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谁与“针”锋:超声引导下MARQUEE®一次性一体式活检针在非靶向肝脏穿刺活检中的应用

2020-10-22 medsci medsci

自从第一例经皮穿刺活检于1883年在德国实施以来,穿刺活检术后病理诊断已经成为一种评估疾病类型与分期的重要方法。

自从第一例经皮穿刺活检于1883年在德国实施以来[1],穿刺活检术后病理诊断已经成为一种评估疾病类型与分期的重要方法[2],[3]。基于影像引导设备的不断发展(主要是超声和CT),穿刺活检的应用范围日益扩展。在目前国家关注医疗费用的大环境下,穿刺活检作为一项物美价廉、安全有效[4]的诊断工具,无疑将成为诊断界的“宠儿”。

非靶向肝脏活检是肝脏疾病诊断的金标准[3],由此来确定是否存在肝病以及肝病程度。其准确性取决于临床获得标本质量和病理学医师的水平,医生水平我们暂不妄论,而我们知道组织样本较小或质量差会妨碍诊断的准确性,并可能会延迟治疗,于是穿刺所得的样本质量比拼顺而成为各大品牌穿刺针“针尖对麦芒”的擂台了。那问题来了,如何获得高质量的穿刺样本呢?

经皮肝脏活检

L.M. Ho等2020年5月发表在Clinical Imaging杂志上的文章:Ultrasound-guide non-targeted liver core biopsy:comparison of the efficacy of two different core needle biopsy systems using an ex-vivo animal model and retrospective review of clinical experience,比较了超声引导下的穿刺活检针对比,也让我们认识了穿刺界冉冉升起的新星——MARQUEE®一次性一体式活检针的取样效果[5]

图1 研究报告

是骡子是马,拉出来遛遛

为了让专业同行更直观看清楚“针锋相对”的结果,我们专门请上英国皇家病理学院作为评审官,来对肝脏活检标本的质量进行评判。

主要评判陈条如下所示:

表1: 英国皇家病理学院肝脏活检标本质量标准

* 实践中常规获得的非靶向肝脏活检的最小数目为两个活检

MARQUEE®一次性一体式活检针针槽

 

首先,让我们来看一下在体外它的表现如何

研究方法:从当地一家杂货店的肉类部门获取了两个完整的新鲜牛肝,由三位经验丰富的放射科医生进行了所有活检,三位医生每人对每个肝脏进行了10次活检,最终对这两个肝脏共进行了60次活检。

研究结果:

表2: 离体样本长度和宽度、碎裂数和门三联管的数据

 

从表格中数据显示,它在取样样本量、样本完整度、有效样本量等方面表现优异。看到这些杠杠的硬核优势,您是否已经期待它的临床表现了呢?

 

接下来,马上为您奉上它的临床表现

研究方法:符合条件的受试者通过2019年9月1日至2019年10月31日期间进行肝脏活检穿刺的病历数据库检索确定。使用 MARQUEE®一次性一体式活检针 (n=10)进行的连续非靶向肝脏活检穿刺符合纳入标准。

研究结果:

表3: 临床样本长度和宽度、碎裂数和门三联管的数据

我们非常欣喜地发现MARQUEE®一次性一体式活检针在临床实践中也表现优异:在福尔马林固定的平均标本长度长,样本中获取到的门三联管数量多,样本100%符合皇家病理学院定义的取样充分性标准。

来一组肝脏活检标本的组织学外观图请大家来感受下:

使用低倍放大倍数从2号肝脏中提取的MARQUEE®一次性一体式活检针活检标本。 未破碎的样本总长度为11.0毫米。 存在十个完整的门户三合会,并标识了代表性的门户区域(箭头)。

 

MARQUEE®一次性一体式活检针不仅注重于临床表现,也关注于用户体验,以下是几位研究者的主观感受分析:

表4: 三名放射科医主观用户经验的定性分析

LOOK!MARQUEE®一次性一体式活检针不仅试验结果优异,医生用后感觉也棒棒的呢!

取样饱满、操作方便、穿刺精准……看到众多优点集于一身的“它”,您是否已然跃跃欲试,渴望亲身体验了呢?说了这么多我们展示一下MARQUEE®一次性一体式活检针的真面目吧!

最后小编给大家撒一波预告,BD MARQUEE®一次性一体式活检针已经正式进入中国,可以与中国医生们见面啦,让我们共同来期待它在华夏大地“大展拳脚”!

 

参考文献:

[1] 张雪哲等.CT导引下经皮细针穿刺活检.临床放射学杂志.1988;22(3):136-9

[2] 中华医学会泌尿外科分会,中国前列腺癌联盟.前列腺穿刺中国专家共识.中华泌尿外科杂志.2016;37(4):241-4

[3] 中华医学会肝病学分会,中华医学会消化病学分会,中华医学会感染病学分会.肝纤维化诊断及治疗共识(2019).临床肝胆病杂

志.2019;35(10):2163-72

[4] de Bazelaire C, et al. Biopsies in oncology. Diagn Interv Imaging. 2014;95(7-8):647-57

[5] Ho LM, et al.Ultrasound-guided non-targeted liver core biopsy: comparison of the efficacy of two different core

needle biopsy systems using an ex-vivo animal model and retrospective review of clinical experience.Clin Imaging.

2020;61:36-42

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    2020-10-24 smlt2008
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    2020-10-24 rgjl
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