Department of Radiology, Ankara Bilkent City Hospital, Ankara, Turkey.
Department of Radiology, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş, Turkey.
Abdom Radiol (NY). 2024 Sep;49(9):3143-3148. doi: 10.1007/s00261-024-04255-2. Epub 2024 Apr 1.
This study was conducted to investigate the effectiveness of strain elastography in guiding precise and sufficient tissue sampling for perihilar cholangiocarcinoma (CCA) biopsies.
Our retrospective analysis included 23 liver biopsies conducted between March 2019 and July 2022 for suspected perihilar CCA. An experienced radiologist performed the biopsies via an ultrasound machine with elastography configuration. Tissue stiffness color maps were used for guiding when the biopsies were performed. Strain index value calculations were made by radiologists on recorded images.
Patient demographics revealed a mean age of 65.17 ± 9.25 years, with a gender distribution of six females and 17 males. Gray-scale examinations unveiled diverse echogenic characteristics in liver lesions. Elastography-guided biopsies demonstrated no need for repeats, while gray-scale biopsies necessitated re-biopsy in four patients, resulting in cholangiocarcinoma diagnosis (P = 0.037). Strain index values showcased strong inter- and intra-observer agreements (P < 0.001). Notably, no post-biopsy complications emerged in either study group.
The diagnostic advantage of elastography, particularly in enhancing accuracy in challenging isoechoic lesions, was demonstrated, although the substantial overlap between strain index values of benign and malignant liver masses limits clinical usefulness of this technique.
本研究旨在探讨应变弹性成像在指导肝门部胆管癌（CCA）活检中进行精确和充分的组织采样的有效性。
我们的回顾性分析纳入了 2019 年 3 月至 2022 年 7 月间进行的 23 例疑似肝门部 CCA 的肝活检。由一位经验丰富的放射科医生在配备有弹性成像功能的超声机上进行活检。在进行活检时，使用组织硬度彩色图谱进行引导。放射科医生在记录的图像上计算应变指数值。
患者的人口统计学特征显示，平均年龄为 65.17±9.25 岁，性别分布为女性 6 例，男性 17 例。肝脏病变的灰阶检查显示出不同的回声特征。弹性成像引导的活检无需重复，而灰阶活检需要在 4 例患者中再次进行，最终诊断为胆管癌（P=0.037）。应变指数值显示出较强的观察者内和观察者间一致性（P<0.001）。值得注意的是，两组研究均未出现活检后并发症。
尽管良性和恶性肝肿块的应变指数值之间存在很大的重叠，限制了该技术的临床实用性，但弹性成像在增强对挑战性等回声病变的准确性方面具有诊断优势。
