超声引导浅表淋巴结穿刺活检325例的临床回顾分析  

Ultrasound-guided biopsy in superficial lymph nodes:A review of 325 patients

作　　者：张云山[1] 李馨[1] 贺声[1] 邱璇[1] 任贺[1] 徐涛[1] 

机构地区：[1]海军总医院超声诊断科,北京100048

出　　处：《中国介入影像与治疗学》2010年第2期153-156,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨超声引导下浅表淋巴结穿刺活检的关键技术及超声对淋巴结良恶性病变的鉴别价值。方法对2006年1月—2009年1月在我科接受超声引导淋巴结穿刺活检的325例患者进行回顾分析。结果穿刺靶淋巴结大小0.8 cm×1.0 cm～5.0 cm×7.0 cm。每例患者穿刺针数3～6针。穿刺组织病理学结果:淋巴结恶性病变230例(70.77%,其中转移性癌134例,恶性淋巴瘤96例);良性病变87例(26.77%,其中特异性感染82例,非特异性感染5例);性质不确定8例(2.46%)。317例(97.54%)所取组织量能满足病理定性诊断要求。以病变淋巴结长径/短径<2、髓质结构不清晰联合淋巴结内多支血管、动脉阻力指数≥0.65为标准诊断,恶性病变的准确率为76.41%。结论超声引导淋巴结穿刺活检技术方法简便易行,是定性诊断浅表淋巴结肿大的可靠手段。Objective To discuss the key technique of ultrasound-guided biopsy in superficial lymph nodes,and to explore the value of ultrasound in qualitative diagnosis for the lymph nodes.Methods Three hundred and twenty-five patients who underwent ultrasound-guided lymph node biopsy from Jan 2006 to Jan 2009 were retrospectively reviewed.Results The sizes of the lymph nodes were 0.8 cm×1.0 cm—5.0 cm×7.0 cm.Each patient was punctured 3 to 6 times.Pathological results showed lymph nodes in 230 patients（70.77%） were malignant,including metastatic carcinoma in 134 patients,malignant lymphoma in 96 patients,while lymph nodes in 87 patients（26.77%） were benign,including specific infection in 82 patients,non-specific infection in 5 patients,whereas uncertain in 8 patients（2.46%）.The tissue amount got from biopsies could be used for qualitative pathological diagnosis in 317 patients（97.54%）.Taking lymph node with the ratio of long diameter to short diameter less than 2,unclear medulla structure,multi-vessel and arterial resistance index ≥0.65 as the standard,the diagnostic accuracy rate of malignant lesions was 76.41%.Conclusion Ultrasound-guided biopsy of superficial lymph nodes is convenient and effective for pathological diagnosis.

关 键 词：超声检查 活组织检查 淋巴结 

分 类 号：R446.8[医药卫生—诊断学] R445.1[医药卫生—临床医学]