超声引导下经皮穿刺活检对颈部肿大淋巴结病变的诊断价值
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摘要
目的探讨超声引导下经皮穿刺活检对颈部淋巴结病变的诊断价值。方法用粗针(16G)和细针(22G)在超声引导下经皮穿刺162例颈部肿大的淋巴结,所取出目标组织能做出明确的组织病理诊断者为取材满意,否则为不满意。全部病例以超声引导穿刺活检病理肯定诊断或术后病理为最后诊断。结果 162例患者中,158例取材满意,穿刺取材满意率为97.5%。超声引导下粗针和细针穿刺活检对诊断颈部淋巴结病变的灵敏度、特异度和准确度分别为98%、100%、99%和86%、100%、96%,两种类型的针良恶性的诊断差异无统计学意义(P>0.05)。而二维超声诊断的相应指标分别为85%、77%、83%,差异有统计学意义(P<0.05)。结论在超声引导下行经皮穿刺活检颈部肿大淋巴结病变的准确度高,并发症低,是临床诊断颈部肿大淋巴结的有效方式。
Objective investigate the value of ultrasound-guided percutaneous cor-needle biopsyof in diagnosis ofneck lymphadenopathy. Methods One hundred and sixty-two patients with neck lymphadenopathyunderwent ultrasound-guided biopsy using coarse andfine needle,Satisfied sampling was defined as the acquiredtissue being large enough to give a definite diagnosis,otherwise as dissatisfied sampling. Final diagnosis was madebased on pathology was taken as the final diagnosls. Results There were 158 satisfied materials in 162 cases,fromwhichdefinite histologic diagnosis could be given,The satisfactory rate of sampling was 97.5%. The sensitivity,specificity and accuracy of USPCNB(coarse and fine) in diagnosis of neck lymphaden-opathy were 100%,93%,99%and 100%,95%,96%.There was no significant different between the two types of needles in the eligibility of sampling(P>0.05).However,the sensitivity,specificity and accuracy index of US in that was 85%,77%,83%respectively.There was significant different(P<0.05). Conclusion US-PCNB is sensitive and accurate in diagnosis of neckymphadenopathy with a lower incidence of complication,it is an effective technique in confirming the diagnosis of necklymphadenopathy.
Objective investigate the value of ultrasound-guided percutaneous cor-needle biopsyof in diagnosis ofneck lymphadenopathy. Methods One hundred and sixty-two patients with neck lymphadenopathyunderwent ultrasound-guided biopsy using coarse andfine needle,Satisfied sampling was defined as the acquiredtissue being large enough to give a definite diagnosis,otherwise as dissatisfied sampling. Final diagnosis was madebased on pathology was taken as the final diagnosls. Results There were 158 satisfied materials in 162 cases,fromwhichdefinite histologic diagnosis could be given,The satisfactory rate of sampling was 97.5%. The sensitivity,specificity and accuracy of USPCNB(coarse and fine) in diagnosis of neck lymphaden-opathy were 100%,93%,99%and 100%,95%,96%.There was no significant different between the two types of needles in the eligibility of sampling(P>0.05).However,the sensitivity,specificity and accuracy index of US in that was 85%,77%,83%respectively.There was significant different(P<0.05). Conclusion US-PCNB is sensitive and accurate in diagnosis of neckymphadenopathy with a lower incidence of complication,it is an effective technique in confirming the diagnosis of necklymphadenopathy.
引文
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[2]杨海英,冯斌,樊安华,等.彩色多普勒超声在诊断颈部淋巴结核及手术定位中的应用[J].中国介入影像与治疗学,2009,6(4):349-351.
[3]Jaromi S,schueller G,Ponhold L,et al.Us-guided 14-gaugecore needle breast biopsy:results of a validation study in 1352 cases[J].Radiology,2008,248(2):406-413.
[4]洪玉蓉,刘学明,张闻,等.超声造影在浅表淋巴结疾病鉴别诊断中的应用研究[J].中华超声影像学杂志,2006,15(11):849-852.
[5]曹兵生,张华,梁建琴,等.超声引导下穿刺活检对颈部淋巴结病变的诊断价值.临床超声医学杂志,2010,12(4):268-270.
[6]张晖,陆清,季正标,等.超声引导下穿刺活检对淋巴瘤的诊断价值[J].中华超声影像学杂志,2015,35(4):364-366.
[7]王琴.全自动与半自动活检针在超声引导下颈部淋巴结穿刺活检中的应用[J].现代实用医学,2013,25(11):1290-1291.