core needle biopsy

核心针活检
  • 文章类型: Journal Article
    芯针活检标本的触摸印记细胞学(TIC)是一种快速现场评估(ROSE)的简便方法,有助于通过细胞学分析快速诊断乳腺肿块。
    评估触摸印迹细胞学在预测乳腺肿块针芯活检的充分性及其对恶性肿瘤的诊断准确性方面的功效。
    这项研究在Burdwan医学院进行了为期两年的研究,研究对象是80例乳腺肿块患者,并同意进行芯针活检进行诊断。
    在80例病例中,79例获得满意的触摸印记材料。只有一种情况没有产生令人满意的材料,因此被排除在分析之外。共43例为恶性,36例芯针活检为良性或炎性。37例通过TIC准确诊断为恶性,35例经TIC准确诊断为良性。灵敏度,特异性,阳性预测值(PPV),TIC的阴性预测值(NPV)为86.05%,97.22%,97.37%,和85.36%,分别,总体准确率为90%。
    芯针活检的TIC是一种快速,可靠,和准确的早期细胞学诊断有症状的乳腺病变的方法。它可以在活检部位常规使用,以评估在芯针活检期间获得的材料的充分性,并计划在恶性乳腺病变的情况下进行进一步的检查。
    UNASSIGNED: Touch imprint cytology (TIC) of core needle biopsy specimen is an easy method of rapid on-site evaluation (ROSE) which aids in the rapid diagnosis of breast lumps by cytological analysis.
    UNASSIGNED: To evaluate the efficacy of touch imprint cytology in predicting the adequacy of needle core biopsy of breast lumps and its diagnostic accuracy for malignancy.
    UNASSIGNED: This study was done in Burdwan Medical College over a period of two years on 80 patients who had presented with breast lumps and had given consent for core needle biopsy for diagnosis.
    UNASSIGNED: Out of 80 cases, satisfactory materials on touch imprint were obtained in 79 cases. Only one case did not yield satisfactory material and hence was excluded from the analysis. A total of 43 cases were malignant, and 36 cases were either benign or inflammatory on core needle biopsy. Thirty-seven cases were accurately diagnosed as malignant by TIC, and 35 cases were accurately diagnosed as benign by TIC. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of TIC were 86.05%, 97.22%, 97.37%, and 85.36%, respectively, and the overall accuracy was 90%.
    UNASSIGNED: TIC of core needle biopsy is a rapid, reliable, and accurate method for early cytological diagnosis of symptomatic breast lesions. It can be used routinely at the site of biopsy to evaluate the adequacy of materials obtained during core needle biopsy and to plan for further workup in case of malignant breast lesions.
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  • 文章类型: Journal Article
    乳腺肿瘤是影响雌性狗和猫的常见肿瘤。我们比较了手术前细针穿刺(FNA)和芯针活检(CNB)诊断猫科动物(n=64)和犬科动物(n=83)乳腺肿瘤的准确性,并将切除组织病理学作为最终诊断的金标准。我们还探索了CNB针尺寸(18G和16G)的影响。FNA,18GCNB和16GCNB在诊断猫乳腺肿瘤方面表现出相似的准确性,范围从90%到97.7%(p>0.05)。然而,这些技术对犬乳腺肿瘤的诊断准确率较低:FNA为46.7%-50.9%,18GCNB为63.3%,16GCNB为73.6%。总之,FNA和CNB可以任选地用作猫科动物和犬科动物乳腺肿瘤的术前诊断方法。然而,影响诊断准确性的因素,如物种和诊断技术,应该考虑。
    Mammary gland tumours are common neoplasms that affect female dogs and cats. We compared the accuracy of pre-surgical fine-needle aspiration (FNA) and core needle biopsy (CNB) diagnosing feline (n = 64) and canine (n = 83) mammary gland tumours with excisional histopathology as the gold standard for the definitive diagnosis. We also explored the impact of CNB needle sizes (18G and 16G). FNA, 18G CNB and 16G CNB demonstrated similar accuracy regarding the diagnosis of feline mammary tumours, ranging from 90% to 97.7% (p > 0.05). However, these techniques displayed lower diagnostic accuracy for canine mammary gland tumours: 46.7%-50.9% for FNA, 63.3% for 18G CNB and 73.6% for 16G CNB. In conclusion, FNA and CNB can be used optionally as pre-surgical diagnostic methods for feline and canine mammary gland tumours. However, factors that affect diagnostic accuracy, such as species and diagnostic techniques, should be considered.
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  • 文章类型: Journal Article
    本研究旨在检查继发性甲状腺恶性肿瘤的超声特征,并比较细针抽吸(FNA)和芯针活检(CNB)在这种情况下的诊断功效。
    对2011年7月至2022年10月在我们中心治疗的29例继发性甲状腺恶性肿瘤患者进行了回顾性分析。分析超声图像和临床资料,根据美国放射学学会甲状腺影像报告和数据系统(ACRTI-RADS)对病变进行分类。
    在研究的29名患者中,原发肿瘤部位主要是食管,肺,还有鼻咽.这些患者中有28人获得了全面的超声数据,提示结节性病变24例,弥漫性病变4例。结节性病变主要为实性或接近实性的低回声结节,具有平行生长和甲状腺外延伸特征,有几个显示巨大钙化。大部分患者均有不同程度的颈部淋巴结转移。FNA准确诊断31.6%的病变为继发性甲状腺恶性肿瘤,5.3%被误诊为甲状腺乳头状癌(PTC)。然而,CNB在诊断继发性甲状腺恶性肿瘤方面表现出100%的可靠性。
    这项研究对继发性甲状腺恶性肿瘤的超声特征进行了分类,确定了结节和弥漫性模式,ACRTI-RADS的应用证明对结节类型有效。在检测这些病变时,与FNA相比,CNB显示出优异的灵敏度。因此,在怀疑是恶性的甲状腺病变的情况下,尤其是颈部淋巴结肿大和有恶性肿瘤病史的患者,CNB被推荐作为选择的诊断方法。
    UNASSIGNED: This study aims to examine the ultrasonographic features of secondary thyroid malignancies and compare the diagnostic efficacy of fine-needle aspiration (FNA) and core needle biopsy (CNB) in this condition.
    UNASSIGNED: A retrospective analysis was conducted on 29 patients with secondary thyroid malignancies treated at our center between July 2011 and October 2022. Ultrasound images and clinical data were analyzed, and the lesions were classified according to the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS).
    UNASSIGNED: Among the 29 patients studied, primary tumor sites were predominantly the esophagus, lung, and nasopharynx. Comprehensive ultrasound data was available for 28 of these patients, revealing nodular lesions in 24 cases and diffuse lesions in 4 cases. Nodular lesions were predominantly solid or nearly solid hypoechoic nodules with parallel growth and extrathyroidal extension features, with a few showing macrocalcifications. Most patients had varying degrees of metastasis to neck lymph nodes. FNA accurately diagnosed 31.6 % of the lesions as secondary thyroid malignancies, while 5.3 % were misdiagnosed as papillary thyroid carcinoma (PTC). However, CNB demonstrated 100 % reliability in diagnosing secondary thyroid malignancies.
    UNASSIGNED: This study\'s categorization of secondary thyroid malignancy ultrasonographic features identifies nodular and diffuse patterns, with the application of ACR TI-RADS proving effective for nodular types. In detecting these lesions, CNB demonstrates superior sensitivity compared to FNA. Thus, in cases of thyroid lesions suspected to be malignant, particularly with enlarged neck lymph nodes and in patients with a history of malignancy, CNB is recommended as the diagnostic method of choice.
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  • 文章类型: Journal Article
    本研究旨在总结原发性甲状腺淋巴瘤(PTL)的临床表现和超声特征,并探讨PTL诊断过程中的关键环节。
    我们对山东省第三医院收治的11例PTL患者的临床和超声特征进行了回顾性分析,中国,2009年5月至2023年8月。所有病例均经超声引导芯针活检或手术切除证实。
    11例患者的平均年龄为64.45±9.85岁。在六个病人中,主要临床表现为颈部可触及肿块,其中5人在3个月至2年内肿块大小显著增加。11例患者同时存在桥本甲状腺炎(HT)。3例患者被诊断为弥漫型PTL,其中超声显示受影响的甲状腺肿大,弥漫性不均匀低回声实质。结节性PTL患者7例,混合型PTL患者1例,结节性病变的超声特征是形态不规则,但边界明显,只有1例出现严重钙化。低回声病变7例(7/11例,63.6%),9例病灶有线性回声链(9/11例,81.8%),病变后方回声增强10例(90.9%)。
    在老年HT患者中,甲状腺体积在短时间内显着增加,并出现与颈部受压相关的症状。超声特征为甲状腺实质的极低回声病变,内部可见更多线性回声链,伴有后回声增强。当遇到这样的演示时,医生必须考虑PTL的可能性。在怀疑的情况下进行芯针活检可以减少误诊的发生率。
    UNASSIGNED: This study aimed to summarize the clinical manifestations and ultrasound characteristics of primary thyroid lymphoma (PTL) and explore the key aspects in the process of diagnosing PTL.
    UNASSIGNED: We conducted a retrospective analysis of the clinical and ultrasound features of 11 patients with PTL who were admitted to Shandong Provincial Third Hospital, China, between May 2009 and August 2023. The pathology was confirmed in all cases through an ultrasound-guided core needle biopsy or surgical resection.
    UNASSIGNED: The mean age of the 11 patients was 64.45±9.85 years. In six patients, the main clinical manifestation was a palpable mass in the neck, five of whom had a significant increase in the size of the mass within 3 months to 2 years. Eleven patients had coexisting Hashimoto\'s thyroiditis (HT). Three patients were diagnosed as having diffuse-type PTL, wherein the ultrasound showed enlargement of the affected thyroid gland with diffusely uneven hypoechoic parenchyma. In 7 patients with nodular type PTL and 1 case of mixed type PTL, the ultrasonographic features of the nodular lesions were of irregular morphology and yet had distinct borders, and only 1 case had gross calcification. There were 7 cases of hypoechoic lesions (7/11 cases, 63.6%), 9 cases where the lesions had linear echo chains (9/11 cases, 81.8%), and 10 cases (90.9%) where there was echogenic enhancement posterior to the lesion.
    UNASSIGNED: In elderly patients with HT, the thyroid volume increases significantly in a short period of time and symptoms associated with compression in the neck region appear. The ultrasound characteristics were extremely hypoechoic lesions in the thyroid parenchyma, with more linear echo chains visible inside, accompanied by posterior echo enhancement. When encountering such presentations, physicians must consider the possibility of PTL. Performing a core needle biopsy in cases that raise suspicion can reduce the incidence of misdiagnosis.
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  • 文章类型: Journal Article
    背景技术组织病理学家通常会遇到用于乳腺纤维上皮病变(FELs)的核心针吸活检(CNB)。由于重叠的组织学特征和CNB材料的有限性质,纤维腺瘤(FA)和叶状肿瘤(PT)之间的区别可能具有挑战性。目的通过与后续手术切除标本的诊断比较,评估CNB诊断FA和PT的准确性。材料和方法在我们的研究中包括了在2001年1月至2020年12月期间进行CNB和随后的手术切除的总共166例乳腺FELs。审查了所有显微镜载玻片,并确诊。结果125例(75%)基于CNB的病例获得了纤维腺瘤或PT的明确诊断,其余41例(25%)在切除标本上分类较好,在CNB上被描述性诊断为纤维上皮病变.113例(90.4%)对CNB和随后的切除标本的诊断一致。在不和谐的12例病例中,在CNB上诊断为FA的三例在切除标本上升级为PT。在CNB上诊断为PT的9例在切除标本上诊断为FA。这些包括常规,细胞,少年,和复杂的FA类型。三个PT,在CNB上报告为FA,最大尺寸为6、12.5和17.5厘米。在CNB进一步分类的23例PT中,3例切除标本上的肿瘤类别发生了变化。CNB诊断的诊断准确率为90.4%。结论CNB诊断具有较好的准确性。在所有>5cm的肿瘤中,应强烈考虑PT诊断。尤其是那些超过10厘米的。移动通信,少年,复杂的FAs可误诊为CNB的PT。与临床和放射学检查结果相关有助于建立正确的诊断。
    Background Core needle biopsy (CNB) for fibroepithelial lesions (FELs) of the breast is commonly encountered by histopathologists. The distinction between fibroadenoma (FA) and phyllodes tumor (PT) can be challenging due to overlapping histological features and the limited nature of CNB material.  Objective This study aimed to assess the accuracy of CNB diagnosis of FA and PT by comparing it with a diagnosis on subsequent surgical excision specimen. Materials and methods A total of 166 cases of FELs of the breast who underwent CNB and subsequent surgical excision between January 2001 and December 2020 were included in our study. All microscopy glass slides were reviewed, and diagnosis confirmed. Results While 125 (75%) cases based on CNB received a definitive diagnosis of either fibroadenoma or PT, the remaining 41 (25%) cases were better classified on excision specimens and were descriptively diagnosed as fibroepithelial lesions on CNB. Diagnoses on CNB and on subsequent excision specimens were concordant in 113 (90.4%) cases. Among 12 cases that were discordant, three cases diagnosed as FA on CNB were upgraded to PT on excision specimens. Nine cases diagnosed as PT on CNB were diagnosed as FA on excision specimens. These included conventional, cellular, juvenile, and complex FA types. Three PTs, which were reported as FA on CNB, measured 6, 12.5, and 17.5 cm in the greatest dimension. Among 23 cases of PT which were further categorized on CNB, tumor categories changed on excision specimens in three cases. The diagnostic accuracy of CNB diagnosis was 90.4%. Conclusion CNB diagnosis showed good accuracy. PT diagnosis should be strongly considered in all tumors measuring >5 cm, especially those exceeding 10 cm. Cellular, juvenile, and complex FAs can be misdiagnosed as PT on CNB. Correlation with clinical and radiological findings can be helpful in establishing correct diagnosis.
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  • 文章类型: Case Reports
    甲状腺神经鞘瘤,一种罕见的甲状腺肿瘤,起源于形成髓鞘的雪旺氏细胞。一名47岁的妇女出现甲状腺结节逐渐扩大,在过去的两年中通过重复超声检查进行了监测。通过芯针活检和免疫组织化学染色诊断甲状腺神经鞘瘤后,患者接受了超声引导微波消融(MWA).随后的甲状腺超声显示肿瘤体积逐渐减小,实现12个月的减量率79.20%。未观察到并发症。超声引导的MWA可能是常规手术治疗甲状腺神经鞘瘤的有效替代方法。
    Thyroid schwannoma, a rare neoplasm of the thyroid gland, originates from Schwann cells that form the myelin sheath. A 47-year-old woman presented with a progressively enlarging thyroid nodule, which was monitored by repeated ultrasonography over the previous 2 years. Following a diagnosis of thyroid schwannoma by core needle biopsy and immunohistochemical staining, the patient underwent ultrasound-guided microwave ablation (MWA). Subsequent thyroid ultrasounds indicated a gradual decrease in the tumor\'s volume, achieving a 12-month volume reduction ratio of 79.20%. No complications were observed. Ultrasound-guided MWA may serve as an effective alternative to conventional surgery for managing thyroid schwannomas.
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  • 文章类型: Journal Article
    Malignant soft tissue tumors, in particular, require a multimodal treatment concept involving interdisciplinary cooperation between radiologists, pathologists, surgeons and oncologists at special tumor centers. The foundations of the treatment decision are the imaging diagnostics and the diagnosis confirmation based on tissue samples. The (local) extent and growth behavior of a tumor are among the most important findings of imaging as they have a direct influence on the surgical procedure. The most important diagnostic procedure here is magnetic resonance imaging (MRI). The T1-weighted and fat-suppressed sequences after i.v. contrast administration are used to visualize the extent of the tumor. In synopsis with diffusion-weighted and T2-weighted sequences, a differentiation between vital tumor tissue and tumor necrosis is additionally possible. This also enables targeted sampling from vital tumor parts so that the patient can be assigned to the appropriate treatment concept as quickly as possible.
    UNASSIGNED: Insbesondere maligne Weichteiltumoren erfordern ein multimodales Therapiekonzept, welches eine interdisziplinäre Zusammenarbeit zwischen Radiologen, Pathologen, Chirurgen und Onkologen an speziellen Tumorzentren beinhaltet. Grundlagen der Therapieentscheidung sind die bildgebende Diagnostik sowie die Diagnosesicherung anhand von Gewebeproben. Zu den wichtigsten Aussagen der Bildgebung gehören die (lokale) Ausdehnung und das Wachstumsverhalten eines Tumors, da diese einen unmittelbaren Einfluss auf das chirurgische Vorgehen haben. Das wichtigste diagnostische Verfahren stellt hierbei die Magnetresonanztomographie (MRT) dar. Zur Darstellung der Tumorausdehnung dienen T1-gewichtete und fettsupprimierte Sequenzen nach i.v. Kontrastmittelgabe. In Zusammenschau mit diffusions- und T2-gewichteten Sequenzen kann zudem eine Differenzierung zwischen vitalem Tumorgewebe und Tumornekrose erfolgen. Dies ermöglicht auch die gezielte Probenentnahme aus vitalen Tumoranteilen, sodass der Patient schnellstmöglich dem passenden Therapiekonzept zugeführt werden kann.
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  • 文章类型: Journal Article
    目的:通过确定组织芯的重量,比较具有不同大小针头的不同活检系统,这是精确病理诊断的重要因素之一,并为选择合适的乳腺活检系统和合适的乳腺癌活检针提供理论依据。
    方法:比较了六种不同的真空辅助活检(VAB)系统和一种具有不同大小针头的芯针活检(CNB)系统,代表15个总组合。组织核心是从鸡胸肉模型中获得的,这是人类乳腺组织的常见替代品。每种组合取5个岩心并称重。
    结果:与相同大小(14-G)针头的VAB组合相比,CNB组合提供了明显更轻的组织核(P<0.01)。使用最厚的针的组合在所有系统中获得最重的(P<0.02)。在具有相同尺寸(12-G)针的VAB系统中,无束缚的无电池VAB系统产生了最轻的样品(P<0.04)。与使用具有篮子的VAB获得的核心重量相比,使用没有篮子的VAB获得的核心重量的百分比变异系数(%CV)显著更小(P<0.01)。
    结论:与CNB系统相比,VAB系统可以产生更大的组织核。在不同的VAB系统中,即使使用相同尺寸的针,组织芯的尺寸也会变化。进行乳房组织活检时,重要的是不仅要考虑CNB与VAB,还要考虑使用哪种针头尺寸的特定设备。
    OBJECTIVE: To compare different biopsy systems with different-sized needles by determining the weight of the tissue cores, which is one of the important factors for precise pathological diagnoses, and to provide a rationale for choosing the appropriate breast biopsy system with the appropriate needle for breast cancer biopsy.
    METHODS: Six different vacuum-assisted biopsy (VAB) systems and one core needle biopsy (CNB) system with different-sized needles in different modes were compared, representing 15 total combinations. Tissue cores were obtained from a chicken breast phantom, which is a common substitute for human breast tissue. Five cores were taken for each combination and weighed.
    RESULTS: The CNB combination provided significantly lighter tissue cores compared with the VAB combinations with the same-size (14-G) needle (P < 0.01). The combinations using the thickest needle obtained the heaviest among all systems (P < 0.02). The untethered battery-free VAB system yielded the lightest specimen among the VAB systems with the same-sized (12-G) needle (P < 0.04). The percent coefficient of variation (%CV) of the core weights obtained using VAB without a basket was significantly smaller compared with the core weights obtained using VAB with a basket (P < 0.01).
    CONCLUSIONS: VAB systems can yield larger tissue cores compared with CNB systems. The size of the tissue cores varies even with the same-sized needle among different VAB systems. When performing a breast tissue biopsy, it is important to consider not only CNB versus VAB but also what specific device to use with which needle size.
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  • 文章类型: Journal Article
    评估超声(US)引导的粗针活检(CNB)在软组织肿瘤(STT)诊断中的诊断率,并分析失败因素。
    回顾性收集了139例接受US指导的CNB和手术切除的STT患者。与手术切除的组织病理学结果相比,活检失败被定义为以下条件:不明确的诊断,包括样本不足和具有正确生物潜力分类的未知亚型;错误的诊断,包括错误的生物潜能分类和具有正确生物潜能分类的错误亚型。从组织病理学角度进行单变量和多变量分析,我们进行了人口统计学特征和US特征以及活检程序,以确定诊断失败的危险因素.
    在我们的研究中,美国指导的CNB对STT的诊断率为78.4%,但是当只考虑STT的正确生物潜力分类时,诊断率为80.6%.多因素分析显示脂肪细胞肿瘤(比值比(OR)=10.195,95%置信区间(CI):1.062-97.861,p=0.044),血管肿瘤(OR=41.710,95%CI:3.126-556.581,p=0.005)和不确定的US诊断(OR=8.641,95%CI:1.852-40.303,p=0.006)与诊断失败相关.III级血管密度(OR=0.019,95%CI:0.001-0.273,p=0.007)使诊断准确性更高。
    美国指导的CNB可以是诊断STT的有效方式。当彩色多普勒超声中肿瘤血管密度为III级时,诊断率可以增加,但在脂肪细胞肿瘤中可以减少,美国诊断不确定的血管肿瘤和肿块。
    UNASSIGNED: To evaluate the diagnostic yield of ultrasonography (US)-guided core needle biopsy (CNB) in the diagnosis of soft tissue tumors (STTs) and to analyze the failure factors.
    UNASSIGNED: 139 patients with STTs that underwent both US-guided CNB and surgical resection were collected retrospectively. Compared with the histopathological results of surgical resection, the biopsy failure was defined as the following conditions: indefinitive diagnosis, including insufficient samples and unknown subtypes with correct biological potential classification; wrong diagnosis, including wrong biological potential classification and wrong subtypes with correct biological potential classification. Univariate and multivariate analyses from the perspectives of histopathological, demographic and US features together with biopsy procedures were performed to determine risk factors for diagnostic failure.
    UNASSIGNED: The diagnostic yield of US-guided CNB for STTs in our study was 78.4%, but when only considering the correct biological potential classification of STTs, the diagnostic yield was 80.6%. The multivariate analysis showed that adipocytic tumors (odds ratio (OR) = 10.195, 95% confidence interval (CI): 1.062 - 97.861, p = 0.044), vascular tumors (OR = 41.710, 95% CI: 3.126 - 556.581, p = 0.005) and indeterminate US diagnosis (OR = 8.641, 95% CI: 1.852 - 40.303, p = 0.006) were correlated with the diagnostic failure. The grade III vascular density (OR = 0.019, 95% CI: 0.001 - 0.273, p = 0.007) enabled a higher diagnostic accuracy.
    UNASSIGNED: US-guided CNB can be an effective modality for the diagnosis of STTs. The diagnostic yield can be increased when the tumor vascular density was grade III in Color Doppler US, but can be decreased in adipocytic tumors, vascular tumors and masses with indeterminate US diagnosis.
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  • 文章类型: Journal Article
    背景:仅根据临床和影像学特征无法明确区分腹膜病变。本研究旨在评估可靠性,诊断价值,超声引导下经皮穿刺活检(PCNB)对腹膜病变的诊断率。
    方法:对129例因腹膜病变而接受PCNB的患者进行回顾性分析,以评估技术完成情况和诊断结果。
    结果:结果表明,超声引导下的PCNB是一种安全可靠的诊断工具,对腹膜病变具有较高的诊断率。技术可行性和诊断合格率分别为100%和89.9%,分别。对于已知癌症病史且目标病变前后直径较短的患者,诊断率较低。
    结论:这些研究结果表明,超声引导下的PCNB可作为腹膜病变的一线诊断工具。因为它提供了一种微创和准确的方法来获得组织样本进行诊断。
    BACKGROUND: Peritoneal lesions cannot be definitively distinguished based on clinical and imaging characteristics alone. This study aimed to evaluate the reliability, diagnostic value, and diagnostic yield of ultrasound-guided percutaneous core needle biopsy (PCNB) for peritoneal lesions.
    METHODS: A retrospective analysis of 129 patients who underwent PCNB for peritoneal lesions was performed to assessed technical completion and diagnostic yield.
    RESULTS: The results showed that ultrasound-guided PCNB is a safe and reliable diagnostic tool with high diagnostic yield for peritoneal lesions. Technical feasibility and diagnostic yield rates were 100% and 89.9%, respectively. The diagnostic yield was lower for patients with a known history of cancer and a short anteroposterior diameter of the target lesion.
    CONCLUSIONS: These findings suggest that ultrasound-guided PCNB could be considered as a first-line diagnostic tool for peritoneal lesions, as it offers a minimally invasive and accurate means of obtaining tissue samples for diagnosis.
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