经软腭超声引导细针穿刺诊断咽旁间隙肿瘤

目的探讨经软腭彩色多普勒超声(CDFI)诊断咽旁间隙肿瘤的应用价值.方法应用7.0 MHz腔内彩色多普勒超声探头对CT或MRI发现的40例(43个)咽旁间隙内可疑病变行软腭CDFI扫查.观察病变形态、大小、内部回声及血流情况,并行超声引导下细针穿刺(FNA)病理细胞学诊断.结果40例经CDFI扫查显示病变43个,FNA细胞学诊断良性病变6个,恶性病变32个,5个病变内未见癌细胞,其中2个病变CDFI检查高度怀疑为恶性病变,经鼻咽活检病理确诊为鼻咽癌.结论经软腭超声引导细针穿刺细胞学诊断是一种诊断鼻咽部肿瘤的新方法.当病变局限于咽旁间隙内时,FNA是对常规鼻咽活检一种有益的补充,可以提高鼻咽癌的早期诊断率.

Ultrasound-guided fine needle aspiration via soft palate for the diagnosis of neoplasms in the parapharyngeal space

Objective To explore a new technique of scanning by color Doppler ultrasound and fine needle aspiration (FNA) guided by ultrasound via soft palate for the diagnosis of neoplasms in the parapha-ryngeal space, the biopsy of which is difficult to obtain from nasopharyngeal cavity. Methods A total of 40 patients with 43 nasopharyngeal lesions, which were detected in parapharyngeal space by CT or MRI, were enrolled. A 7.0 MHz frequency intra-cavity transducer of color Doppler ultrasound was used to observe the parapharyngeal space via soft palate by color Doppler flow imaging ( CDFI). During the procedure, the tumor size, image, internal echo and color flow were evaluated and an invasive ultrasonography was performed with FNA for cytological diagnosis. Results The images of all the 43 lesions (in 40 cases) were successfully acquired by ultrasonography. The diagnosis of malignancy was established by ultrasound-guided FNA in 32 lesions; and 9 lesions were diagnosed as benign by FNA. The rest 2 lesions were highly suspected based on the ultrasonography in spite of the benign result by FNA; therefore further biopsy were performed and both were reported as malignancy. Conclusions Color Doppler ultrasound-guided FNA, via soft palate, is a new method for diagnosis of nasopharyngeal neoplasms. It can be a helpful adjuvant for routine nasopharyngeal biopsy when the lesion is limited in parapharyngeal space, thus improving the early diagnostic rate of nasopharyngeal carcinoma.