超声引导下脾粗针穿刺活检的探讨性研究

目的探讨超声引导下经皮粗针穿刺活检在脾中的安全性和有效性。方法25例行超声引导下脾穿刺活检的患者,局灶性病变19例(单发11例,多发8例),结节大小(3.76±1.37)cm;弥漫性病变6例。18G组织切割活检针配以自动弹射式活检枪取病变组织至少2条,活检后患者平卧位监测生命体征1个小时。最后诊断以术后病理(14例)及综合临床相应治疗过程和影像学检查为标准(11例)。结果25例患者,每例进针次数为2～3次,平均(2.28±0.46)次;11例加做了免疫组化(恶性10例,良性1例),24例明确了诊断,准确率96%,1例假阴性患者最后诊断为Castleman's病;1例并发了出血。结论只要患者的凝血功能正常范围,应用18G粗针行超声引导下脾经皮穿刺活检是安全、有效、可行的。

Percutaneous ultrasound-guided splenic core needle biopsy: primary study

Objective To explore the safety and efficacy of percutaneous ultrasound-guided core needle biopsy in the spleen. Methods Twenty-five patients undergoing splenic biopsy for focal lesions (n=19: single 11, multiple 8) or diffuse splenomegaly (n=6) were analyzed, average lesion size was (3.76±1.37) cm. In each patient, at least 2 samples were obtained with 18 G core edge-cutting needle combined with an automated biopsy gun. After the procedure, the patients were observed in supine position to monitor vital signs. Final diagnosis was established by surgical pathology (n=14) and combination of clinical course and imaging follow-up (n=11). Results Needle passes of each patient was 2-3, average 2.28±0.46. Eleven cases underwent immunohistochemical stains, 10 malignant and 1 benign. The accuracy of ultrasound-guided spleen biopsy in this series was 96%. One false negative case was finally diagnosed Castleman's disease by clinical course. One patient complained post-procedure haemorrhage. Conclusion As far as coagulative function was normal, percutaneous ultrasound-guided splenic biopsy with 18 G needle is safe, efficient and feasible.