Department of Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany.
Eur Radiol. 2012 Mar;22(3):663-71. doi: 10.1007/s00330-011-2297-x. Epub 2011 Sep 30.
To assess the accuracy, the duration and factors that influence the duration of MRI-guided liver or soft-tissue biopsies.
Nineteen liver biopsies and 19 soft-tissue biopsies performed using 1.5T-MRI guidance were retrospectively analysed. Diagnostic performance and complications were assessed. Intervention time was subdivided into preparation period, puncture period and control period. Correlation between procedure time and target size, skin-to-target-distance, used sequences and interventionalists' experience were analysed.
Overall sensitivity, specificity and accuracy were 0.86, 1.0 and 0.92, respectively. Two minor complications occurred. Overall median procedure time was 103.5 min. Liver biopsies lasted longer than soft-tissue biopsies (mean([soft-tissue]): 73.0 min, mean([liver]): 134.1 min, P < 0.001). The most time consuming part was the preparation period in both, soft-tissue and liver biopsies corresponding to 59.6% and 47.4% of the total intervention time, respectively. Total procedure time in liver biopsies (P = 0.027) and puncture period in liver and soft-tissue biopsies (P ([liver]) = 0.048, P ([soft-tissue]) = 0.005) was significantly prolonged for longer skin-to-target-distances. Lower numbers of image acquisitions (P ([liver]) = 0.0007, P ([soft-tissue]) = 0.0012) and interventionalists' experience reduces the procedure duration significantly (P < 0.05), besides all false-negative results appeared during the first five biopsies of each individual radiologist.
The interventionalists' experience, skin-to-target-distances and number of image acquisition influence the procedure time significantly.
•Appropriate training and supervision is essential for inexperienced interventionalists. •Two perpendicular image orientations should confirm the correct biopsy needle position. •Communication between interventionalist and technician is essential for a fluent biopsy procedure. •To shorten intervention time appropriate previous imaging is essential.
评估 MRI 引导下肝脏或软组织活检的准确性、时长及影响时长的因素。
回顾性分析了 19 例肝脏活检和 19 例软组织活检，均采用 1.5T-MRI 引导。评估了诊断性能和并发症。将介入时间分为准备期、穿刺期和控制期。分析了程序时间与目标大小、皮肤到目标距离、使用的序列和介入医生经验之间的关系。
总敏感度、特异性和准确性分别为 0.86、1.0 和 0.92。发生 2 例轻微并发症。总中位数手术时间为 103.5 分钟。肝脏活检耗时长于软组织活检（软组织活检：73.0 分钟，肝脏活检：134.1 分钟，P<0.001）。最耗时的部分是准备期，在软组织和肝脏活检中分别占总介入时间的 59.6%和 47.4%。肝脏活检的总手术时间（P=0.027）和肝脏及软组织活检的穿刺时间（P（肝）=0.048，P（软组织）=0.005）随着皮肤到目标距离的增加而显著延长。图像采集次数较少（P（肝）=0.0007，P（软组织）=0.0012）和介入医生的经验减少了手术时间（P<0.05），此外，所有假阴性结果均出现在每位放射科医生的前五次活检中。
介入医生的经验、皮肤到目标距离和图像采集次数显著影响手术时间。
对无经验的介入医生进行适当的培训和监督至关重要。
两个垂直的图像方向应确认活检针的正确位置。
介入医生和技术员之间的沟通对于流畅的活检过程至关重要。
为缩短干预时间，适当的术前成像至关重要。
