Reddy V B, Gattuso P, Abraham K P, Moncada R, Castelli M J
Department of Pathology, Loyola University Medical Center, Maywood.
Acta Cytol. 1991 Nov-Dec;35(6):753-6.
With the increased sophistication of radiologic imaging techniques, the sensitivity of detecting nonpalpable, deep-seated lesions has greatly improved. Coupling these techniques with fine needle aspiration biopsy (FNAB) provides a cost-effective, minimum-risk, highly sensitive and specific method of diagnostically evaluating the lesions. Over a four-year period (1985-1989) a total of 2,229 FNABs were performed at Loyola University Medical Center, Chicago; 539 of these biopsies were computed tomographically guided. The geographic computed tomographic biopsy sites were: thorax, 267 (49.54%); abdomen, 175 (32.47%); and retroperitoneum, 97 (18%). Four hundred eighty FNAB cases were diagnostic, with subsequent histologic follow-up in 284 (58%) cases. Fifty-nine (10.9%) FNABs were unsatisfactory; of them, 31 had subsequent diagnostic histology, and 9 remained unsatisfactory. A good correlation between FNAB and histology was observed, with an overall sensitivity of 93.2%, specificity of 98.8%, false-negative rate of 6.8% and false-positive rate of 1.2%. Diagnostic pitfalls and biopsy adequacy in computed tomographically guided FNABs are discussed.
随着放射成像技术的日益复杂，检测不可触及的深部病变的敏感性有了极大提高。将这些技术与细针穿刺活检（FNAB）相结合，提供了一种经济高效、风险最小、高度敏感且特异的病变诊断评估方法。在四年期间（1985 - 1989年），芝加哥洛约拉大学医学中心共进行了2229例FNAB；其中539例活检是在计算机断层扫描引导下进行的。计算机断层扫描活检的部位分布为：胸部，267例（49.54%）；腹部，175例（32.47%）；腹膜后，97例（18%）。480例FNAB病例诊断明确，其中284例（58%）随后进行了组织学随访。59例（10.9%）FNAB结果不理想；其中31例随后进行了诊断性组织学检查，9例仍不理想。观察到FNAB与组织学之间具有良好的相关性，总体敏感性为93.2%，特异性为98.8%，假阴性率为6.8%，假阳性率为1.2%。本文讨论了计算机断层扫描引导下FNAB的诊断陷阱和活检充分性。
