摘要
目的探讨钝针穿刺技术在X线计算机断层摄影(CT)引导经皮胰腺病变穿刺活检中的应用价值及安全性。方法回顾分析2021年10月至2023年10月在郑州大学第一附属医院使用钝针穿刺技术进行CT引导经皮胰腺穿刺活检的103例胰腺病变患者的临床资料,其中男性64例,女性39例,年龄(61.5±12.3)岁。根据穿刺通路分为两组:普通路径组(n=70)和困难路径组(n=33)。记录患者的穿刺操作时间、调针所需CT扫描次数、并发症发生率等临床资料,评估技术成功率、诊断率、准确率、灵敏度、特异度、假阴性率。结果总体人群的技术成功率为100%(103/103)。根据术后病理及临床随访,103例患者最终诊断为肿瘤性病变者98例,为非肿瘤性病变者5例,总体经皮穿刺活检的诊断率为91.3%(94/103),假阴性率为5.8%(6/103),敏感度为92.9%(90/98),特异度为100%(90/90)。普通路径组和困难路径组患者的操作时间[(22.8±6.3)min比(22.4±7.9)min]、调针所需CT扫描次数[5.0(3.0,6.0)次比5.0(4.0,7.5)次]、穿刺深度[(69.9±15.4)mm比(73.7±17.4)mm]、诊断率[90.0%(63/70)比93.9%(31/33)]、准确率[(90.0%(63/70))比(93.9%(31/33))]等穿刺活检的相关资料比较,差异均无统计学意义(均P>0.05)。共有8例患者出现并发症,5例出血和3例单纯性胰腺炎均经内科疗后好转。困难路径组和普通路径组患者的并发症发生率差异无统计学意义[9.1%(3/33)比7.1%(5/70),χ^(2)=0.12,P=0.730]。结论钝针穿刺技术在CT引导经皮胰腺病变穿刺活检中具有较高的技术成功率、诊断率、准确性及安全性,且可用于困难穿刺路径的胰腺病变患者。
Objective To validate the application value and safety of blunt-tip needle technique for computer tomography(CT)-guided percutaneous biopsy of pancreatic lesions.Methods Clinical data of 103 patients with pancreatic lesions undergoing CT-guided percutaneous biopsy with blunt-tip needle approach in the First Affiliated Hospital of Zhengzhou University from October 2021 to October 2023 were retrospectively analyzed,including 64 males and 39 females,aged(61.5±12.3)years.According to the access routes,procedures were divided into regular group(n=70)and hard-to-reach group(n=33).Technical data such as the duration of procedure,number of needle correction scans,and the incidence of complications were recorded.The technical success rate,diagnostic yield,accuracy,sensitivity,specificity,and false-negative rates were compared between groups.Results The overall technical success rate was 100%(103/103).According to postoperative pathology and clinical follow-ups,the final diagnosis of 103 patients was 98 cases with neoplastic lesions and 5 with non-neoplastic lesions.The overall diagnostic rate of percutaneous biopsy was 91.3%(94/103),with a false negative rate of 5.8%(6/103),sensitivity of 92.9%(90/98),and specificity of 100%(90/90).Duration of procedure[(22.8±6.3)min vs.(22.4±7.9)min],number of needle correction scans[5.0(3.0,6.0)times vs.5.0(4.0,7.5)times],length of target access[(69.9±15.4)mm vs.(73.7±17.4)mm],diagnostic yield[90.0%(63/70)vs.93.9%(31/33)],and accuracy rate[90.0%(63/70)vs.93.9%(31/33)]were comparable between regular group and hard-to-reach group(all P>0.05).Complications occurred in 8 patients,including 5 patients with hemorrhage and 3 with pancreatitis,which were successfully managed with conventional therapy.The incidence of complications were similar between the hard-to-reach and regular group[9.1%(3/33)vs.7.1%(5/70),χ^(2)=0.12,P=0.730].Conclusion CT-guided percutaneous biopsy in the diagnosis of pancreatic lesions with blunt-tip needle approach has a satisfactory technical success rate,diagnostic yield,accuracy,and safety,which can be used in patients with hard-to-reach lesions.
作者
王猛
周志刚
杜可朴
李帅
高飞
李亚丹
高梦宇
Wang Meng;Zhou Zhigang;Du Kepu;Li Shuai;Gao Fei;Li Yadan;Gao Mengyu(Department of Radiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华肝胆外科杂志》
北大核心
2025年第2期121-125,共5页
Chinese Journal of Hepatobiliary Surgery
关键词
胰腺肿瘤
CT引导
穿刺活检
钝针
Pancreatic neoplasms
CT-guided
Biopsy
Blunt-tip needle
