超声造影引导肝占位穿刺活检的应用价值#br# #br#

目的 探讨超声造影引导穿刺活检在肝占位性病变中的应用价值。方法 回顾性分析2016年1月至2017年1月行超声造影引导肝占位穿刺活检患者的临床与影像学资料，共33例患者35个病灶。在超声造影引导下选择穿刺部位和进针路径，并实时引导完成穿刺活检。计算取材成功率和诊断准确率。结果 所有病例均顺利完成穿刺，每个病灶穿刺两针，取材成功率为1000％。33例患者中，恶性28例：肝细胞癌13例，胆管细胞癌10例，神经内分泌癌3例，转移性尿路上皮癌1例，转移性鳞状细胞癌1例；良性5例：炎性病变2例，肝细胞腺瘤1例，异型增生结节2例。诊断准确率为100％。仅1例出现并发症，为肝包膜下少量出血。结论 超声造影可更加清晰地显示肝内病灶，实时造影模式下进行穿刺活检，可提高穿刺诊断的阳性率。

The value of contrast enhanced ultrasound in guiding biopsy of hepatic space occupying lesions

ObjectiveTo evaluate the value of contrast enhanced ultrasound（CEUS） guided biopsy in hepatic lesions. MethodsA total of 33 patients with 35 lesions underwent contrast enhanced ultrasound guided biopsy from Jan 2016 to Jan 2017 were enrolled in this study. Guided by contrast enhanced ultrasound， the puncture site and needle path were selected and guided real time biopsy was performed. Puncture successful rate and diagnostic accuracy were calculated. ResultsAll the patients were performed successfully， and each lesion was punctured twice. The puncture successful rate was 1000％. Among 33 patients， 28 cases were diagnosed with malignancies （13 cases of hepatocellular carcinoma， 10 cases of cholangio cellular carcinoma， 3 cases of neuroendocrine carcinoma， 1 case of metastatic urothelial carcinoma and 1 case of metastatic squamous cell carcinoma）， and 5 cases were benign（2 cases of inflammatory lesions， hepatocellular adenoma in 1 case and dysplasia nodules in 2 cases）. The diagnostic accuracy was 1000％. Puncture complication was found in 1 case （small amount of bleeding under hepatic capsule）. ConclusionContrast enhanced ultrasound can clearly display intrahepatic lesions， and real time biopsy can improve the positive rate of puncture diagnosis.