超声造影引导下粗针活检在诊断颈部淋巴结结核中的研究  

Evaluation of Contrast-enhanced Ultrasound Guided Core-Needle Biopsy For Diagnosis of Cervical Tuberculous Lymphadenitis

作　　者：赵丹 蒋天安[1] 杨高怡[2] 赵齐羽[1] 王彩芬[2] Zhao Dan;Jiang Tian’an;Yang Gaoyi;Zhao Qiyu;Wang Caifen(Department of Ultrasonography, the First Affiliated Hospital, Zhejiang University,Hangzhou,Zhejiang 310003,China;Department of Ultrasonography,Zhejiang Integrated Traditional and Western Medicine Hospital, Tuberculosis Diagnostic and Treatment Center of Zhejiang Province,Hangzhou, Zhejiang 310003,China)

机构地区：[1]浙江大学医学院附属第一医院超声科,杭州市310003 [2]杭州市红十字会医院超声科

出　　处：《中国超声医学杂志》2019年第5期385-388,共4页Chinese Journal of Ultrasound in Medicine

基　　金：杭州市科技发展计划(No.20150633B27)

摘　　要：目的评价超声造影(CEUS)引导下粗针活检在诊断颈部淋巴结结核(CTC)中的价值。方法回顾分析171例最终被证实为颈部淋巴结结核的超声图像特点,并根据穿刺引导方式的不同,将其分为常规超声(US)组87例和CEUS组84例,对比分析两组间的诊断准确率。同时,根据淋巴结的大小进行组内和组间诊断准确率比较。结果 171例中,141例能通过粗针活检直接被诊断为淋巴结结核,确诊病例中64例使用常规超声引导,77例使用超声造影融合常规超声引导。诊断准确率分别为73.6%(64/87)和91.7%(77/84),存在显著的差异(P<0.01)。在亚组分析中,中等大小淋巴结(2.0cm<长径≤3.0cm)和较大淋巴结(长径>3.0cm)的两种不同引导方式的活检诊断准确率也存在差异。结论在诊断颈部淋巴结结核方面,与传统超声引导淋巴结粗针活检相比较,超声造影融合常规超声引导淋巴结粗针活检具有一定的优越性,特别是当淋巴结较大时更明显。Objective To investigate the diagnostic value of core-needle biopsy(CNB)guided by contrast-enhanced ultrasound(CEUS)in cervical tuberculous lymphadenitis(CTL).Methods The sonographic features of 171 cases of were retrospectively analyzed.According to the different ways of puncture guidance,they were divided into two groups:conventional ultrasound(US)group(n=87)and CEUS group(n=84).The comparison of diagnostic efficacy between two groups was compared and analyzed.Results Among the 171 patients,141 patients were directly diagnosed to be CTL by CNB,including 77 patients in CEUS-guided CNB group and 64 patients in US-guided CNB group.The diagnostic accuracy was 91.7%(77/84)and 73.6%(64/87),respectively.There were cignificant difference(P<0.01).Meanwhile,according to the size of lymph nodes,the diagnostic accuracy of intra-group and intergroup was compared.For subgroup,the diagnostic accuracy of the different guiding methods was also different in medium size group(2.0 cm<length diameter≤3.0 cm)and large size group(length diameter>3.0 cm).Conclusions In the diagnosis of CTL,compared with the US-guided CNB,CEUS-guided CNB have certain advantages,especially for larger lymph nodes.

关 键 词：超声造影 粗针活检 颈部 淋巴结结核 

分 类 号：R445.1[医药卫生—影像医学与核医学] R522[医药卫生—诊断学]