经直肠超声引导活检在内镜阴性的直肠病变患者中的价值。
Value of transrectal ultrasound-guided biopsy in endoscopy negative biopsy patients with rectal lesions.
机构信息
Department of Ultrasound, Sichuan Cancer Hospital & Institute, Affiliate Cancer Hospital of University of Electronic Science and Technology of China (UESTC), Chengdu, China.
出版信息
BMC Gastroenterol. 2023 May 22;23(1):173. doi: 10.1186/s12876-023-02806-3.
OBJECTIVE
To evaluate the value of transrectal ultrasound (TRUS) guided biopsy in endoscopy negative biopsy patients with rectal lesions.
METHODS
150 endoscopy negative biopsy result rectal lesions adopted the transrectal ultrasound-guided biopsy. Based on whether the patients received contrast-enhanced ultrasound examination or not before the biopsies, all enrolled cases were divided into TRUS guided group and contrast-enhanced TRUS (CE-TRUS) guided group, and the safety and diagnostic performances were analyzed retrospectively.
RESULTS
We obtained adequate specimens in the majority of cases (98.7%,148/150); There were no complications identified in our study. 126 patients received contrast-enhanced TRUS examination before biopsy to evaluate vascular perfusion and necrosis. The sensitivity, specificity, PPV, NPV, and overall accuracy of all biopsies were 89.1%, 100%,100%, 70.4%, and 91.3% respectively; The sensitivity, specificity, PPV, NPV, and accuracy for TRUS-guided biopsy and CE-TRUS guided biopsy were 73.7%, 100%,100%, 50%,79.2% and 92.1%,100%,100%,75%,93.6% separately; The increase in correct diagnoses was significant (p < 0.05) between TRUS guided biopsy and CE-TRUS guided biopsy.
CONCLUSION
TRUS-guided biopsy is a reliable procedure that can be augmented by endoscopic biopsy techniques if the biopsy yields negative results. CE-TRUS might assist in the location of the biopsy and decrease sampling errors.
目的
评估经直肠超声（TRUS）引导下活检在经内镜阴性活检的直肠病变患者中的价值。
方法
对 150 例经内镜阴性活检结果的直肠病变患者采用经直肠超声引导下活检。根据患者在活检前是否接受增强超声检查，将所有入组病例分为 TRUS 引导组和增强 TRUS（CE-TRUS）引导组，回顾性分析其安全性和诊断性能。
结果
我们获得了大多数情况下（98.7%，148/150）的充足标本；研究中未发现任何并发症。126 例患者在活检前接受了增强 TRUS 检查，以评估血管灌注和坏死情况。所有活检的敏感性、特异性、PPV、NPV 和总准确性分别为 89.1%、100%、100%、70.4%和 91.3%；TRUS 引导活检和 CE-TRUS 引导活检的敏感性、特异性、PPV、NPV 和准确性分别为 73.7%、100%、100%、50%和 79.2%、100%、100%、75%和 93.6%；TRUS 引导活检和 CE-TRUS 引导活检之间的正确诊断率显著增加（p<0.05）。
结论
TRUS 引导活检是一种可靠的方法，如果活检结果为阴性，可以结合内镜活检技术进行。CE-TRUS 可能有助于活检部位的定位，减少采样误差。
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