Vadvala Harshna V, Furtado Vanessa Fiorini, Kambadakone Avinash, Frenk Nathan E, Mueller Peter R, Arellano Ronald S
Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 2 Suite 270, Boston, MA 02114.
Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 2 Suite 270, Boston, MA 02114.
J Vasc Interv Radiol. 2017 Nov;28(11):1569-1576. doi: 10.1016/j.jvir.2017.07.001. Epub 2017 Sep 13.
To assess biopsy technique, technical success rate, and diagnostic yield of image-guided percutaneous biopsy of omental and mesenteric lesions.
This retrospective study included 186 patients (89 men, 97 women; mean [SD] age, 63 [13.8] y) who underwent percutaneous image-guided biopsy of omentum and mesentery between March 2007 and August 2015. Biopsies were performed with computed tomography (CT) (n = 172) or ultrasound (US) (n = 14) guidance using coaxial technique yielding core and fine-needle aspiration (FNA) specimens. Biopsy results were classified as diagnostic (neoplastic or nonneoplastic) or nondiagnostic based on histopathology and cytology. Technical success rate and diagnostic yield of omental and mesenteric lesions were calculated.
There were 186 image-guided percutaneous biopsies of omental (n = 95) and mesenteric (n = 91) lesions performed. Technical success rate was 99.5% for all biopsies, 100% for omental biopsies, and 98.9% for mesenteric biopsies. Overall sensitivity was 95.5%, specificity was 100%, negative predictive value was 78.3%, and positive predictive value was 100%, which was comparable for omental and mesenteric biopsies. Core biopsies had higher diagnostic yields compared with FNA: 98.4% versus 84% overall, 99% versus 88% for omental biopsies, and 97.7% versus 80% for mesenteric biopsies. Spearman rank correlation showed no correlation between lesion size and diagnostic yield (P = .14) and lesion depth and diagnostic yield (P = .29) for both groups. There were 5 complications.
Image-guided percutaneous omental and mesenteric biopsies have high technical success rates and diagnostic yield regardless of lesion size or depth from the skin for both omental and mesenteric specimens.
评估影像引导下经皮穿刺活检大网膜和肠系膜病变的活检技术、技术成功率及诊断率。
本回顾性研究纳入了2007年3月至2015年8月期间接受影像引导下经皮穿刺大网膜和肠系膜活检的186例患者（89例男性，97例女性；平均[标准差]年龄63[13.8]岁）。活检采用计算机断层扫描（CT）（n = 172）或超声（US）（n = 14）引导，使用同轴技术获取芯针活检和细针穿刺抽吸（FNA）标本。根据组织病理学和细胞学结果，将活检结果分为诊断性（肿瘤性或非肿瘤性）或非诊断性。计算大网膜和肠系膜病变的技术成功率及诊断率。
共对186例大网膜（n = 95）和肠系膜（n = 91）病变进行了影像引导下经皮穿刺活检。所有活检的技术成功率为99.5%，大网膜活检为100%，肠系膜活检为98.9%。总体敏感性为95.5%，特异性为100%，阴性预测值为78.3%，阳性预测值为100%，大网膜和肠系膜活检结果相当。芯针活检的诊断率高于FNA：总体诊断率分别为98.4%和84%，大网膜活检分别为99%和88%，肠系膜活检分别为97.7%和80%。Spearman等级相关性分析显示，两组病变大小与诊断率（P = 0.14）及病变深度与诊断率（P = 0.29）之间均无相关性。发生了5例并发症。
影像引导下经皮穿刺大网膜和肠系膜活检技术成功率及诊断率高，无论病变大小或距皮肤的深度如何，大网膜和肠系膜标本均如此。
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