Partovi Sasan, Lu Ziang, Kessner Rivka, Yu Alice, Ahmed Yasmine, Patel Indravadan J, Nakamoto Dean A, Azar Nami
Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.
Department of Radiology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
J Gastrointest Oncol. 2017 Dec;8(6):1056-1064. doi: 10.21037/jgo.2017.08.17.
To assess the technical success of contrast enhanced ultrasound (CEUS) guided biopsies of liver lesions poorly visualized on B-mode ultrasound.
Patients were selected during the procedure based on the real-time clinical scenario of unsatisfactory B-mode ultrasound lesion visualization and all patients would have otherwise undergone CT guided liver lesion biopsy. A total of 26 patients underwent CEUS guided biopsy and were included in this retrospective analysis. The review of the patients' files included demographic information, lesion characteristics on imaging, procedural details and pathology outcome. Technical success was defined as concordance between the radiological findings, pathology report and clinical follow-up-demonstrating lack of need for re-biopsy or re-biopsy with identical pathological results. Patients with less than 2 months follow-up were excluded from the study.
CEUS guided liver biopsy was successful in 23 out of 26 patients (88.5%). The average procedure time was 30.7±12.3 minutes and the average lesion size was 2.2±1.7 cm. The majority of lesions (80.8%) were hypoenhancing on the delayed phase of CEUS. The mean number of samples taken from each lesion per procedure was 3.2 (±1.7).
CEUS guidance biopsies of focal liver lesions (FLL) that were difficult to visualize on B-mode ultrasound demonstrated high success rate and may be an evolving image guidance modality in selected patients to avoid CT guided procedures.
评估超声造影（CEUS）引导下对B超难以清晰显示的肝脏病变进行活检的技术成功率。
根据实时临床情况，选择B超对病变显示不满意的患者进行操作，否则所有患者均接受CT引导下肝脏病变活检。共有26例患者接受了CEUS引导下活检，并纳入本回顾性分析。查阅患者病历，包括人口统计学信息、影像学上的病变特征、操作细节和病理结果。技术成功定义为影像学检查结果、病理报告和临床随访结果一致，即无需再次活检或再次活检结果相同。随访时间少于2个月的患者被排除在研究之外。
26例患者中23例（88.5%）CEUS引导下肝脏活检成功。平均操作时间为30.7±12.3分钟，平均病变大小为2.2±1.7厘米。大多数病变（80.8%）在CEUS延迟期呈低增强。每次操作从每个病变获取的样本平均数为3.2（±1.7）。
对于B超难以清晰显示的局灶性肝病变（FLL），CEUS引导下活检成功率高，可能是特定患者避免CT引导操作的一种不断发展的影像引导方式。
