Objectives Contrast-enhanced ultrasound (CEUS) assesses omental lesion nature, but CEUS-guided biopsy feasibility, effectiveness, and safety are uncertain. Methods From January 2020 to January 2024, patients scheduled for ultrasound-guided omental biopsy at the First Hospital of China Medical University were enrolled. They were divided into CEUS-guided and conventional ultrasound-guided groups, balanced using propensity score matching (PSM). Success rate, diagnostic accuracy, and complication rate were compared. Subgroup analyses considered sonographic features, with significance at p < 0.05. Results After PSM, 310 CEUS-guided and 160 conventional ultrasound-guided patients were analyzed. Groups were similar in demographics and omental characteristics (p > 0.05). CEUS-guided biopsy had higher sample acquisition (97.42% vs. 93.13%, p = 0.029) and diagnostic accuracy (96.03% vs. 87.92%, p = 0.002). Overall complication rate was 9.36% (44/470), with distant metastasis in 0.43% (2/470). Complication rates did not differ significantly between groups. In hyperechoic group, dense group, and non-nodule group, CEUS-guided biopsy had higher success (97.99% vs. 92.55%, p = 0.042) and accuracy (96.48% vs. 86.17%, p = 0.002). In non-nodule group, CEUS-guided accuracy was superior (93.41% vs. 84.11%, p = 0.015). Conclusion Ultrasound-guided omental biopsy is a safe and effective method for obtaining samples. CEUS-guided omental biopsy enhances sample acquisition and diagnostic accuracy, especially in hyperechoic group, dense group, and non-nodule group, suggesting it is a more accurate and effective diagnostic method. Key Points <Emphasis Type="BoldItalic">Question</Emphasis> Selecting a puncture site for diffuse lesions of the greater omentum presents challenges, as conventional ultrasound-guided biopsy often encounters difficulties in avoiding local necrotic tissue. <Emphasis Type="BoldItalic">Findings</Emphasis> Ultrasound-guided biopsy of the greater omentum is a safe and effective diagnostic method, especially when augmented with CEUS, which can significantly enhance diagnostic accuracy. <Emphasis Type="BoldItalic">Clinical relevance</Emphasis> CEUS can markedly enhance diagnostic accuracy by providing a robust foundation for selecting the biopsy site and pathway. Therefore, it is advisable to routinely employ CEUS-guided puncture pathways for atypical omental lesions. Graphical Abstract

Safety and efficacy evaluation of contrast-enhanced ultrasound-guided omental biopsy: a single-center prospective study

期刊论文
发表日期：

2025年3月27日

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Zhiguang Chen,
Zhiqun Bai,
Puxu Yang,
Liang Sang,
Xiang Li,
Xuemei Wang,
Yanjun Liu

摘要

Objectives

Contrast-enhanced ultrasound (CEUS) assesses omental lesion nature, but CEUS-guided biopsy feasibility, effectiveness, and safety are uncertain.

Methods

From January 2020 to January 2024, patients scheduled for ultrasound-guided omental biopsy at the First Hospital of China Medical University were enrolled. They were divided into CEUS-guided and conventional ultrasound-guided groups, balanced using propensity score matching (PSM). Success rate, diagnostic accuracy, and complication rate were compared. Subgroup analyses considered sonographic features, with significance at p < 0.05.

Results

After PSM, 310 CEUS-guided and 160 conventional ultrasound-guided patients were analyzed. Groups were similar in demographics and omental characteristics (p > 0.05). CEUS-guided biopsy had higher sample acquisition (97.42% vs. 93.13%, p = 0.029) and diagnostic accuracy (96.03% vs. 87.92%, p = 0.002). Overall complication rate was 9.36% (44/470), with distant metastasis in 0.43% (2/470). Complication rates did not differ significantly between groups. In hyperechoic group, dense group, and non-nodule group, CEUS-guided biopsy had higher success (97.99% vs. 92.55%, p = 0.042) and accuracy (96.48% vs. 86.17%, p = 0.002). In non-nodule group, CEUS-guided accuracy was superior (93.41% vs. 84.11%, p = 0.015).

Conclusion

Ultrasound-guided omental biopsy is a safe and effective method for obtaining samples. CEUS-guided omental biopsy enhances sample acquisition and diagnostic accuracy, especially in hyperechoic group, dense group, and non-nodule group, suggesting it is a more accurate and effective diagnostic method.

Key Points

Question Selecting a puncture site for diffuse lesions of the greater omentum presents challenges, as conventional ultrasound-guided biopsy often encounters difficulties in avoiding local necrotic tissue.

Findings Ultrasound-guided biopsy of the greater omentum is a safe and effective diagnostic method, especially when augmented with CEUS, which can significantly enhance diagnostic accuracy.

Clinical relevance CEUS can markedly enhance diagnostic accuracy by providing a robust foundation for selecting the biopsy site and pathway. Therefore, it is advisable to routinely employ CEUS-guided puncture pathways for atypical omental lesions.

Graphical Abstract