1.0TMR 引导经皮同轴切割针活检在胰腺病变诊断中的应用。
1.0T MR-guided percutaneous coaxial cutting needle biopsy in pancreatic lesion diagnosis.
机构信息
Department of Minimally Invasive Tumor, Tai'an Central Hospital, Tai'an, Shandong, P.R. China.
Department of Interventional Therapy, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, P.R. China.
出版信息
J Magn Reson Imaging. 2018 Aug;48(2):382-388. doi: 10.1002/jmri.25952. Epub 2018 Jan 10.
BACKGROUND
Pancreatic carcinoma is a common cause of cancer deaths worldwide. Biopsy is often required for the initial diagnosis of pancreatic masses. Biopsy can be performed endoscopically or percutaneously with computed tomography (CT) and ultrasound (US) guidance. MRI offers many inherent advantages over CT and US.
PURPOSE/HYPOTHESIS: To prospectively evaluate the feasibility, accuracy, and safety of MRI-guided percutaneous coaxial cutting needle biopsy of pancreatic lesions using an open 1.0T high-field MR scanner.
STUDY TYPE
Prospective.
POPULATION
Thirty-one patients with 31 pancreatic lesions underwent MR-guided percutaneous coaxial cutting needle biopsy.
FIELD STRENGTH/SEQUENCE: 1.0T T WI-TSE PDW-aTSE T WI-TFE.
ASSESSMENT
Final diagnosis was confirmed by surgery and clinical follow-up for at least 12 months. The accuracy, sensitivity, and specificity were calculated. Complications were recorded.
STATISTICAL TESTS
There was no statistical analysis in this study.
RESULTS
The procedure was technically successful and final biopsy samples were adequate for histopathological examination in all patients. Biopsy pathology revealed malignant pancreatic tumor in 25 patients (25/31, 80.6%), and benign pancreatic lesions were present in six patients (6/31, 19.4%). The final diagnosis was pancreatic malignancy in 27 patients and benign disease in four patients, which was confirmed by surgery and clinical follow-up. Two biopsy results were false-negative. The diagnostic accuracy in biopsies was 93.5% (29 of 31). The sensitivity to detect a malignant disease was 92.6% (25 of 27), and the specificity was 100%. All patients tolerated the procedure well; minor peripancreatic hemorrhage was found in two patients after the procedure, and none had major complications either during or after the procedure.
DATA CONCLUSION
MRI-guided percutaneous biopsy of pancreatic lesions using an open 1.0T high-field scanner has high diagnostic accuracy, which is feasible and safe for use in clinical practice.
LEVEL OF EVIDENCE
2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2018;48:382-388.
背景
胰腺癌是全球癌症死亡的常见原因。对于胰腺肿块的初步诊断，通常需要进行活检。活检可以通过内镜或 CT 和超声 (US) 引导下的经皮进行。与 CT 和 US 相比，MRI 具有许多固有优势。
目的/假设：前瞻性评估使用开放式 1.0T 高场 MR 扫描仪对胰腺病变进行 MRI 引导下经皮同轴切割针活检的可行性、准确性和安全性。
研究类型
前瞻性。
人群
31 例 31 个胰腺病变患者接受了 MRI 引导下经皮同轴切割针活检。
磁场强度/序列：1.0T T1WI-TSE PDW-aTSE T1WI-TFE。
评估
最终诊断通过手术和至少 12 个月的临床随访得到证实。计算准确性、敏感性和特异性。记录并发症。
统计检验
本研究未进行统计学分析。
结果
该操作在技术上是成功的，所有患者的最终活检样本均足以进行组织病理学检查。活检病理显示 25 例患者（25/31，80.6%）为恶性胰腺肿瘤，6 例患者（6/31，19.4%）为良性胰腺病变。最终诊断为 27 例胰腺恶性肿瘤和 4 例良性疾病，经手术和临床随访证实。两次活检结果均为假阴性。活检的诊断准确率为 93.5%（31 例中有 29 例）。检测恶性疾病的敏感性为 92.6%（27 例中有 25 例），特异性为 100%。所有患者均能很好地耐受该操作；2 例患者在操作后出现轻微胰周出血，且无患者在操作过程中或操作后出现严重并发症。
数据结论
使用开放式 1.0T 高场扫描仪对胰腺病变进行 MRI 引导下经皮活检具有较高的诊断准确性，在临床实践中具有可行性和安全性。
证据水平
2 技术功效：2 级。J. MAGN. RESON. IMAGING 2018;48:382-388.
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