrast-enhanced ultrasound(CEUS)guided needle biopsy in hepatic space occupying lesions.Methods The clinical data of 53 patients with hepatic space occupying lesions who underwent needle biopsy guided by CEUS in our hospital were retrospectively analyzed.The liver-occupied and enhanced position guided by CEUS was selected as the target,guided and completed the percutaneous liver biopsy in real time.The success rate of sampling and the accuracy of diagnosis were calculated.Results Under the guidance of CEUS,the enhanced active area was selected for puncture biopsy.The time of puncture needles was 2-3 times,with an average of(2.56±0.24)times.The pathological results of needle biopsy of 53 patients with hepatic space occupying lesions included 39 cases of hepatocellular carcinoma,1 case of cholangiocarcinoma,6 cases of metastatic liver cancer,3 cases of nodular cirrhosis,1 case of cavernous hemangioma,1 case of inflammatory lesions,2 cases of focal nodular hyperplasia.The success rate of sampling of needle biopsy guided by CEUS was 100%(53/53),and the diagnostic accuracy was 100%(53/53).There were no complications such as hepatic or abdominal hemorrhage,pneumothorax,bile leakage and large vessel damage.Conclusion CEUS can show liver lesions more clearly,accurately determine the necrosis and blood supply area of the lesion,and improve the success rate and accuracy of puncture diagnosis.