Heilo A, Stenwig A E
Department of Radiology, Norwegian Radium Hospital, Oslo.
Radiology. 1997 Sep;204(3):719-22. doi: 10.1148/radiology.204.3.9280249.
To assess the clinical usefulness of ultrasound (US)-guided, 18-gauge core-needle biopsy of liver hemangiomas performed with a one-hand automatic-sampling technique.
In 491 US-guided core-needle biopsies of the liver, hemangioma was suspected at US in 51 cases. Hemangiomas were confirmed histologically in 29 cases, a malignant lesion was revealed in six cases, and no specific diagnosis could be made in 16 cases. Hemangioma was diagnosed in 18 lesions that appeared malignant at US. The hemangiomas were 7-114 mm in diameter (mean, 45 mm).
The histologic diagnosis of hemangioma was unequivocal in 47 biopsy specimens. A cuff of normal hepatic parenchyma could be interposed between the capsule and the margin of the hemangioma in all procedures but one, in which two direct punctures were made of a protruding giant hemangioma. An average of 1.4 punctures were performed at each biopsy session. There were no false-positive findings and 15 or perhaps 16 false-negative findings. There were no serious complications.
US-guided core needle biopsy seems to be a safe procedure when the diagnosis of hemangioma must be ascertained. Conclusive biopsy findings may shorten the diagnostic work-up, benefiting the patient and the hospital.
评估采用单手自动采样技术在超声(US)引导下对肝脏血管瘤进行18G粗针活检的临床实用性。
在491例US引导下的肝脏粗针活检中,超声检查怀疑有51例为血管瘤。组织学确诊血管瘤29例,发现恶性病变6例,16例未作出明确诊断。18个超声表现为恶性的病灶被诊断为血管瘤。这些血管瘤直径为7 - 114mm(平均45mm)。
47份活检标本中血管瘤的组织学诊断明确。除1例对突出的巨大血管瘤进行了两次直接穿刺外,所有操作中均能在血管瘤的包膜与边缘之间插入一圈正常肝实质。每次活检平均穿刺1.4次。无假阳性结果,有15例或可能16例假阴性结果。无严重并发症。
当必须确定血管瘤的诊断时,US引导下的粗针活检似乎是一种安全的操作。确定性的活检结果可缩短诊断检查时间,使患者和医院均受益。