Zeng Xian-Tao, Liang Xia, Hong Zhi-Liang, Chen Sheng, Yang Jian-Chuan, Lin Yu-Cheng, Wu Song-Song
Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.
Fujian Provincial Key Laboratory of Critical Care Medicine, Fuzhou, China.
Front Oncol. 2024 Apr 24;14:1297153. doi: 10.3389/fonc.2024.1297153. eCollection 2024.
This study aims to evaluate the efficacy and safety of ultrasound-guided percutaneous biopsy of the first hepatic hilum lesion, and examine its clinical value of diagnosis and treatment.
We conducted a retrospective study on patients diagnosed with the first hepatic hilum lesions at Fujian Provincial Hospital between February 2015 and October 2022. We selected patients who had lesions in the first hepatic hilum(including a 2cm surrounding area of the left/right hepatic ducts and upper-middle segment of the common bile duct) and the liver periphery(in the peripheral area of the liver, outside of the above-mentioned first hepatic porta region). These patients underwent percutaneous ultrasound-guided core needle biopsy (PUS-CNB) with cognitive fusion guidance using CT, MRI, or PET-CT. We compared the safety and efficacy of PUS-CNB in the first hepatic hilum and the liver periphery to explore the value of PUS-CNB in optimizing the clinical treatment of the first hepatic hilum lesions.
The studied includes 38 cases of the first hepatic hilum cases (18 females; 20 males), 23 presented with mass-forming tumors while the remaining 15 exhibited diffuse infiltrative tumors, with an average diameter of 4.65± 2.51 cm. The percutaneous biopsy procedure, conducted under ultrasound guidance, had an average operation time of 14.55 ± 2.73 minutes, and resulted in a postoperative bleeding volume of approximately 10.79 ± 2.79 ml. The diagnostic success rate was noted to be as high as 92.11% among the participants who underwent percutaneous biopsy of the first hepatic hilum. Procedural complications, such as bleeding, bile leakage, intestinal perforation, infection or needle tract seeding, did not occur during or after the biopsy procedure. Affected by biopsy results, 5 altered their clinical treatment plans accordingly, 24patients received non-surgical treatment, 9 underwent surgical treatment, 5 underwent radiofrequency ablation for the lesions. The study comprised a total of 112 cases for percutaneous biopsy of the liver periphery. The safety and effectiveness of the two biopsy techniques were comparable, with diagnostic success rates of 92.11% VS. 94.34%, respectively ( = 0.61).
Cognitive fusion of ultrasound and multi-modal imaging for the first hepatic hilum lesion puncture biopsy is a safe and effective diagnostic procedure, with better diagnostic rate, may improve clinical value of diagnosis and treatment of various diseases.
本研究旨在评估超声引导下经皮穿刺活检第一肝门部病变的有效性和安全性，并探讨其诊断和治疗的临床价值。
我们对2015年2月至2022年10月在福建省立医院被诊断为第一肝门部病变的患者进行了一项回顾性研究。我们选择了第一肝门部（包括左右肝管及胆总管中上段周围2cm区域）和肝周边（肝脏周边区域，即上述第一肝门区域以外）有病变的患者。这些患者在CT、MRI或PET-CT认知融合引导下接受了经皮超声引导下的粗针穿刺活检（PUS-CNB）。我们比较了PUS-CNB在第一肝门部和肝周边的安全性和有效性，以探讨PUS-CNB在优化第一肝门部病变临床治疗中的价值。
研究纳入第一肝门部病例38例（女性18例；男性20例），其中23例为肿块型肿瘤，其余15例为弥漫浸润型肿瘤，平均直径4.65±2.51cm。在超声引导下进行的经皮活检操作，平均手术时间为14.55±2.73分钟，术后出血量约为10.79±2.79ml。在接受第一肝门部经皮活检的参与者中，诊断成功率高达92.11%。活检过程中及术后未发生出血、胆漏、肠穿孔、感染或针道种植等手术并发症。受活检结果影响，5例相应改变了临床治疗方案，24例患者接受了非手术治疗，9例接受了手术治疗，5例对病变进行了射频消融。本研究共纳入肝周边经皮活检病例112例。两种活检技术的安全性和有效性相当，诊断成功率分别为92.11%和94.34%（P=0.61）。
超声与多模态成像认知融合用于第一肝门部病变穿刺活检是一种安全有效的诊断方法，诊断率较高，可能提高各种疾病的诊断和治疗临床价值。
