超声引导下肝穿刺活检术在不明原因肝病病因分析中的价值

肝脏 ›› 2025, Vol. 30 ›› Issue (7): 1000-1004.

超声引导下肝穿刺活检术在不明原因肝病病因分析中的价值

范文涛, 贺飞, 严攀

430050 湖北武汉武汉科技大学附属汉阳医院超声科(范文涛,严攀);430064 湖北武汉武汉科技大学附属同济天佑医院介入超声科(贺飞)

收稿日期:2024-11-20 出版日期:2025-07-31 发布日期:2025-08-11
通讯作者: 严攀,Email:18602738204@163.com
基金资助:
湖北省卫健委科研课题(2021W373)

The value of ultrasound-guided liver puncture biopsy in the etiologic analysis of unexplained liver disease

FAN Wen-tao¹, HE Fei², YAN Pan¹

1. Department of Ultrasound, Hanyang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan 430050, China;
2. Department of Interventional Ultrasound, Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan 430064, China

Received:2024-11-20 Online:2025-07-31 Published:2025-08-11
Contact: YAN Pan, Email: 18602738204@163.com

摘要/Abstract

摘要： 目的分析超声引导下肝穿刺活检术在不明原因肝病病因分析中的价值,为提高不明原因肝病的诊断率提供依据。方法对2019年12月—2023年12月收治的100例不明原因肝病患者进行回顾性分析,所有患者均进行超声引导下肝穿刺活检术检查,以临床特征结合肝穿刺病理检查作为肝病诊断的金标准。比较超声引导下肝穿刺活检术检查结果并分析其诊断价值。结果 100例患者中,通过临床特征结合肝穿刺病理检查明确诊断的病例共 94 例,为自身免疫性肝病、胆汁淤积性肝病、高胆红素血症、脂肪性肝病、酒精性肝病,阳性诊断率为94.00%(94/100)。超声引导下肝穿刺活检术检查自身免疫性肝病、胆汁淤积性肝病、高胆红素血症、脂肪性肝病、酒精性肝病共90例,阳性诊断率为90.00%(90/100),假阳性率为0.00%,Kappa值为0.858,与临床特征结合肝穿刺病理检查的一致性较好。超声引导下肝穿刺活检术检查的灵敏度、特异度、准确度、阳性预测值分别为95.74%、100.00%、96.00%、100.00%,与临床特征结合肝穿刺病理检查具有较高的一致性和诊断价值,差异无统计学意义(均P>0.05)。结论超声引导肝穿刺活检技术在面对不明原因肝病病因的诊疗中,展现出了极高的诊断效能,能够及时为临床决策提供精准依据,从而有效指导治疗方案的制定与实施。

关键词: 超声, 肝穿刺活检术, 肝病, 自身免疫性肝病, 胆汁淤积性肝病

Abstract: Objective To analyze the value of ultrasound-guided liver puncture biopsy in the etiological analysis of unexplained liver disease, and to provide a basis for improving the diagnostic rate of unexplained liver disease. Methods 100 cases of patients with unexplained liver disease admitted retrospectively from December 2019 to December 2023 were examined by ultrasound-guided hepatic aspiration biopsy, and clinical features combined with hepatic aspiration pathology were used as the “gold standard”. The results of ultrasound-guided hepatic aspiration biopsy examination and the diagnostic value of ultrasound-guided hepatic aspiration biopsy examination were compared. Results In 100 patients, clinical features combined with pathological examination by liver puncture led to a clear diagnosis of autoimmune liver disease, cholestatic liver disease, hyperbilirubinemia, steatohepatopathy, and alcoholic liver disease, which amounted to 94 cases, with a positive diagnostic rate of 94.00% (94/100). A total of 90 cases of autoimmune liver disease, cholestatic liver disease, hyperbilirubinemia, steatohepatopathy, and alcoholic liver disease were examined by ultrasound-guided hepatic perforation biopsy, with a positive diagnostic rate of 90.00% (90/100), a false-positive rate of 0.00%, and a Kappa value of 0.858, which showed a good concordance with the clinical features in combination with the hepatic perforation pathologic examination. The sensitivity, specificity, accuracy, and positive predictive value of ultrasound-guided liver puncture biopsy examination were 95.74%, 100.00%, 96.00%, and 100.00%, respectively, which were in high concordance with the clinical features combined with the pathologic examination of liver puncture, and had high diagnostic value, and the differences were not statistically significant (all P>0.05). Conclusion Ultrasound-guided hepatic puncture biopsy has demonstrated high diagnostic efficacy in the diagnosis and treatment of unknown causes of liver function abnormalities, and it can provide an accurate basis for clinical decision-making in a timely manner, thus effectively guiding the formulation and implementation of treatment programs.

Key words: Ultrasound, Hepatic aspiration biopsy, Liver disease, Autoimmune liver disease, Cholestatic liver disease

范文涛, 贺飞, 严攀. 超声引导下肝穿刺活检术在不明原因肝病病因分析中的价值[J]. 肝脏, 2025, 30(7): 1000-1004.

FAN Wen-tao, HE Fei, YAN Pan. The value of ultrasound-guided liver puncture biopsy in the etiologic analysis of unexplained liver disease[J]. Chinese Hepatolgy, 2025, 30(7): 1000-1004.

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