Department of Radiology and Medical Research Institute, School of Medicine, Ewha Womans University, Yangcheon-gu, Seoul 158-710, Korea.
Radiology. 2011 Oct;261(1):311-7. doi: 10.1148/radiol.11103523. Epub 2011 Aug 24.
To evaluate the diagnostic efficacy of ultrasonographically (US) guided percutaneous core biopsy of reticular infiltrations alone without mass in the mesentery and omentum at contrast material-enhanced abdominal computed tomography (CT).
This study was approved by the institutional review board, and the need for obtaining signed informed consent was waived for this retrospective analysis. From March 2004 to May 2009, 45 patients (mean age, 52.3 years; age range, 21-89 years) with reticular infiltrations alone without mass in the mesentery and omentum at contrast-enhanced abdominal CT underwent US-guided percutaneous core biopsy. Twenty-one men and 24 women were included. The area with the severest infiltrations at CT was targeted during real-time US-guided percutaneous biopsy. Biopsy results were compared with the final results of surgery or follow-up. The diagnostic accuracy of US-guided percutaneous biopsy was then calculated.
One patient had an insufficient biopsy specimen. Among the 44 patients with sufficient biopsy specimens, 17 patients had malignancy, 12 had tuberculosis, and 15 had nonspecific inflammation. All 29 patients with malignancy and tuberculosis at biopsy had that confirmed with surgery or follow-up results. Two of 15 patients with nonspecific inflammation at percutaneous biopsy were confirmed as having malignancy at surgery and four as having tuberculosis after improvement with empirical antituberculosis therapy. The diagnostic accuracy of US-guided percutaneous biopsy of reticular infiltrations in the mesentery and omentum was 84%; the sensitivity and specificity was, respectively, 89% and 100% for malignancy, 75% and 100% for tuberculosis, and 90% and 83% for nonspecific inflammation.
US-guided percutaneous core biopsy is a feasible diagnostic method with high specificity for confirmative diagnosis of reticular infiltrations alone in the mesentery and omentum at contrast-enhanced CT.
评估对比增强腹部计算机断层扫描（CT）未见肠系膜和网膜肿块的网状浸润时单独行超声引导经皮核心活检的诊断效能。
本研究经机构审查委员会批准，由于这是一项回顾性分析，因此免除了签署知情同意书的要求。2004 年 3 月至 2009 年 5 月，45 例（平均年龄 52.3 岁；年龄范围 21-89 岁）在对比增强腹部 CT 未见肠系膜和网膜肿块的网状浸润患者接受了超声引导经皮核心活检。其中男 21 例，女 24 例。实时超声引导下经皮活检以 CT 上浸润最严重的区域为靶点。将活检结果与手术或随访的最终结果进行比较，然后计算超声引导经皮活检的诊断准确性。
1 例患者的活检标本量不足。在 44 例有足够活检标本的患者中，17 例为恶性肿瘤，12 例为结核病，15 例为非特异性炎症。所有 29 例经活检证实为恶性肿瘤和结核病的患者均经手术或随访证实，经皮活检诊断为非特异性炎症的 15 例患者中，有 2 例经手术证实为恶性肿瘤，4 例经经验性抗结核治疗后改善而诊断为结核病。超声引导经皮活检对肠系膜和网膜网状浸润的诊断准确性为 84%；对恶性肿瘤的敏感性和特异性分别为 89%和 100%，对结核病的敏感性和特异性分别为 75%和 100%，对非特异性炎症的敏感性和特异性分别为 90%和 83%。
超声引导经皮核心活检是一种可行的诊断方法，对对比增强 CT 未见肠系膜和网膜肿块的网状浸润具有高特异性，可明确诊断。
