肝硬化患者与非肝硬化患者超声引导下经皮大网膜活检的对比研究
Comparative Study of Ultrasound-guided Percutaneous Omental Biopsy in Cirrhotics and Noncirrhotics.
作者信息
Patidar Yashwant, Chalamarla Lakshmi K, Mukund Amar, Rastogi Archana, Sharma Manoj K
机构信息
Department of Interventional Radiology, Institute of Liver & Biliary Sciences, New Delhi, India.
Department of Pathology, Institute of Liver and Biliary Sciences, New Delhi, India.
出版信息
J Clin Exp Hepatol. 2020 May-Jun;10(3):194-200. doi: 10.1016/j.jceh.2019.10.003. Epub 2019 Oct 31.
BACKGROUND
To evaluate the safety and efficacy of ultrasound-guided (US-guided) omental biopsy in patients with liver cirrhosis and compare these with the noncirrhotic patients.
METHODS
We retrospectively studied the US-guided omental biopsies (73 males, 14 females with mean age 52.71 ± 15.90 y) between January 2012 and December 2018. Patients with biopsy-proven liver cirrhosis (n = 31) who underwent omental biopsy were included in Group 1, and patients without any features of the chronic liver disease (n = 56) were included in Group 2. The technical success, diagnostic parameters, complications, imaging appearance, and histopathology spectrum were compared between the two groups. Also, univariate analysis was done to evaluate the association of a parameter with histopathology.
RESULTS
The technical success, sample adequacy, diagnostic accuracy of Group 1 were 100%, 96.77%, and 96.77%, respectively, and for Group 2, these were 100%, 98.21%, and 98.21%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value of Group 1 were 95%, 100%, 100%, 91.67%, respectively, and for Group 2, these were 97.92%, 100%, 100%, 88.89%, respectively. There was one complication of abdominal wall hematoma in Group 1 (3.2%), which was managed conservatively. Smudged imaging appearance and nonspecific inflammation on histopathology were more common in Group 1, and there was a significant association of increased omental thickening with specific pathology in Group 1.
CONCLUSION
US-guided omental biopsy in patients with liver cirrhosis is safe and effective with comparable results to noncirrhotic patients.
背景
评估超声引导下对肝硬化患者进行网膜活检的安全性和有效性，并与非肝硬化患者进行比较。
方法
我们回顾性研究了2012年1月至2018年12月期间超声引导下的网膜活检（73例男性，14例女性，平均年龄52.71±15.90岁）。经活检证实为肝硬化的患者（n = 31）接受网膜活检被纳入第1组，无任何慢性肝病特征的患者（n = 56）被纳入第2组。比较两组之间的技术成功率、诊断参数、并发症、影像学表现和组织病理学谱。此外，进行单因素分析以评估参数与组织病理学的关联。
结果
第1组的技术成功率、样本充足率、诊断准确率分别为100%、96.77%和96.77%，第2组分别为100%、98.21%和98.21%。第1组的敏感性、特异性、阳性预测值、阴性预测值分别为95%、100%、100%、91.67%，第2组分别为97.92%、100%、100%、88.89%。第1组有1例腹壁血肿并发症（3.2%），经保守治疗。第1组中模糊的影像学表现和组织病理学上的非特异性炎症更为常见，且第1组网膜增厚增加与特定病理有显著关联。
结论
超声引导下对肝硬化患者进行网膜活检是安全有效的，结果与非肝硬化患者相当。
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