摘要
目的 观察超声引导下经皮穿刺活检诊断胰腺实性病变的效能,探讨诊断准确率影响因素。方法 回顾性分析746例因胰腺实性病变接受经皮超声引导下粗针穿刺活检(US-CNB)患者,记录临床及影像学资料、胰腺穿刺相关资料和病理诊断;以穿刺12个月后临床随访结果为最终诊断,评估US-CNB诊断胰腺实性病变的效能。以单因素分析及logistic回归分析筛选影响US-CNB诊断准确率的因素。结果 742穿刺活检成功,技术成功率99.46%(742/746)。US-CNB准确诊断706例(准确组)、不准确36例(不准确组),其诊断胰腺实性病变的敏感度、特异度、准确率、阳性预测值及阴性预测值分别为95.25%(702/737)、80.00%(4/5)、95.15%(706/742)、99.86%(702/703)和10.26%(4/39)。31例(31/742,4.18%)发生轻度并发症,4例(4/742,0.54%)发生严重并发症。组间患者年龄,胰腺病灶最大径<2 cm、病灶边界不清晰及病灶位于胰头部占比差异均有统计学意义(P均<0.1)。回归分析显示,病灶最大径<2 cm是US-CNB诊断准确率的独立影响因素(OR=3.054,P=0.030)。结论 超声引导下经皮胰腺病变穿刺活检安全、可靠,但病灶体积小可能影响其准确性。
Objective To observe diagnostic efficacy of ultrasound-guided percutaneous biopsy for solid pancreatic lesions,also to explore the impact factors of diagnostic accuracy.Methods Data of 746 patients with solid pancreatic lesions underwent ultrasound-guided core needle biopsy(US-CNB)were retrospectively analyzed.Clinical data,imaging records,pancreatic puncture-related information and pathological diagnosis details were collected.After 12 months follow-up,the final clinical diagnoses were assessed,and the efficacy of US-CNB for diagnosing solid pancreatic lesions was evaluated.Univariate analysis and logistic regression analysis were used to screen impact factors for US-CNB diagnostic accuracy of solid pancreatic lesions.Results US-CNB was successfully performed in 742 cases,with the technical success rate of 99.46%(742/746).US-CNB accurately diagnosed pancreatic lesions in 706 cases(accurate group)but inaccurately judged 36 cases(inaccurate group).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of US-CNB for diagnosing solid pancreatic lesions was 95.25%(702/737),80.00%(4/5),95.15%(706/742),99.86%(702/703)and 10.26%(4/39),respectively.Mild post-procedural complications occurred in 31 cases(31/742,4.18%),while severe complications observed in 4 cases(4/742,0.54%).There were significant differences of patients'age and the ratio of lesions with the maximum diameter<2 cm,with unclear boundaries or located in the head of pancreas between groups(all P<0.1).Regression analysis showed that the maximum diameter of lesion<2 cm was the independent impact factor of the accuracy of US-CNB for diagnosing solid pancreatic lesions(OR=3.054,P=0.030).Conclusion Ultrasound-guided percutaneous biopsy of solid pancreatic lesion was safe and reliable,but its accuracy might decrease in small size lesions.
作者
许丹霞
陈强
章尧
柴玮璐
张同龙
蒋天安
赵齐羽
XU Danxia;CHEN Qiang;ZHANG Yao;CHAI Weilu;ZHANG Tonglong;JIANG Tian'an;ZHAO Qiyu(Department of Ultrasound Medicine,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310000,China;Department of R&D,Zhejiang Curaway Medical Technology Co.,Ltd.,Hangzhou 310000,China)
出处
《中国医学影像技术》
CSCD
北大核心
2024年第4期494-497,共4页
Chinese Journal of Medical Imaging Technology
基金
国家自然科学基金(82171937)。
作者简介
第一作者:许丹霞(1988-),女,浙江台州人,硕士,主治医师。研究方向:超声诊断、超声介入。E-mail:xudanxia125@zju.edu.cn;通信作者:赵齐羽,浙江大学医学院附属第一医院超声医学科,310000。E-mail:derman2000@zju.edu.cn。
