Department of Diagnostic Radiology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Department of Gynecology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Abdom Radiol (NY). 2021 Sep;46(9):4499-4508. doi: 10.1007/s00261-021-03088-7. Epub 2021 May 28.
To evaluate the diagnostic yield, safety, and factors associated with the diagnostic yield of percutaneous core needle biopsy (PNB) for peritoneal/omental lesions.
Consecutive 297 patients (67 men, 230 women; median age, 64 years [range 15-87]) who underwent a PNB for 311 peritoneal/omental lesions at a single center from April 2010 to March 2020 were evaluated retrospectively. The preprocedural CT findings, diagnostic yield, sensitivity, specificity, PPV, NPV, technical success rate, and adverse events were analyzed. Surgical or clinical diagnosis with follow-up was the diagnostic reference standard. Adverse events were evaluated using the Society of Interventional Radiology guidelines.
The median anteroposterior (AP) diameter and CT value of the target lesion were 24 mm (range 5-78) and 46 HU (range - 75 to 140), respectively. Ascites was interposed on the puncture route in 106 patients (34.1%). The technical success rate was 100%. The diagnostic yield, sensitivity, specificity, PPV, and NPV were 93.9%, 93.8%, 100%, 100%, and 20.8%, respectively. Minor complications were observed following five procedures (1.6%). The diagnostic yield was lower for fat-dominant lesions than for other lesions (82.6% vs. 95.8%, p = 0.002). The diagnostic PNB group had a greater AP diameter than did the non-diagnostic PNB group (27.3 ± 13.0 vs. 20.7 ± 8.4 mm, p = 0.037).
PNB for peritoneal/omental lesions provided a sufficiently high diagnostic yield and minimal adverse events. Lesions with a greater AP diameter and a higher density on CT would provide more diagnostic specimens from this technique.
评估经皮核心针穿刺活检（PNB）诊断腹膜/网膜病变的诊断率、安全性以及与诊断率相关的因素。
回顾性分析 2010 年 4 月至 2020 年 3 月在单一中心接受 PNB 治疗的 311 例腹膜/网膜病变的 297 例连续患者（67 例男性，230 例女性；中位年龄 64 岁[范围 15-87]）。分析了术前 CT 表现、诊断率、敏感度、特异度、阳性预测值、阴性预测值、技术成功率和不良事件。手术或临床诊断并随访作为诊断参考标准。根据介入放射学会指南评估不良事件。
靶病变的前后径（AP）和 CT 值中位数分别为 24mm（范围 5-78）和 46HU（范围-75 至 140）。106 例患者（34.1%）穿刺路径中有腹水。技术成功率为 100%。诊断率、敏感度、特异度、阳性预测值和阴性预测值分别为 93.9%、93.8%、100%、100%和 20.8%。5 例患者出现轻微并发症（1.6%）。与其他病变相比，脂肪占主导地位的病变诊断率较低（82.6%对 95.8%，p=0.002）。诊断性 PNB 组的 AP 直径大于非诊断性 PNB 组（27.3±13.0 对 20.7±8.4mm，p=0.037）。
PNB 对腹膜/网膜病变提供了足够高的诊断率和最小的不良事件。CT 上 AP 直径较大且密度较高的病变采用该技术可提供更多的诊断标本。
