Kettenbach J, Blum M, El-RaBadi K, Langenberger H, Happel B, Berger J, Ba-Ssalamah A
Klinische Abteilung für Angiographie und Interventionelle Radiologie, Universitätsklinik für Radiodiagnostik, Medizinische Universität Wien, Osterreich.
Radiologe. 2005 Jan;45(1):44-54. doi: 10.1007/s00117-004-1151-4.
To classify a liver tumor, image-guided percutaneous biopsy of a liver lesion is indicated. Using ultrasound (US) to guide a biopsy needle into a liver lesion has been proven useful and safe. If a lesion cannot be seen on US or the access to a lesion has been complicated by its position, CT-guided biopsy can be performed. If a lesion cannot be delineated on US or CT, MR-guided biopsy is recommended. Using hepatospecific contrast agents, the time span to delineate tumor tissue can be prolonged. To differentiate diffuse liver disease, transvenous biopsy under fluoroscopic control can be performed if a percutaneous biopsy is contraindicated. In recent years fine-needle aspiration biopsy has been increasingly replaced by coaxial 14-20 G core biopsy, which is a safe and efficient technique to classify liver lesions and has a low complication rate.
为了对肝脏肿瘤进行分类，需要对肝脏病变进行影像引导下的经皮活检。已证实使用超声（US）引导活检针进入肝脏病变是有用且安全的。如果在超声上看不到病变或病变位置导致穿刺进入困难，可进行CT引导下的活检。如果在超声或CT上都无法清晰显示病变，则建议进行MR引导下的活检。使用肝脏特异性造影剂，可以延长勾勒肿瘤组织的时间范围。为了鉴别弥漫性肝病，如果经皮活检禁忌，可以在透视控制下进行经静脉活检。近年来，细针穿刺活检越来越多地被同轴14 - 20G粗针活检所取代，这是一种对肝脏病变进行分类的安全、高效技术，并发症发生率低。
