Department of Radiology, Mayo Clinic School of Medicine, Rochester, MN, USA.
Abdom Radiol (NY). 2017 May;42(5):1566-1570. doi: 10.1007/s00261-017-1043-5.
To determine the efficacy and safety of percutaneous omental biopsy.
Retrospective review was performed of all 181 percutaneous omental biopsies performed at a single institution between 9/18/2002 and 2/12/2016. Mean patient age was 67 (±14) years, and 114 (63%) patients were female. Biopsy results were compared to subsequent surgical pathology and paracentesis cytology, when available, and cases were further evaluated based on the imaging appearance of the omental abnormality. Complications were classified using Society of Interventional Radiology (SIR) consensus guidelines.
Of the 181 cases, histopathology was positive for malignancy in 166 (92%) patients and showed benign inflammation/fibrosis in 15 (8%) patients. Seventy-three (40%) patients underwent subsequent surgery, and omental malignancy was diagnosed in every case. Percutaneous omental biopsy and surgical pathology results were concordant in all but 1 case (diagnostic accuracy of 99%). In contrast, the accuracy of paracentesis cytology in surgically confirmed malignant cases was only 76% (p = 0.004). Biopsy was positive for malignancy in 95% of patients with omental caking, 92% with omental nodularity, 80% with a single omental nodule, and 20% with omental thickening (p = <0.001). In 118 (65%) patients, a previously unknown (new or additional) malignancy was diagnosed. No clinically significant complications occurred.
Percutaneous biopsy is an effective and safe method to evaluate omental abnormalities. Omental biopsy is more sensitive than paracentesis cytology for determining malignancy. Omental malignancy is more likely as the abnormality advances through the spectrum of imaging appearances from omental thickening to omental caking.
确定经皮网膜活检的疗效和安全性。
对 2002 年 9 月 18 日至 2016 年 2 月 12 日期间在一家机构进行的所有 181 例经皮网膜活检进行回顾性分析。平均患者年龄为 67（±14）岁，114 例（63%）为女性。将活检结果与随后的外科病理学和腹腔穿刺细胞学进行比较，如果有，则进一步根据网膜异常的影像学表现进行评估。并发症的分类采用介入放射学会（SIR）共识指南。
181 例中，组织病理学显示恶性肿瘤阳性的有 166 例（92%），良性炎症/纤维化的有 15 例（8%）。73 例（40%）患者随后进行了手术，所有病例均诊断为网膜恶性肿瘤。除 1 例（诊断准确率为 99%）外，经皮网膜活检和外科病理结果均一致。相比之下，在手术证实的恶性病例中，腹腔穿刺细胞学的准确率仅为 76%（p=0.004）。网膜结块患者中，95%的活检呈恶性肿瘤阳性，92%的网膜结节患者，80%的单个网膜结节患者，20%的网膜增厚患者（p<0.001）。在 118 例（65%）患者中，诊断出以前未知（新的或额外的）恶性肿瘤。无临床意义的并发症发生。
经皮活检是一种评估网膜异常的有效且安全的方法。与腹腔穿刺细胞学相比，网膜活检对确定恶性肿瘤更敏感。随着异常从网膜增厚到网膜结块的影像学表现进展，网膜恶性肿瘤的可能性更大。
