Haage P, Piroth W, Staatz G, Adam G, Günther R W
Klinik für Radiologische Diagnostik, Universitätsklinikurn der RWTH Aachen.
Rofo. 1999 Jul;171(1):44-8. doi: 10.1055/s-1999-9895.
Analysis and comparison of CT-guided 14- and 18-gauge cutting needle biopsies to accurately assess focal liver disease.
The data of 272 CT-guided biopsies in 268 patients were evaluated retrospectively with regard to sensitivity, specificity and complication rate of the chosen needle caliber in differentiating between benign and malignant disease as well as in the ability to determine specific cell types in the various disorders. A 14-gauge (G) needle was used in 101 (37.1%) cases, an 18-g needle biopsy was performed in 171 (62.9%) cases. The Fisher exact test was employed for statistical analysis.
Cutting needle biopsy yielded sufficient histologic material in 267 of 272 (98.2%) cases. Correct diagnosis of malignancy was established in 178 of 191 (93.2%) lesions, 73 of 76 (96.1%) disorders were accurately defined as benign, resulting in an overall value of 94.0% (251 of 267). Of these 251 biopsies a definite histological diagnosis could be determined in 90.6% of the cases employing a 14 G needle and in 90.3% using an 18-g needle. The sensitivity, specificity and rate of complications were 94.8%, 92.0%, 3.0% for the 14-g needle and 92.7%, 97.6%, 0.6% for the 18-g needle, respectively. There were no statistically significant differences with regard to the needle size.
CT-guided biopsy of hepatic lesions with the 18-g biopsy needle is of equivalent diagnostic accuracy when compared with the 14-g needle.
分析和比较CT引导下14号和18号切割针活检术，以准确评估肝脏局灶性病变。
回顾性评估268例患者的272例CT引导下活检数据，包括所选针径在鉴别良恶性疾病方面的敏感性、特异性和并发症发生率，以及在各种疾病中确定特定细胞类型的能力。101例（37.1%）使用14号（G）针，171例（62.9%）进行18号针活检。采用Fisher精确检验进行统计分析。
272例中有267例（98.2%）通过切割针活检获得了足够的组织学材料。191个病变中有178个（93.2%）被正确诊断为恶性，76个疾病中有73个（96.1%）被准确判定为良性，总体准确率为94.0%（267例中的251例）。在这251例活检中，使用14G针的病例中有90.6%能确定明确的组织学诊断，使用18号针的病例中有90.3%能确定。14号针的敏感性、特异性和并发症发生率分别为94.8%、92.0%、3.0%，18号针分别为92.7%、97.6%、0.6%。针径方面无统计学显著差异。
与14号针相比，CT引导下使用18号活检针对肝脏病变进行活检具有同等的诊断准确性。
