Department of Medical Imaging, the Ottawa Hospital, Ontario, Canada.
The Ottawa Hospital Research Institute Clinical Epidemiology Program, Ontario, Canada.
Can Assoc Radiol J. 2021 May;72(2):311-316. doi: 10.1177/0846537120903692. Epub 2020 Mar 11.
The purpose of this study is to assess the complication rate of percutaneous image-guided biopsy of the spleen at our institution and to evaluate for variables associated with complication rate.
This is a Research Ethics Board approved retrospective study of consecutive patients who underwent image-guided biopsy of the spleen at our institution from January 2010 to November 2019. Complications, imaging findings, and pathologic diagnosis were reviewed. Complications (major and minor) were classified per Society of Interventional Radiology Guidelines, and complication rate was calculated. Logistic regression was applied to determine factors associated with complications. Diagnostic yield was calculated.
In all, 55 patients (28 female) underwent splenic biopsy using ultrasound guidance. The most common indication was possible lymphoma in 41 (71.7%) patients followed by query metastasis 18 (31.5%) patients. Core biopsies (18 g/20 g) were done in 53 (92%) cases, and fine-needle aspiration (22 g) was performed in 4 (8%). The median number of samples collected was 4 (range: 2-9). The results were diagnostic in 54 cases (94.7%, 95% confidence interval [CI]: 88.7-100.0). There were 12 (21%, 95% CI: 10.1-31.9) patients with minor complications and 2 (3.5%, 95% CI: 0.0-8.4) with major complications (2 splenic bleeds requiring embolization, no splenectomy, or deaths). No variables (needle size, lesion size, and number of passes) were associated with complication rate.
Percutaneous image-guided biopsy of the spleen at a single tertiary care institution demonstrates major complication rate comparable to that in the literature with no variables associated with complication rate; there were no cases of splenectomy or death.
本研究旨在评估我院经皮影像引导下脾脏活检的并发症发生率，并评估与并发症发生率相关的变量。
这是一项经机构伦理委员会批准的回顾性研究，连续纳入 2010 年 1 月至 2019 年 11 月在我院行影像引导下脾脏活检的患者。回顾分析并发症、影像学表现和病理诊断。根据介入放射学会指南对并发症（主要和次要）进行分类，并计算并发症发生率。应用逻辑回归分析确定与并发症相关的因素。计算诊断率。
共有 55 例患者（28 例女性）接受超声引导下脾脏活检。最常见的适应证是 41 例（71.7%）可能为淋巴瘤，其次是 18 例（31.5%）为转移性病变。53 例（92%）行核心活检（18g/20g），4 例（8%）行细针抽吸活检（22g）。采集样本中位数为 4 个（范围：2-9 个）。54 例（94.7%，95%置信区间[CI]：88.7-100.0）结果为诊断性。12 例（21%，95%CI：10.1-31.9）患者出现轻微并发症，2 例（3.5%，95%CI：0.0-8.4）患者出现严重并发症（2 例脾出血需行栓塞治疗，无脾切除或死亡）。未发现与并发症发生率相关的变量（针的大小、病变的大小和穿刺次数）。
在一家三级保健机构进行的经皮影像引导下脾脏活检的主要并发症发生率与文献报道的相似，且无与并发症发生率相关的变量；无脾切除或死亡病例。
