Department of Ultrasound, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Medicine & Laboratory of Translational Research in Ultrasound Theranostics, Chengdu, China.
Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China.
BMC Cancer. 2024 Oct 28;24(1):1323. doi: 10.1186/s12885-024-13106-8.
To compare the diagnostic performance of pancreatic lesions using percutaneous ultrasound (US)-guided core needle biopsy (CNB) with and without contrast-enhanced ultrasound (CEUS).
The patients were divided into two groups, US and CEUS group, based on whether CEUS was performed prior to biopsy. Before and after propensity score matching (PSM), the CNB-relevant characteristics of the two groups, including the first puncture success rate, the number of sampling, complication rate, type of complications, and degree of abdominal pain, were compared. The accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) of percutaneous US-guided CNB were compared between the groups.
This study included 277 patients (173 men and 104 women) with pancreatic lesions who underwent percutaneous CNB before PSM; 190 patients in the CEUS group, and 87 in the US group prior to CNB. After controlling for potential biases using PSM, no significant differences were observed in the complication rate, type of complications, or degree of abdominal pain between the CEUS and US groups (P > 0.05). However, significant differences were observed in the first puncture success rate and the number of sampling (P < 0.05). Importantly, before and after PSM, the CEUS group achieved a higher first-puncture success rate while obtaining a lower number of sampling (P < 0.05). Compared to the US group, the CEUS group demonstrated improved accuracy, sensitivity, specificity, PPV, and NPV of 13.1%, 14.9%, 13.4%, 2.5%, and 38.7%, respectively. Furthermore, the significant difference was observed in the AUC for diagnostic performance between the two groups when compared using DeLong's test (P = 0.043).
Performing CEUS before percutaneous CNB for pancreatic lesions can help achieve better biopsy results, reduce the number of punctures samples, increase the success rate of biopsies, and avoid the need for repeat biopsies.
比较经皮超声（US）引导下与增强超声（CEUS）引导下使用核心针穿刺活检（CNB）对胰腺病变的诊断性能。
根据是否进行 CEUS 将患者分为 US 组和 CEUS 组。在进行倾向评分匹配（PSM）前后，比较两组的 CNB 相关特征，包括首次穿刺成功率、采样数量、并发症发生率、并发症类型和腹痛程度。比较两组经皮 US 引导下 CNB 的准确性、敏感度、特异度、阳性预测值（PPV）、阴性预测值（NPV）和曲线下面积（AUC）。
本研究纳入了 277 例（男 173 例，女 104 例）接受经皮 CNB 治疗的胰腺病变患者，PSM 前，CEUS 组 190 例，US 组 87 例。经 PSM 控制潜在偏倚后，CEUS 组与 US 组的并发症发生率、并发症类型或腹痛程度无显著差异（P＞0.05）。但两组的首次穿刺成功率和采样数量有显著差异（P＜0.05）。重要的是，PSM 前后，CEUS 组首次穿刺成功率更高，采样数量更少（P＜0.05）。与 US 组相比，CEUS 组的准确性、敏感度、特异度、PPV 和 NPV 分别提高了 13.1%、14.9%、13.4%、2.5%和 38.7%。此外，DeLong 检验显示两组诊断性能的 AUC 存在显著差异（P=0.043）。
对胰腺病变患者行 CEUS 引导下经皮 CNB 可获得更好的活检结果，减少穿刺样本数量，提高活检成功率，避免重复活检。
