Objective To discuss the value of ultrasound - guided fine needle aspiration biopsy (US - FNA) in the diagnosis of intrahepatic solid small occupying lesion. Methods US - FNA was carried out in 36 cases of intrahepatic solid small nodule with the diameter less than 3. 0 cm which could not be determined by conventional ultrasound or CT examination. The tissues obtained were pathologically examined. Those patients diagnosed qualitatively as benign lesion received the regular follow - up by ultrasound or CT examination. Results The successful rate of sampling was 100% and 34 cases were successful sampling at one time (94.4%). Biopsy was performed 38 times. The diagnostic accuracy was 97. 2% and the false negative rate was 2. 8%, There were 24 cases diagnosed as primary hepatocellular carcinoma, 3 ones as hepatic metastasic carcinoma, 3 ones as hepatic hemangioma, 2 ones as liver cirrhotic nodule, 3 ones as liver abscess, and 1 as hepatic carcinoid. In one case, the first - time pathological result showed he was of non - malignant lesion. But the reexamination after 1 month showed the increment of the intrahepatic nodule, and he was finally diagnosed as primary hepatocellular carcinoma by US - FNA. Needle tract implantation occurred in one case. No other severe complication occurred in these patients. Conclusion US - FNA is an accurate, fast, minimally invasive, and economical method for the diagnosis of intrahepatic solid small occupying lesion.%目的 探讨超声引导下细针穿刺活检(US-FNA)对肝内实性小占位病变定性诊断的价值.方法 对36例经常规超声或CT无法定性的直径＜3 cm的肝内实性小结节进行US-FNA,所获组织行病理学检查,对定性诊断为良性病变的患者均以超声或CT行定期随访.结果 US-FNA取材成功率为100％,共穿刺38次,其中一次取材成功者达34例(94.4％),诊断准确率达97.2％,假阴性率2.8％.诊断原发性肝细胞肝癌24例,肝转移癌3例,肝血管瘤3例,肝硬化结节2例,肝脓肿3例,肝类癌1例.其中1例首次病理结果为非恶性病变,1个月复后查发现患者肝内结节增大,再次行US-FNA确诊为原发性肝细胞癌.所有患者术后无严重并发症发生,1例发生针道转移.结论 US-FNA是一种准确、快速、微创及经济的肝内实性小占位病变定性诊断方法.
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