在肺动脉质量患者中应用成像引导的皮肤内血管活检:一篇评论
Hongxia Wu1,2, Kaiquan Zhuo3, Li Guo1,2
1Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China.
Advances in therapy
|June 11, 2024
概括
图像引导的皮肤内血管活检 (PEB) 是诊断肺动脉 (PA) 质量的安全有效方法. 这种技术提供了早期的病理诊断,将瘤与栓塞区分开来,成功率高.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 干预性放射学 干预性放射学
背景情况:
- 肺动脉 (PA) 质量很少见,并且将瘤与栓塞区分开来可能具有挑战性.
- 对于PA质量的外科活检是侵入性的,昂贵的,并带有重大风险.
- 准确的组织学诊断对于适当的患者管理至关重要.
研究的目的:
- 评估成像指导的皮肤内血管活检 (PEB) 的疗效和安全性,用于PA质的组织学诊断.
- 为了比较不同PEB技术的诊断成功率.
- 评估PA群体中与PEB相关的并发症率.
主要方法:
- 在主要数据库 (Cochrane,Medline,Embase,Web of Science) 进行了系统的文献搜索,直到2023年8月.
- 对33项研究的回顾性审查,涉及87名接受PEB的PA质量患者.
- 对不同PEB技术的分析:导管吸收 (PEB-CA),囊活检 (PEB-FB) 和定向性切除术 (PEB-DA).
主要成果:
- 中瘤是最常见的组织学发现 (75.9%),其次是瘤栓塞 (6.9%) 和肺栓塞 (3.4%).
- 在所有PEB方法中,技术成功率很高 (PEB-CA为92.1%,PEB-FB为94.6%,PEB-DA为100%).
- 临床诊断成功率各不相同:PEB-FB (85.7%) 和PEB-DA (100%) 的表现明显优于PEB-CA (44.7%). 与PEB-CA相比,PEB-FB的成功率更高 (p < 0.001).
结论:
- 图像引导PEB是一种安全有效的微创技术,用于早期诊断PA群体的病理.
- 与PEB导管吸入 (PEB-CA) 相比,PEB-囊活检 (PEB-FB) 显示出更高的诊断准确性.
- 这种手术的并发症率很低,只报告了一例出血性心脏栓塞病例.
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