To explore the application value of ultrasound-guided coaxial needle biopsy combined with contrast-enhanced ultrasound for focal liver lesions.

Clinical data of 165 patients with focal liver lesions who underwent percutaneous liver biopsy with ultrasound-guided coaxial needle and contrast-enhanced ultrasound from March 2018 to March 2019 at the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. Among them, 109 patients were male and 56 female, with a mean age of (56±11) years. The mean diameter of lesions was (3.4±1.2) cm.The informed consents of all patients were obtained and the local ethical committee approval was received. The liver lesions were localized and punctured with ultrasound-guided coaxial needle and contrast-enhanced ultrasound. The puncturing and sampling, pathologic diagnosis, and post-puncture complications were observed.

Coaxial needle can get samples from multiple sites and directions for several times through a single attempt. The success rate for puncture was 100%(165/165) with an average of 3-4 times of sampling. The confirm diagnosis rate by pathological finding was 100%(165/165), including 98 cases of hepatocellular carcinoma, 12 cholangiocellular carcinoma, 3 inflammatory pseudotumor, 2 epithelial-derived tumor, 2 tuberculosis, 9 nodular cirrhosis, 18 metastases, 3 cavernous hemangioma, 5 hepatic adenoma,5 inflammatory changes, 6 focal nodular hyperplasia, 1 cholangiocarcinoma and 1 hyaline vascular Castleman's disease. Post-puncture complications included mild local pain, with an incidence of 33.9%(56/165) and bleeding with an incidence of 0.6%(1/165).

Puncture biopsy of hepatic mass by ultrasound-guided coaxial cannula needle and contrast-enhanced ultrasoud is a simple and easy operation that provides clear manifestation of puncture target, clear observation of the activity of lesion. Samples can be extracted from multiple sites by single attempt with a high puncture success rate and low incidence of complications, which is of high clinical application value.