Stattaus J, Kühl H, Hauth E A, Kalkmann J, Baba H A, Forsting M
Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Germany.
Radiologe. 2007 May;47(5):430-8. doi: 10.1007/s00117-005-1336-5.
Percutaneous cutting needle biopsy of focal liver lesions under CT guidance has established itself as a standard method. The purpose of this study was to evaluate which diagnostic quality can be achieved under guidance of multislice CT (MSCT) and with the use of different needle sizes.
The data of 163 MSCT-guided core biopsies of focal liver lesions were evaluated. A 16G biopsy needle was used in 121 cases and an 18G needle in 42 cases.
The sensitivity, specificity, and accuracy for all biopsies were 93.3, 100.0, and 94.5%. The corresponding values were 97.2, 100.0, and 97.5% for the 16G needle and 78.6, 100.0, and 85.7% for the 18G needle, respectively. A definite histological diagnosis could be obtained in 90.0% of the cases (16G 94.0%, 18G 75.8%). These differences were statistically highly significant. Bleeding complications were recognized in seven biopsies (4.3%). In one patient a fatal bleeding occurred after the biopsy. Median biopsy duration was 27 min.
Core biopsy under MSCT guidance is a fast and very accurate method to obtain a histological diagnosis in focal liver lesions. The usage of a 16G needle in comparison to an 18G needle yielded a significantly higher rate of correct results with regard to differentiation between benign and malignant disease as well as establishing a definite histological diagnosis. For an accurate diagnosis of liver lesions a 16G needle is recommended. After biopsy, the patients have to be closely monitored.
CT引导下经皮穿刺切割针活检已成为肝脏局灶性病变的标准诊断方法。本研究旨在评估在多层螺旋CT（MSCT）引导下使用不同规格穿刺针能达到何种诊断质量。
对163例MSCT引导下肝脏局灶性病变的粗针活检数据进行评估。其中121例使用16G活检针，42例使用18G活检针。
所有活检的敏感性、特异性和准确性分别为93.3%、100.0%和94.5%。16G针的相应值分别为97.2%、100.0%和97.5%，18G针的相应值分别为78.6%、100.0%和85.7%。90.0%的病例（16G针为94.0%，18G针为75.8%）可获得明确的组织学诊断。这些差异具有高度统计学意义。7例活检（4.3%）出现出血并发症。1例患者活检后发生致命性出血。活检中位时间为27分钟。
MSCT引导下粗针活检是获取肝脏局灶性病变组织学诊断的快速且非常准确的方法。与18G针相比，使用16G针在鉴别良恶性疾病以及确立明确的组织学诊断方面能获得显著更高的正确诊断率。对于肝脏病变的准确诊断，推荐使用16G针。活检后，必须对患者进行密切监测。
