Department of Radiology, College of Medicine, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea.
Department of Hematology and Oncology, College of Medicien, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea.
Acta Radiol. 2023 May;64(5):1770-1774. doi: 10.1177/02841851231151369. Epub 2023 Feb 6.
Patients with underlying hematologic malignancy have a higher risk of developing systemic amyloidosis, which worsens their prognosis. Histopathologic detection of amyloid deposits in tissue biopsy specimens is the only diagnostic method for amyloidosis.
To compare the efficacy of ultrasound-guided percutaneous core needle biopsy (USPCB) of abdominal subcutaneous fat with that of bone marrow biopsy (BMB) for diagnosing amyloidosis.
A total of 90 consecutive patients with underlying hematologic disorders who underwent both USPCB of abdominal subcutaneous fat and BMB for suspicion of amyloid deposition during a 10-year period were included in this retrospective study.
The sensitivity and specificity of detecting amyloid deposition were 85.7% and 100%, respectively, with USPCB as opposed to 4.8% and 100%, respectively, with BMB, and the sensitivity was significantly higher with USPCB ( < 0.001). The mean number of times USPCB was performed was 3.3. There were no major complications associated with USPCB. The sensitivity of detecting amyloidosis was not different between the 18-G needle group and the 14-G group (100% vs. 80%; = 0.623). Logistic regression analysis revealed that acquiring more cores from USPCB and thinner fat tissues were statistically significant factors that affected the diagnostic accuracy of USPCB for amyloid detection.
The sensitivity of amyloid deposition was significantly higher with USPCB of abdominal subcutaneous fat than BMB. Acquiring more cores by multiple biopsies instead of using a larger bore needle and thin subcutaneous fat pad may be a favorable factor for the diagnostic accuracy of USPCB.
患有基础血液恶性肿瘤的患者发生全身性淀粉样变性的风险较高，这会使他们的预后恶化。组织活检标本中淀粉样沉积物的组织病理学检测是淀粉样变性的唯一诊断方法。
比较超声引导下经皮腹部皮下脂肪芯针活检（USPCB）与骨髓活检（BMB）诊断淀粉样变性的效果。
回顾性分析了 10 年间共 90 例基础血液病患者，因怀疑有淀粉样沉积而行 USPCB 及 BMB，纳入本研究。
与 BMB 相比，USPCB 检测淀粉样沉积的敏感性和特异性分别为 85.7%和 100%，敏感性明显更高（ < 0.001）。USPCB 的平均操作次数为 3.3 次。USPCB 无主要并发症。18-G 针组和 14-G 组检测淀粉样变性的敏感性无差异（100%比 80%； = 0.623）。Logistic 回归分析显示，从 USPCB 获得更多芯针和更薄的脂肪组织是影响 USPCB 检测淀粉样物质准确性的统计学显著因素。
与 BMB 相比，USPCB 检测腹部皮下脂肪的淀粉样沉积的敏感性更高。通过多次活检获得更多芯针，而不是使用更大的针管和更薄的皮下脂肪垫，可能是提高 USPCB 诊断准确性的有利因素。
