Gittinger Fleur Sophie, Wetterich Laura, Michl Patrick, Ripoll A Cristina
Martin-Luther Universitätsklinikum Halle-Saale, Klinik für Innere Medizin I, Halle- Saale, Germany Universitätsklinikum Jena, Klinik für Innere Medizin IV, Jena, Germany.
J Med Ultrasound. 2022 Jul 5;30(4):266-271. doi: 10.4103/jmu.jmu_184_21. eCollection 2022 Oct-Dec.
The aim of this study was to evaluate the usefulness of the presence of tissue transition in liver lesion biopsies to predict a successful outcome, as observed by modified macroscopic on-site evaluation (MOSE).
This is a retrospective analysis of 264 ultrasound-guided liver lesion biopsies, examining the influence the presence of tissue transition (visible color changes in biopsy specimens as evaluated visually) has on two endpoints (1) material retrieval, (2) attaining a definitive diagnosis) representing successful liver lesion biopsies, compared to previously evaluated variables in this context. Uni- and multivariate analyses were performed using SPSS 21.0.
Material retrieval and a definitive diagnosis occurred in 224/264 (84.8%) and 217/264 (82.2%) cases, the latter occurring more often when visual inspection revealed macroscopic tissue transition (92/96 [95.8%]) than when not (124/165 [75.2%]), < 0.001. Tissue transition in biopsies was more common in secondary (74/162 [45.7%]) than (18/54 [33.3%]) primary liver lesions, though this was not significant ( = 0.112). On multivariate analysis, tissue transition in biopsies was an independent predictor of a definitive diagnosis and material retrieval.
In liver lesion biopsies, MOSE of color transition in biopsies can indicate success. This is easily incorporated into clinical practice and can help overcome the lack of an on-site pathologist.
本研究的目的是评估肝脏病变活检中组织转变的存在对于预测成功结果的有用性，如通过改良的宏观现场评估（MOSE）所观察到的那样。
这是一项对264例超声引导下肝脏病变活检的回顾性分析，研究组织转变（通过视觉评估活检标本中可见的颜色变化）对两个终点（1）取材成功，（2）获得明确诊断）的影响，这两个终点代表肝脏病变活检成功，与此前在此背景下评估的变量进行比较。使用SPSS 21.0进行单因素和多因素分析。
取材成功和获得明确诊断分别发生在224/264（84.8%）和217/264（82.2%）的病例中，当肉眼检查显示有宏观组织转变时，后者的发生率更高（92/96 [95.8%]），而无宏观组织转变时发生率为124/165（75.2%），P < 0.001。活检中的组织转变在继发性肝脏病变（74/162 [45.7%]）中比原发性肝脏病变（18/54 [33.3%]）中更常见，尽管差异无统计学意义（P = 0.112）。多因素分析显示，活检中的组织转变是获得明确诊断和取材成功的独立预测因素。
在肝脏病变活检中，对活检中颜色转变进行MOSE可提示活检成功。这可轻松纳入临床实践，并有助于克服现场病理医生短缺的问题。
