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血管钳活检在血管阻塞性疾病诊断中的临床应用:一项初步研究。

Clinical application of intravascular forceps biopsy in the diagnosis of vascular obstructive diseases: a pilot study.

作者信息

Song Mengyao, Zhou Xueliang, Sigdel Milan, Hou Rongna, Han Xinwei, Liu Yiming, Xu Kaihao, Jiao Dechao

机构信息

Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Quant Imaging Med Surg. 2024 Jan 3;14(1):852-860. doi: 10.21037/qims-23-597. Epub 2024 Jan 2.

Abstract

BACKGROUND

The sampling of vascular obstruction diseases remains a challenge in clinical practice. This retrospective study aimed to evaluate the feasibility, accuracy, and safety of intravascular forceps biopsy (IVFB) for the diagnosis of vascular obstructive diseases.

METHODS

From January 2015 to January 2022, of the total of 35 patients who underwent IVFB (21 male, 14 female; mean age 60±11 years; range, 39-81 years), 32 (91.4%) did so during interventional planned revascularization procedures and 3 (8.6%) did so due so due to inaccessible or failed percutaneous access. The outcomes of technical success, biopsy times, patient radiation dose (PRD), complications, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy rate (AR) were analyzed.

RESULTS

The technical success of IVFB was 100%. The median number of biopsies taken per biopsy session and PRD were 4.0 (range, 3-6) and 712.6 mGy (range, 383.4-1,450.8), respectively. The sensitivity, specificity, PPV, NPV, and AR of IVFB were 87.5% (21/24), 100% (11/11), 100% (21/21), 78.6% (11/14), and 91.4% (32/35), respectively. There were no complications related to IVFB.

CONCLUSIONS

IVFB is a technically feasible and safe technique with good diagnostic value. The procedure should be considered in patients who are not suitable for percutaneous access, show indistinct imaging characteristics, or are scheduled to undergo revascularization procedure.

摘要

背景

血管阻塞性疾病的取样在临床实践中仍然是一项挑战。这项回顾性研究旨在评估血管内钳取活检术(IVFB)用于诊断血管阻塞性疾病的可行性、准确性和安全性。

方法

2015年1月至2022年1月,共有35例患者接受了IVFB(男性21例,女性14例;平均年龄60±11岁;范围39 - 81岁),其中32例(91.4%)在介入性计划性血运重建手术期间进行,3例(8.6%)因经皮穿刺无法进行或失败而进行。分析了技术成功率、活检次数、患者辐射剂量(PRD)、并发症、敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)和准确率(AR)。

结果

IVFB的技术成功率为100%。每次活检的活检次数中位数和PRD分别为4.0(范围3 - 6)和712.6 mGy(范围383.4 - 1450.8)。IVFB的敏感性、特异性、PPV、NPV和AR分别为87.5%(21/24)、100%(11/11)、100%(21/21)、78.6%(11/14)和91.4%(32/35)。未发生与IVFB相关的并发症。

结论

IVFB是一种技术上可行且安全的技术,具有良好的诊断价值。对于不适合经皮穿刺、影像学特征不明确或计划进行血运重建手术的患者,应考虑采用该方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdbe/10784002/03c18ab3b652/qims-14-01-852-f1.jpg

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