Pombo F, Rodriguez E, Martin R, Lago M
Department of Radiology, Hospital Juan Canalejo, La Coruña, Spain.
Acta Radiol. 1997 Nov;38(6):978-81. doi: 10.1080/02841859709172113.
To assess the accuracy and clinical usefulness of CT-guided core-needle biopsy in the diagnosis of omental pathology.
We retrospectively reviewed the results of CT-guided percutaneous core biopsies in 25 patients with focal (n = 2) or diffuse (n = 23) omental pathology. These results were compared to the final diagnoses as determined by laparotomy (n = 15), laparoscopic biopsy (n = 3), endoscopic biopsy (n = 1), or by the results of percutaneous biopsy and clinical-radiological and bacteriological modalities (n = 6). The final diagnoses showed 4 patients with isolated omental pathology and 21 with widespread peritoneal involvement. The CT-guided biopsies were performed with 1.0-1.8-mm Surecut core-needles.
In 16 patients, the final diagnosis was metastatic adenocarcinoma--with the primary tumor sites in the ovary (n = 3), stomach (n = 1), appendix (n = 2), and unknown (n = 10). In the remaining 9 patients, the final diagnosis was hepatocellular carcinoma, lymphoma, and mesothelioma in 1 patient each; tuberculosis in 5; and actinomycosis in 1. Sufficient histological (n = 16) or cytological (n = 8) material was obtained by CT biopsy in 24/25 (96%) cases; the specimen was insufficient for diagnosis in 1 case. In differentiating benign from malignant disease, CT-guided biopsy showed a sensitivity, specificity and accuracy of respectively 89.5%, 100% and 92%. It gave a specific diagnosis in 78.9% (15/19) of patients with malignant conditions and in 50% (3/6) of patients with benign disorders. There were no biopsy-related complications.
CT-guided percutaneous core-needle biopsy of the omentum is a safe, useful and highly accurate procedure for diagnosing malignant omental pathology.
评估CT引导下粗针穿刺活检在大网膜病变诊断中的准确性及临床实用性。
我们回顾性分析了25例有局灶性（n = 2）或弥漫性（n = 23）大网膜病变患者的CT引导下经皮粗针穿刺活检结果。将这些结果与开腹手术（n = 15）、腹腔镜活检（n = 3）、内镜活检（n = 1）或经皮活检及临床 - 放射学和细菌学检查结果（n = 6）所确定的最终诊断进行比较。最终诊断显示4例为孤立性大网膜病变，21例有广泛的腹膜受累。CT引导下活检使用1.0 - 1.8毫米的Surecut粗针进行。
16例患者最终诊断为转移性腺癌，原发肿瘤部位分别为卵巢（n = 3）、胃（n = 1）、阑尾（n = 2），原发部位不明者（n = 10）。其余9例患者中，最终诊断为肝细胞癌、淋巴瘤、间皮瘤各1例；结核5例；放线菌病1例。24/25（96%）例通过CT活检获得了足够的组织学（n = 16）或细胞学（n = 8）材料；1例标本不足以诊断。在鉴别良恶性疾病时，CT引导下活检的敏感性、特异性和准确性分别为89.5%、100%和92%。在恶性疾病患者中，78.9%（15/19）获得了明确诊断，在良性疾病患者中，50%（3/6）获得了明确诊断。未发生与活检相关的并发症。
CT引导下经皮大网膜粗针穿刺活检是诊断恶性大网膜病变的一种安全、有用且高度准确的方法。
