摘要
目的探讨超声引导经皮粗针穿刺活检(percutaneous ultrasound-guided core needle biopsy,PUS-CNB)与超声内镜引导下细针穿刺(endoscopic ultrasound-guided fine needle aspiration,EUS-FNA)在胰腺占位性病变诊断中的安全性及临床价值。方法选取109例临床难以确诊的胰腺占位病变,超声引导下避开大血管进针并对病灶内高度可疑处进行取材,其中单独行PUS-CNB者82例,单独行EUS-FNA者19例,两者均行者8例。术前记录病灶部位、大小等,所取标本有明确病理诊断者为取材满意,穿刺过程中因存在高风险因素最终无法穿刺为取材不成功,穿刺术后随访并记录并发症。结果PUS-CNB取材满意率和取材成功率分别为98.89%和100%,诊断准确率和假阴性率分别为97.78%和2.22%;EUS-FNA取材满意率和取材成功率分别为96.15%和96.30%,诊断准确率和假阴性率分别为80.77%和23.81%。两者穿刺术后均未出现严重的胰瘘、出血、针道处种植转移等并发症。结论PUS-CNB和EUS-FNA均是安全有效的诊断胰腺良恶性占位性病变的方法,具有较高的临床价值。合理选择应用EUS-FNA和PUS-CNB,可安全可靠地鉴别诊断胰腺良恶性病变。
Objective To explore the safety and clinical value of percutaneous ultrasound-guided core needle biopsy(PUS-CNB) and endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) in pancreas mass. Methods Ultrasound-guided biopsy were performed in 109 cases who were difficult to diagnose to get specimens from the highly suspicious parts of the lesions by avoiding vessels. PUS-CNB were performed in 82 cases, EUS-FNA in 19 cases and both in 8 cases. The site and size of lesions were recorded preopeartion. Specimens with clear pathological diagnosis were considered as satisfactory materials. Specimens that were impossible to puncture due to the existence of high risk factors in the process of puncture were considered as unsuccessful biopsy. All patients were followed up after biopsy and complications were recorded. Results The satisfaction rate and success rate of PUS-CNB were 98.89% and 100%, the diagnostic accuracy and false negative rate were 97.78% and 2.22%. The satisfaction rate and success rate of EUS-FNA were 96.15% and 96.30%, the diagnostic accuracy and false negative rate were 80.77% and 23.81%. There were no serious complications such as pancreatic fistula, hemorrhage and needle transfer at the needle site after puncture. Conclusions Both PUS-CNB and EUS-FNA are safe and effective methods for the diagnosis of benign and malignant pancreatic lesions and have high clinical values. Reasonable selection of EUS-FNA and PUS-CNB can safely and reliably identify and diffentiate the benign and malignant pancreatic lesions.
作者
骆洁丽
张超
黄封博
陈建设
孙杨
黄品同
Luo Jieli;Zhang Chao;Huang Fengbo;Chen Jianshe;Sun Yang;Huang Pintong(Department of Ultrasonography,the Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China;Department of Pathology,the Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2019年第9期771-775,共5页
Chinese Journal of Ultrasonography
基金
国家自然科学基金(81527803,81420108018)
中国超声医师科技新星计划(KJXX2018003).
关键词
超声引导经皮粗针穿刺活检
超声内镜引导下细针穿刺
胰腺占位
并发症
Percutaneous ultrasound-guided core needle biopsy
Endoscopic ultrasound-guided fine needle aspiration
Pancreas mass
Complication
