Department of Interventional Radiology, Unit 1471, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030-4009, USA.
Department of Radiology, The University of Texas Southwestern, Dallas, TX, 75390, USA.
Eur Radiol. 2024 Sep;34(9):5551-5560. doi: 10.1007/s00330-024-10656-0. Epub 2024 Feb 24.
To evaluate the technical success and outcomes of renal biopsies performed under magnetic resonance imaging (MRI) using a closed-bore, 1.5-Tesla MRI unit.
We retrospectively reviewed our institutional biopsy database and included 150 consecutive MRI-guided biopsies for renal masses between November 2007 and March 2020. We recorded age, sex, BMI, tumor characteristics, RENAL nephrometry score, MRI scan sequence, biopsy technique, complications, diagnostic yield, pathologic outcome, and follow-up imaging. Univariate logistic regression was used to assess the association between different parameters and the development of complications. McNemar's test was used to assess the association between paired diagnostic yield measurements for fine-needle aspiration and core samples.
A total of 150 biopsies for 150 lesions were performed in 150 patients. The median tumor size was 2.7 cm. The median BMI was 28.3. The lesions were solid, partially necrotic/cystic, and predominantly cystic in 137, eight, and five patients, respectively. Image guidance using fat saturation steady-state free precession sequence was recorded in 95% of the biopsy procedures. Samples were obtained using both fine-needle aspiration (FNA) and cores in 99 patients (66%), cores only in 40 (26%), and FNA only in three (2%). Tissue sampling was diagnostic in 144 (96%) lesions. No major complication developed following any of the biopsy procedures. The median follow-up imaging duration was 8 years and none of the patients developed biopsy-related long-term complication or tumor seeding.
MRI-guided renal biopsy is safe and effective, with high diagnostic yield and no major complications.
Image-guided renal biopsy is safe and effective, and should be included in the management algorithm of patients with renal masses. Core biopsy is recommended.
• MRI-guided biopsy is a safe and effective technique for sampling of renal lesions. • MRI-guided biopsy has high diagnostic yield with no major complications. • Percutaneous image-guided biopsy plays a key role in the management of patients with renal masses.
评估在使用封闭式 1.5T 磁共振成像（MRI）设备进行肾脏活检的技术成功率和结果。
我们回顾性地审查了我们的机构活检数据库，并纳入了 2007 年 11 月至 2020 年 3 月期间 150 例连续的 MRI 引导下肾脏肿块活检。我们记录了年龄、性别、BMI、肿瘤特征、RENAL 肾单位评分、MRI 扫描序列、活检技术、并发症、诊断率、病理结果和随访影像学。使用单变量逻辑回归评估不同参数与并发症发生之间的关联。使用 McNemar 检验评估细针抽吸和核心样本的配对诊断率测量之间的关联。
在 150 例患者的 150 个病灶中进行了总共 150 次活检。肿瘤大小中位数为 2.7cm，BMI 中位数为 28.3。137 例患者的病灶为实性、部分坏死/囊性和主要囊性，分别为 8 例和 5 例。95%的活检过程中记录了使用脂肪饱和稳态自由进动序列进行的图像引导。99 例患者（66%）同时采用细针抽吸（FNA）和核心取样，40 例（26%）仅采用核心取样，3 例（2%）仅采用 FNA 取样。144 个（96%）病灶的组织取样具有诊断性。任何活检过程均未发生重大并发症。中位随访影像学时间为 8 年，无患者发生与活检相关的长期并发症或肿瘤种植。
MRI 引导下的肾脏活检是安全有效的，具有较高的诊断率且无重大并发症。
图像引导下的肾脏活检是一种安全有效的肾脏病变取样技术，应纳入肾脏肿块患者的管理算法中。推荐进行核心活检。
MRI 引导下的活检是一种安全有效的技术，可用于肾病变取样。
MRI 引导下的活检具有高诊断率且无重大并发症。
经皮图像引导活检在肾脏肿块患者的管理中起着关键作用。
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