Department of Radiology, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Department of Radiology, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Can Assoc Radiol J. 2019 May;70(2):199-203. doi: 10.1016/j.carj.2018.10.014. Epub 2019 Mar 17.
Image-guided biopsy is an important tool in the diagnosis of solid pancreatic masses. This study aims to evaluate the accuracy and complications associated with this procedure.
We conducted a retrospective cohort study of all patients referred to interventional radiology for pancreatic biopsy at our institution from July 2004-July 2015. Two radiologists independently reviewed the images, technical aspects, and clinical characteristics.
A total of 82 patients underwent pancreatic biopsy using a combination of computed tomography (CT) and/or ultrasound guidance. Mean age was 67.8 years with 56% males. Most lesions were located in the head (63.4%), followed by the tail (19.5%), and the body (17.1%). The procedures were performed using the anterior (79.3%), lateral (7.3%), or posterior (13.4%) approach, with direct access in 85.4% of the patients and indirect access (transgastric or transhepatic) in 14.6% of cases. Core biopsies were obtained in 81.7% of cases, and fine needle aspiration was performed in 18.3% of cases. Needle size varied from 18-22 gauge (median 20 gauge). The median number of samples collected was 3 (range 1-8). A conclusive result was obtained in 82.9% of cases. There were 9 (11%) patients with minor complications: minor bleeding, pain, and inadvertent bowel puncture with no clinical repercussion. There were no deaths or major complications.
Percutaneous image-guided pancreatic mass biopsy can be performed safely with excellent accuracy. Our results are comparable with endoscopic biopsy/aspiration, and percutaneous biopsy may be used as an alternative, particularly at institutions where endoscopy facilities are limited.
影像引导下活检是诊断实体胰腺肿块的重要手段。本研究旨在评估该操作的准确性和相关并发症。
我们对 2004 年 7 月至 2015 年 7 月期间在我院介入放射科接受胰腺活检的所有患者进行了回顾性队列研究。两名放射科医生独立地对图像、技术方面和临床特征进行了回顾。
共有 82 例患者接受了 CT 和/或超声引导下的胰腺活检。平均年龄为 67.8 岁，男性占 56%。大多数病变位于胰头部（63.4%），其次是胰尾部（19.5%）和胰体部（17.1%）。操作采用前入路（79.3%）、侧入路（7.3%）或后入路（13.4%），85.4%的患者采用直接入路，14.6%的患者采用间接入路（经胃或经肝）。81.7%的病例获得了核心活检，18.3%的病例进行了细针抽吸。针的大小为 18-22 号（中位数 20 号）。中位数采集样本数为 3 个（范围 1-8 个）。82.9%的病例获得了明确的结果。有 9 例（11%）患者出现轻微并发症：轻微出血、疼痛和无意中穿刺到肠管，但无临床后果。无死亡或严重并发症。
经皮影像引导下胰腺肿块活检可以安全地进行，且具有很高的准确性。我们的结果与内镜活检/抽吸相当，在内镜设施有限的机构，经皮活检可以作为替代方法。
