Department of Radiology, Ankara Oncology Education and Research Hospital, Ankara, Turkey.
Neoplasma. 2011;58(2):146-52. doi: 10.4149/neo_2011_02_146.
Our objective was to examine the variables affecting diagnostic yield and complications in percutaneous ultrasonography-guided needle biopsies of solid renal masses. Percutaneous ultrasonography-guided needle biopsy of solid renal masses was performed in 172 patients with either large size (18G) cutting needles or small size (20G) aspiration needles. Retrospectively, 120 patients with diagnosis by percutaneous biopsy and follow-up data were included in this series. Age, gender, side, locations in kidneys, necrosis, calcification, maximum size, needle groups due to needle size and type (either 18G cutting needles or 20G aspiration needles), and needle pass were selected as variables. Their role was investigated in diagnostic yield. Two needle groups were divided and compared for diagnostic yield and safety. Also, change in treatment was evaluated. The mean maximum size of the masses was 8.8±4.9 cm. The only predictor affecting accuracy was side of kidney (p=0.002). Among patients, 15 (12.5%) and 105 (87.5%) had benign and malignant solid masses, respectively. Small and large needle groups did not differ in accuracy, 80.3% vs. 87.1% (p=1.000). Technical success was detected as 100%. No major complications neither tumor seeding was seen. Percutaneous ultrasonography-guided needle biopsy of solid renal masses is effective and safe method with large size cutting needles and small aspiration needles. Change in clinical management was significant at 63.3% rate. Diagnostic yield was low in left kidney relating to right kidney, 69.4 vs. 93.1, while upper lobe location did not lead to significant false result. Repeat biopsies can be taken under CT guidance after nondiagnostic diagnosis in solid tumors of left kidney. All the needles including large cutting type were found safe.
我们的目的是研究影响经皮超声引导下肾实性肿块穿刺活检诊断率和并发症的变量。对 172 例肾实性肿块患者进行了经皮超声引导下穿刺活检,使用的是大口径(18G)切割针或小口径(20G)抽吸针。回顾性分析了本系列中经皮活检诊断并随访资料完整的 120 例患者。选择年龄、性别、侧别、肾脏位置、坏死、钙化、最大直径、因针的大小和类型(18G 切割针或 20G 抽吸针)分组的针数以及进针次数作为变量。研究这些变量对诊断率的作用。将两组针数进行分组比较,比较其诊断率和安全性。还评估了治疗方案的改变。肿块的平均最大直径为 8.8±4.9cm。唯一影响准确性的预测因素是肾脏侧别(p=0.002)。在患者中,15 例(12.5%)和 105 例(87.5%)分别为良性和恶性实性肿块。小针和大针组在准确性上无差异,分别为 80.3%和 87.1%(p=1.000)。技术成功率为 100%。未见严重并发症和肿瘤种植。经皮超声引导下肾实性肿块穿刺活检使用大口径切割针和小口径抽吸针是一种有效且安全的方法。临床管理的改变率为 63.3%。左肾的诊断率低于右肾,分别为 69.4%和 93.1%,而上叶位置不会导致假阳性结果。左肾实性肿瘤诊断为非典型时,可在 CT 引导下进行重复活检。所有的针,包括大切割型,均被认为是安全的。