Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine, Pusan National University, Busan, Republic of Korea.
Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine, Pusan National University, Busan, Republic of Korea.
J Vasc Interv Radiol. 2023 Dec;34(12):2128-2136. doi: 10.1016/j.jvir.2023.08.034. Epub 2023 Aug 29.
To evaluate the effectiveness of track embolization using gelatin sponge slurry in percutaneous ultrasound (US)-guided liver biopsy.
Among the 543 patients who underwent percutaneous US-guided liver biopsies between September 2018 and August 2021, 338 who did not undergo track embolization and 105 who underwent track embolization were included in the analysis. All procedures were performed with 18-gauge coaxial core biopsy needles. Patients' laboratory data were reviewed. Patients in both groups were subdivided into the following 2 groups: (a) those with targeted biopsy for a focal liver lesion and (b) those with nontargeted biopsy for a liver parenchyma. Moreover, postbiopsy events, such as transfusion and transarterial embolization, were assessed. To minimize selection bias, propensity score matching (PSM) was performed.
After PSM, all factors that could affect bleeding risk were well-matched and well-balanced between the 2 groups (P > .474). In the non-track embolization group, 17 (16.2%) patients experienced major or minor bleeding-related adverse events (AEs). In contrast, in the track embolization group, only 5 (4.8%) patients experienced major or minor bleeding-related AEs, which was significantly lower than that in the non-track embolization group (P = .007). All 5 (4.8%) cases of major bleeding-related AEs were observed in the non-track embolization group (P = .024).
In this study, a retrospective analysis was performed using PSM for percutaneous US-guided liver biopsy. Track embolization using gelatin sponge slurry is significantly superior in the prevention of bleeding-related AEs after US-guided liver biopsy.
评估经皮超声（US）引导下肝脏活检中使用明胶海绵浆进行轨道栓塞的效果。
在 2018 年 9 月至 2021 年 8 月期间进行的 543 例经皮 US 引导下肝脏活检患者中，未进行轨道栓塞的 338 例和进行轨道栓塞的 105 例被纳入分析。所有操作均使用 18 号同轴芯活检针进行。回顾患者的实验室数据。将两组患者分为以下 2 组：（a）靶向活检局灶性肝脏病变的患者，和（b）非靶向活检肝实质的患者。此外，评估了活检后的事件，如输血和经动脉栓塞。为了尽量减少选择偏倚，进行了倾向评分匹配（PSM）。
在 PSM 后，两组之间所有可能影响出血风险的因素均得到很好的匹配和平衡（P＞.474）。在非轨道栓塞组中，17（16.2%）例患者发生严重或轻微的与出血相关的不良事件（AE）。相比之下，在轨道栓塞组中，仅有 5（4.8%）例患者发生严重或轻微的与出血相关的 AE，明显低于非轨道栓塞组（P=.007）。所有 5（4.8%）例严重出血相关 AE 均发生在非轨道栓塞组（P=.024）。
在本研究中，使用 PSM 对经皮 US 引导下肝脏活检进行了回顾性分析。在 US 引导下肝脏活检后，使用明胶海绵浆进行轨道栓塞在预防与出血相关的 AE 方面具有明显优势。
