Chen Zhiguang, Bai Zhiqun, Yang Puxu, Sang Liang, Li Xiang, Wang Xuemei, Liu Yanjun
Department of Ultrasound, The First Hospital of China Medical University, Shenyang, China.
Eur Radiol. 2025 Mar 27. doi: 10.1007/s00330-025-11489-1.
Contrast-enhanced ultrasound (CEUS) assesses omental lesion nature, but CEUS-guided biopsy feasibility, effectiveness, and safety are uncertain.
From January 2020 to January 2024, patients scheduled for ultrasound-guided omental biopsy at the First Hospital of China Medical University were enrolled. They were divided into CEUS-guided and conventional ultrasound-guided groups, balanced using propensity score matching (PSM). Success rate, diagnostic accuracy, and complication rate were compared. Subgroup analyses considered sonographic features, with significance at p < 0.05.
After PSM, 310 CEUS-guided and 160 conventional ultrasound-guided patients were analyzed. Groups were similar in demographics and omental characteristics (p > 0.05). CEUS-guided biopsy had higher sample acquisition (97.42% vs. 93.13%, p = 0.029) and diagnostic accuracy (96.03% vs. 87.92%, p = 0.002). Overall complication rate was 9.36% (44/470), with distant metastasis in 0.43% (2/470). Complication rates did not differ significantly between groups. In hyperechoic group, dense group, and non-nodule group, CEUS-guided biopsy had higher success (97.99% vs. 92.55%, p = 0.042) and accuracy (96.48% vs. 86.17%, p = 0.002). In non-nodule group, CEUS-guided accuracy was superior (93.41% vs. 84.11%, p = 0.015).
Ultrasound-guided omental biopsy is a safe and effective method for obtaining samples. CEUS-guided omental biopsy enhances sample acquisition and diagnostic accuracy, especially in hyperechoic group, dense group, and non-nodule group, suggesting it is a more accurate and effective diagnostic method.
Question Selecting a puncture site for diffuse lesions of the greater omentum presents challenges, as conventional ultrasound-guided biopsy often encounters difficulties in avoiding local necrotic tissue. Findings Ultrasound-guided biopsy of the greater omentum is a safe and effective diagnostic method, especially when augmented with CEUS, which can significantly enhance diagnostic accuracy. Clinical relevance CEUS can markedly enhance diagnostic accuracy by providing a robust foundation for selecting the biopsy site and pathway. Therefore, it is advisable to routinely employ CEUS-guided puncture pathways for atypical omental lesions.
超声造影（CEUS）可评估大网膜病变性质，但CEUS引导下活检的可行性、有效性及安全性尚不确定。
纳入2020年1月至2024年1月在中国医科大学附属第一医院计划接受超声引导下大网膜活检的患者。将他们分为CEUS引导组和传统超声引导组，采用倾向评分匹配（PSM）进行平衡。比较成功率、诊断准确性和并发症发生率。亚组分析考虑了超声特征，p<0.05具有统计学意义。
PSM后，分析了310例CEUS引导组和160例传统超声引导组患者。两组在人口统计学和大网膜特征方面相似（p>0.05）。CEUS引导下活检的样本获取率（97.42%对93.13%，p=0.029）和诊断准确性（96.03%对87.92%，p=0.002）更高。总体并发症发生率为9.36%（44/470），远处转移率为0.43%（2/470）。两组并发症发生率差异无统计学意义。在高回声组、致密组和非结节组中，CEUS引导下活检的成功率（97.99%对92.55%，p=0.042）和准确性（96.48%对86.17%，p=0.002）更高。在非结节组中，CEUS引导下的准确性更优（93.41%对84.11%，p=0.015）。
超声引导下大网膜活检是获取样本的安全有效方法。CEUS引导下大网膜活检可提高样本获取率和诊断准确性，尤其是在高回声组、致密组和非结节组，提示其是一种更准确有效的诊断方法。
问题 对于大网膜弥漫性病变选择穿刺部位存在挑战，因为传统超声引导下活检在避免局部坏死组织方面常遇到困难。发现 超声引导下大网膜活检是一种安全有效的诊断方法，尤其是联合CEUS时，可显著提高诊断准确性。临床意义 CEUS可为选择活检部位和路径提供有力依据，从而显著提高诊断准确性。因此，对于非典型大网膜病变，建议常规采用CEUS引导的穿刺路径。
