超声引导下经皮细针穿刺活检诊断胰腺病变

发布时间：2018-05-08 14:24

本文选题：超声检查 + 介入性　；参考：《中国医学影像技术》2015年10期

【摘要】：目的探讨超声引导下经皮细针穿刺活检诊断胰腺病变的临床应用价值。方法选取本院胰腺病变患者104例,均于超声引导下用20G自动切割针行经皮穿刺活检。104例患者中16例以手术后病理做最终诊断,88例以活检病理结合影像学检查及随访结果做最终诊断。评价穿刺活检取材满意率,诊断符合率及术后并发症情况。结果 104例患者中胰腺局灶性病变97例(97/104,93.27%),其中实性病变84例(84/97,86.60%),囊实性病变13例(13/97,13.40%),弥漫性病变7例(7/97,6.73%)。104例患者共接受112次穿刺活检,97次取材满意并得到病理诊断,其中实性病变取材满意率(89/97,91.75%)高于囊实性病变(8/15,53.33%),优势比为9.973。97例取材满意标本中得到的病理诊断与最终诊断相符者89例,8例诊断不相符者均误诊为胰腺炎。活检诊断的准确率、敏感度、特异度分别为91.75%(89/97)、90.12%(73/81)、100%(16/16)。患者活检后7例发生并发症,均为轻-中度腹痛,无严重并发症发生。结论超声引导下经皮细针穿刺活检胰腺病变安全、有效,其对胰腺实性病变取材满意率优于囊实性病变。
[Abstract]:Objective to evaluate the clinical value of ultrasound-guided percutaneous fine needle biopsy in the diagnosis of pancreatic lesions. Methods 104 patients with pancreatic lesions in our hospital were selected. Under the guidance of ultrasound, percutaneous biopsy with 20G automatic cutting needle was performed in 16 out of 104 patients. The final diagnosis was performed in 88 cases by biopsy and pathology combined with imaging examination and follow up results. To evaluate the satisfaction rate, diagnostic coincidence rate and postoperative complications of puncture biopsy. Results among 104 patients, 97 cases were focal pancreatic lesions, including 84 cases of solid lesions, 84 cases of solid lesions, 13 cases of cystic and solid lesions, 7 cases of diffuse lesions, and 7 cases of diffuse lesions. A total of 112 biopsies were obtained from 97 cases, and the pathological diagnosis was obtained. The satisfactory rate of solid lesions (89 / 97 / 91.75) was higher than that of cystic and solid lesions (8 / 15 / 53.33). The dominant ratio was 9.973.97 cases of satisfactory specimens. 89 cases (89 / 8) were misdiagnosed as pancreatitis. The accuracy, sensitivity and specificity of biopsy diagnosis were 91.75 / 97 / 90.12 and 73 / 81 / 100 / 16 / 16 respectively. Complications occurred in 7 cases after biopsy, all of which were mild to moderate abdominal pain, and no serious complications occurred. Conclusion Ultrasound-guided percutaneous fine needle biopsy of pancreatic lesions is safe and effective.
【作者单位】：中山大学附属第一医院介入超声科;中山大学超声诊断与介入超声研究所;
【基金】：国家自然科学基金(81371555)
【分类号】：R576;R445.1

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