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[肝脏实性病变的核心活检能否实现准确的组织学分类?常规临床条件下的前瞻性研究结果]

[Does the core biopsy of solid liver lesions permit an exact histological classification? Results of a prospective study under routine clinical conditions].

作者信息

Knöpfle E, Bohndorf K, Wagner T

机构信息

Klinik für Diagnostische Radiologie und Neuroradiologie, Zentralklinikum Augsburg.

出版信息

Rofo. 1997 Oct;167(4):406-11. doi: 10.1055/s-2007-1015552.

Abstract

PURPOSE

The aim of this prospective study was to answer the question to what extent percutaneous core-cut biopsy of solid lesions of the liver can permit (sub-)classification under routine conditions.

MATERIAL AND METHODS

Subject of this study were 80 percutaneous core-cut biopsies of solid liver lesions in 75 patients. The biopsies were done consecutively under routine conditions by 10 different radiologists with Tru-Cut-needles and a biopsy gun with sonographic (n = 73) or CT (n = 7) guidance. After receiving the histological analysis, the radiologists then prospectively divided the biopsies into "valid" und "unclear" using clinical and radiologic data of the respective patient. The results were verified by a second biopsy, follow-up or surgery.

RESULTS

80% of all histological analyses were rated as "valid", 20% as "unclear". The accuracy of the "valid" reports in respect of ranking was 95% and 90% for the accurate tumour classification. These values were reduced to 81.3% and 74%, respectively, with regard to the total number of cases. The negative predictive value was reduced from 78% to 51.7%.

CONCLUSION

Core-cut biopsy of solid liver lesions guided by imaging yields good results even under routine conditions as long as all histological reports have been correlated with imaging and clinical informations.

摘要

目的

这项前瞻性研究的目的是回答在常规条件下,经皮肝实性病变穿刺活检在多大程度上能够实现(亚)分类。

材料与方法

本研究的对象是75例患者的80次经皮肝实性病变穿刺活检。活检由10位不同的放射科医生在常规条件下连续进行,使用Tru-Cut针和带有超声引导(n = 73)或CT引导(n = 7)的活检枪。在获得组织学分析结果后,放射科医生随后利用各自患者的临床和放射学数据将活检结果前瞻性地分为“有效”和“不明确”两类。结果通过再次活检、随访或手术进行验证。

结果

所有组织学分析中,80%被评为“有效”,20%为“不明确”。“有效”报告在分级方面的准确率为95%,准确肿瘤分类的准确率为90%。就病例总数而言,这些值分别降至81.3%和74%。阴性预测值从78%降至51.7%。

结论

只要所有组织学报告都与影像学和临床信息相关,即使在常规条件下,影像引导下的肝实性病变穿刺活检也能取得良好结果。

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