[Application of computed tomography guided percutaneous fine-needle aspiration biopsy in examination of pancreas and Vater's ampulla].

OBJECTIVE

To evaluate the effects of computed tomography (CT) guided percutaneous fine-needle aspiration biopsy (FANB) in examination of pancreas and Vater's ampulla.

METHODS

One hundred and six patients, 71 males and 35 females, aged 21 approximately 74, with lesions located in the pancreas and Vater's ampulla, 1.5 approximately 5 cm in size (< 3 cm in 32 cases and >or= 3 cm in 74 cases), underwent CT guided percutaneous FANB with 22-gauge needle (in 84 cases) or 20-gauge needle (in 22 cases) by anterior approach. The biopsy sites included the head of pancreas and ampulla (n = 70), body of pancreas (n = 24), and tail of pancreas (n = 12). The key points of FANB included selection of appropriate cross-section, entry of needle, and multiple insertion in fan-like fashion with fast puncture and aspiration. Pathological examination was done to all biopsy specimens.

RESULTS

All lesions were safely accessed with an accuracy rate of 100% and without major complications. Pathological examination showed that 83 lesions were malignant, 5 of which were confirmed as false-positive, and 20 lesions were benign 2 of which were confirmed as false-negative, and 3 lesions were true-negative. The accuracy rates of diagnosis of malignant lesions and of diagnosis of benign lesion were 94% and 90% respectively (P > 0.05). The accuracy rate of diagnosis was 96% for the lesions >or= 3 cm was 96% and 88% for the lesions < 3 cm (P > 0.05). The accuracy rates of diagnosis were 93%, 92%, and 100% for the lesions located in the head of pancreas and ampulla of Vater, body of pancreas, and tail of pancreas (P > 0.05).

CONCLUSION

CT guided percutaneous FANB is a safe and effective method for the diagnosis and differential diagnosis of lesions in the pancreas.