超声造影在辅助颈部肿大淋巴结穿刺活检中的价值

目的探讨超声造影在颈部肿大淋巴结粗针活检中的临床应用价值。方法回顾性分析我院行粗针穿刺活检的颈部肿大淋巴结患者400例,其中200例穿刺前进行超声造影检查并引导穿刺(超声造影引导组),200例仅行常规超声检查并引导穿刺(常规超声引导组),比较两组患者的取材成功率和病理诊断准确率。将淋巴结直径进一步细分,比较直径<1.5 cm、1.5~2.2 cm、>2.2 cm时两组患者的取材成功率和病理诊断准确率。结果超声造影引导组穿刺取材成功率及病理诊断准确率分别为90.5%、91.0%,高于常规超声引导组(80.0%、77.0%),两组比较差异均有统计学意义(均P<0.05);且当淋巴结直径1.5~2.2 cm时,超声造影引导组穿刺取材成功率及病理诊断准确率分别为100%、95.3%,高于常规超声引导组(86.8%、74.6%),差异均有统计学意义(均P<0.05)。结论超声造影在颈部肿大淋巴粗针穿刺中,提高了穿刺取材的成功率及病理诊断准确率,尤其对直径1.5~2.2 cm肿大淋巴结临床应用价值更佳。

Value of contrast-enhanced ultrasound guided fine-needle aspiration biopsy for enlarged cervical lymph nodes

ObjectiveTo investigate the clinical value of contrast-enhanced ultrasound guided fine-needle aspiration biopsy for enlarged cervical lymph nodes.Methods Image data of 400 patients with enlarged cervical lymph nodes underwentultrasound guided fine-needle biopsy in our hospital were collected and retrospectively analyzed.Among them,CEUS wasperformed for 200 patients before puncture(CEUS-guided group),another 200 patients underwent conventional ultrasoundexamination and puncture(conventional ultrasound-guided group),and the success rate of obtaining lymph nodule tissues and theaccuracy of histopathological diagnosis between the two groups were calculted and compared.The lymph node diameter was furthersubdivided,the rate of successful sample taken and pathological diagnosis accuracy of patients with diameters<1.5 cm,1.5~2.2 cm and>2.2 cm were calculated and compared.ResultsThe success rate and accuracy of pathological diagnosis in the CEUS-guided group were 90.5%and 91.0%,respectively,which were higher than those in the conventional ultrasound-guided group(80.0%and 77.0%).The differences were statistically significan(tboth P<0.05).For lymph nodes with a diameter of 1.5~2.2 cm,therate of successful sample taken and pathological diagnosis accuracy of the CEUS-guided group were 100%and 95.3%,respectively,which were significantly higher than those of the conventional ultrasound-guided group(86.8%and 74.6%,both P<0.05).ConclusionContrast-enhanced ultrasound can improve the success rate of puncture and pathological diagnosis in the fine needleaspiration of cervical enlarged lymph nodes,especially for clinical application of enlarged lymph nodes with a diameter of 1.5~2.2 cm.