Gastrointestinal tract lesions may be accurately visualized by US; although the diagnosis of such lesions is conventionally obtained with endoscopic biopsy, the possibility to obtain the diagnosis of neoplasia by using a ultrasound-guided fine needle biopsy (USFNB)has been reported. In this study we aimed to evaluate the safety and accuracy of USFNB using a 18-gauge aspiration needle in the diagnosis of gastrointestinal tract lesions.
85 patients (M/F 50/35, median age 69 yrs) underwent in the last 15 years a percutaneous USFNB. All patients were fasting and signed a written informed consent; no bowel preparation or antibiotic prophylaxis was used. No local anaesthesia. Contraindications were severe coagulation impairment and presence of distended bowel loops.
Results: The intestinal USFNB represented the 3.1 % (81/2676) of all abdominal USFNB performed; 27 were made on gastric wall, 30 at colon-sigma and 24 at the small bowel. The indications to the procedure were impossibility to perform endoscopy in 20 cases, non-diagnostic endoscopic biopsies in 47 cases and endoscopically inaccessible lesion in 14 cases. The gold standard were surgery or II level technique imaging. Sensitivity, specificity, diagnostic accuracy, predictive positive and negative values were 90%, 100%, 90%, 100%, and 87%, respectively. The procedure was well tolerated; no mortality has been reported.
Conclusion: Our study demonstrates that 18-G USFNB of gut wall is a simple, safe and accurate approach to obtain histologic sampling of gastrointestinal wall lesions, in case of endoscopic failure. By using a larger size needle an higher accuracy has been achieved without any complications.