Silverman S G, Mueller P R, Pinkney L P, Koenker R M, Seltzer S E
Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115.
Radiology. 1993 Jun;187(3):715-8. doi: 10.1148/radiology.187.3.8497619.
A retrospective study of 97 patients undergoing 101 image-guided adrenal biopsies (IGABs) was performed to analyze the effects of specific pathologic results on test characteristics. Three categories of pathologic results (benign adrenal tissue, malignant tissue, and nondiagnostic) were compared with outcomes. Diagnostic samples were obtained in 86% of cases. Among 72 patients with proved outcomes, IGAB had an accuracy of 96%, a sensitivity of 93%, and a negative predictive value of 91% (92% in patients with bronchogenic carcinoma). In this subset of patients, 33 had biopsy specimens that contained benign adrenal tissue. In these 33 patients, three masses (each smaller than 3 cm) proved malignant. In the 14 patients with nondiagnostic samples, two masses proved malignant. Obtaining benign adrenal tissue was highly predictive of benignity, even in the setting of lung cancer. The authors conclude that IGAB is an accurate procedure in both oncologic and nononcologic patients. However, when the biopsy specimen does not contain benign adrenal tissue or malignant cells, repeat percutaneous biopsy or surgery should be considered.
对97例接受101次影像引导下肾上腺活检（IGAB）的患者进行了一项回顾性研究，以分析特定病理结果对检查特征的影响。将三类病理结果（良性肾上腺组织、恶性组织和非诊断性结果）与结果进行比较。86%的病例获得了诊断性样本。在72例已证实结果的患者中，IGAB的准确率为96%，敏感性为93%，阴性预测值为91%（在支气管源性癌患者中为92%）。在这组患者中，33例活检标本含有良性肾上腺组织。在这33例患者中，有三个肿块（每个均小于3 cm）被证实为恶性。在14例非诊断性样本的患者中，有两个肿块被证实为恶性。即使在肺癌患者中，获得良性肾上腺组织也高度提示为良性病变。作者得出结论，IGAB在肿瘤患者和非肿瘤患者中都是一种准确的检查方法。然而，当活检标本不包含良性肾上腺组织或恶性细胞时，应考虑重复经皮活检或手术。
