Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Pathology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Acta Radiol. 2022 Feb;63(2):149-158. doi: 10.1177/0284185121990286. Epub 2021 Feb 2.
Computed tomography (CT)-guided biopsy is emerging as a preferred method for obtaining tissue samples from retroperitoneal lesions due to clear visualization of needle and vessels.
To assess diagnostic yield and safety of CT-guided biopsy of retroperitoneal lesions and compare CT findings in different disease categories.
This retrospective analytical study included 86 patients with retroperitoneal lesions who underwent CT-guided biopsy from December 2010 to March 2020. All procedures were performed with co-axial technique and multiple cores were obtained and subjected to histopathology. Additional tests like immunohistochemistry or microbiological analysis were done depending on clinical suspicion. Diagnostic yield calculation and comparison of imaging findings was done by one-way ANOVA, chi-square, and Fisher's exact tests.
CT-guided biopsy was technically successful in all cases with a diagnostic yield of 91.9%. Minor complications in the form of small hematomas were seen in two patients. Major disease categories on final diagnosis were lymphoma, tuberculosis, and metastases. A variety of malignant and benign soft-tissue neoplasms were also noted less commonly. With help of immunohistochemistry, lymphoma subtype was established in 88.8% of cases. Addition of microbiological tests like the GeneXpert assay helped in the diagnosis of tuberculosis in some cases. A mass-like appearance and vascular encasement was common in metastatic group and lymphoma.
Percutaneous CT-guided biopsy is a safe method for the sampling of retroperitoneal lesions with high diagnostic yield. Imaging findings are mostly overlapping; however, some features are more common in a particular disease condition.
由于能够清晰显示针和血管，计算机断层扫描（CT）引导下的活检已成为从腹膜后病变获取组织样本的首选方法。
评估 CT 引导下腹膜后病变活检的诊断率和安全性，并比较不同疾病类别的 CT 表现。
本回顾性分析研究纳入了 2010 年 12 月至 2020 年 3 月期间 86 例接受 CT 引导下活检的腹膜后病变患者。所有操作均采用同轴技术进行，获取多个核心标本进行组织病理学检查。根据临床怀疑，进行额外的免疫组织化学或微生物分析等检查。通过单因素方差分析、卡方检验和 Fisher 确切检验，计算诊断率并比较影像学表现。
所有病例均成功完成 CT 引导下活检，技术成功率为 91.9%。两名患者出现小血肿等轻微并发症。最终诊断的主要疾病类别为淋巴瘤、结核和转移瘤。也较少见地发现了多种恶性和良性软组织肿瘤。通过免疫组织化学检查，88.8%的病例确定了淋巴瘤亚型。添加 GeneXpert 检测等微生物学检查有助于诊断结核病。在转移性组和淋巴瘤中，肿块样外观和血管包绕是常见的。
经皮 CT 引导下活检是一种安全的腹膜后病变取样方法，具有较高的诊断率。影像学表现大多重叠，但某些特征在特定疾病条件下更为常见。
