CT/超声引导经皮穿刺组织活检术在颅外神经鞘瘤诊治中的临床应用  

Clinical Application of CT/ultrasound Guided Percutaneous Tissue Biopsy in the Diagnosis and Treatment of Extracranial Schwannoma

作　　者：宋新浩[1] 李帅[2] 王俊魁[1] 王肖辉 SONG Xin-hao;LI Shuai;WANG Jun-kui;WANG Xiao-hui(Department of Ultrasound,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan Province,China;Department of Medical Imaging and Nuclear Medicine,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州大学第一附属医院超声科 [2]郑州大学第一附属医院影像医学与核医学科,河南郑州450000

出　　处：《中国CT和MRI杂志》2024年第7期28-30,共3页Chinese Journal of CT and MRI

基　　金：河南省高等学校重点科研项目(23A320050)。

摘　　要：目的探讨CT/超声引导经皮穿刺组织活检术在颅外神经鞘瘤诊治中的临床应用。方法回顾性分析郑州大学第一附属医院2012年1月-2022年12月术后常规病理诊断为颅外神经鞘瘤并术前行超声或CT引导经皮穿刺组织活检术的177例患者,其中超声引导者79例,CT引导者98例,总结其肿瘤大小、肿瘤位置、穿刺时间、穿刺过程、病理符合率、并发症发生率等临床资料,并比较腹部病变中两种引导方式有无差异,探讨不同部位合适引导方式。结果2例浅表病变患者因远端疼痛、麻木不适仅穿刺1针,余175例穿刺顺利完成,病理符合率中超声为94.94%(75/79),CT为92.86%(91/98);并发症发生率超声为7.59%(6/79),CT为9.18%(9/98)。腹部病变中超声组15例,CT组29例,穿刺时间比较差异具有统计学意义(P<0.05),病理符合率、并发症发生率差异无统计学意义(P>0.05)。结论经皮穿刺组织活检术诊断神经鞘瘤安全有效,并发症发生率低,胸部病变首选CT引导,其余部位病变均可首选超声引导,病变较大时穿刺前可选择超微血流成像、超声造影、对比增强CT等选择合适靶病灶减少组织不满意率。Objective To explore the clinical application of CT/ultrasound guided percutaneous tissue biopsy in the diagnosis and treatment of extracranial schwannoma.Methods A retrospective analysis of 177 patients with extracranial schwannoma diagnosed by routine pathology after surgery from January 2012 to December 2022 in the First Affiliated Hospital of Zhengzhou University and preoperative ultrasound or CT-guided percutaneous biopsy was performed.Among them,79 cases were guided by ultrasound and 98 cases were guided by CT.The clinical data such as tumor size,tumor location,puncture time,puncture process,pathological coincidence rate,and complications rate were summarized.Results Only one needle was punctured in 2 patients with superficial lesions due to distal pain and numbness,and the remaining 175 cases were successfully punctured.The pathological coincidence rate of ultrasound was 94.94%(75/79)and that of CT was 92.86%(91/98).The incidence of complications was7.59%(6/79)in ultrasound and 9.18%(9/98)in CT.In abdominal lesions,there were 15 cases in the ultrasound group and 29 cases in the CT group,and the difference in puncture time was statistically significant(P<0.05).There was no significant difference in pathological coincidence rate and complication rate(P>0.05).Conclusion Ultrasound or CT-guided percutaneous puncture biopsy is safe and effective in the diagnosis of schwannoma with low complication rate.CT-guided is the first choice for chest lesions,and ultrasound-guided is the first choice for other lesions.When the lesion is large,superb blood flow imaging,contrast-enhanced ultrasound and contrast-enhanced CT can be selected before puncture to select the appropriate target lesion to reduce the tissue dissatisfaction rate.

关 键 词：神经鞘瘤 经皮穿刺组织活检术 CT 超声 病理 并发症 

分 类 号：R445.2[医药卫生—影像医学与核医学] R445.1[医药卫生—诊断学] R36[医药卫生—临床医学]