在诊断价值,安全性和成本效益方面,对胰腺损伤的不同活检技术的比较分析
Wuyongga Bao1, Keyu Zeng1, Jiayan Huang1
1Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, China.
Quantitative imaging in medicine and surgery
|May 19, 2025
概括
穿皮超声指导核心针活检 (US-CNB) 和计算机断层扫描指导核心针活检 (CT-CNB) 为胰腺损伤提供了优越的诊断准确性和成本效益,相比内超声指导细针吸收 (EUS-FNA). 这些发现强调了US-CNB和CT-CNB在诊断胰腺癌方面的效率.
科学领域:
- 胃肠病学和肝病学
- 手术瘤学手术瘤学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 胰腺癌需要早期和准确的诊断,因为它的高死亡率.
- 影像检查至关重要,但通过活检的病理确认是最终的.
- 穿皮超声引导核心针活检 (US-CNB),CT引导核心针活检 (CT-CNB) 和内超声引导细针吸收 (EUS-FNA) 是主要的活检方法.
研究的目的:
- 为了比较US-CNB,CT-CNB和EUS-FNA对可疑胰腺病变的诊断价值.
- 评估这三种活检技术的安全性.
- 评估美国-CNB,CT-CNB和EUS-FNA的成本效益.
主要方法:
- 从2018年1月到2023年1月,对399名怀疑患有恶性胰腺病变的患者进行了回顾性评估.
- 在US-CNB,CT-CNB和EUS-FNA组之间比较技术成功,样本充分性,诊断准确性和并发症率.
- 计算每个方法的成本效益 (C/E) 和增量成本效益比率 (ICER).
主要成果:
- 所有的方法都取得了100%的技术成功.
- 美国-CNB (97.70%) 和CT-CNB (90.90%) 的样本充分性和诊断准确性明显高于EUS-FNA (74.03%和69.80%).
- 所有方法的并发症率都相似 (美国-CNB: 15.12%,CT-CNB: 16.36%,EUS-FNA: 10.47%),没有显著差异.
结论:
- 与EUS-FNA相比,US-CNB和CT-CNB在疑似恶性胰腺病变方面提供了更高的诊断准确性和样本充分性.
- 在三种活检方法中,没有观察到并发症率的显著差异.
- 在诊断胰腺病变方面,US-CNB和CT-CNB比EUS-FNA更具成本效益和经济效率.
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