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Usefulness of Sonographic Guidance During Percutaneous Biopsy of Mesenteric Masses

¹ Department of Radiology, Duke University Medical Center, Box 3808, Rm. 2526 Blue Zone S., Durham, NC 27710.
² Department of Radiology, Suburban Hospital, 8600 Old Georgetown Rd., Bethesda, MD 20814.

OBJECTIVE. The objective of our study was to determine the usefulness of sonographic guidance for biopsy of mesenteric masses.

MATERIALS AND METHODS. Twenty-five sonographically guided percutaneous biopsies of mesenteric masses were performed in 23 patients. Biopsies were performed with an 18-, 20-, or 22-gauge self-aspirating needle or core biopsy device. Final pathology results and patient medical records were reviewed for biopsy accuracy and complications. A biopsy was considered successful if a specific benign or malignant diagnosis was rendered by the pathologist or if surgical–pathologic confirmation was obtained.

RESULTS. Open surgical biopsy was performed after sonographically guided biopsy in 13 patients and led to 12 concordant diagnoses (nine true-positives and three true-negatives) and one discordant diagnosis (false-negative). Specific pathologic diagnosis was rendered for the 10 percutaneous biopsies that were not confirmed by surgical biopsy: five biopsies matched known primary malignancies, consistent with metastases; four biopsies revealed primary tumors, and one biopsy revealed chronic inflammation (nine true-positives and one true-negative). Two biopsies were nondiagnostic because of insufficient material (n = 1) and necrotic tumor (n = 1). In the biopsies with diagnostic tissue specimens, sonographically guided biopsy achieved a sensitivity of 95% (18/19) and specificity of 100% (4/4) for allowing neoplastic tissue to be distinguished from nonneoplastic tissue. Complications included a mesenteric hematoma and abdominal wall cellulitis.

CONCLUSION. Percutaneous biopsy of mesenteric masses is a useful and safe procedure.

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