Division of Ultrasound Imaging, Department of Radiology, Ronald Reagan Medical Center, University of California, Los Angeles, CA 90095, USA.
J Ultrasound Med. 2009 Dec;28(12):1679-84. doi: 10.7863/jum.2009.28.12.1679.
The purpose of this study was to evaluate the diagnostic value of ultrasound-guided neck mass biopsy (fine-needle capillary sampling biopsy [FNC] technique).
With Institutional Review Board approval, all patients who had an ultrasound-guided neck mass FNC biopsy between January 2000 and December 2006 were retrieved from the ultrasound database. A total of 132 neck mass biopsies were performed in 124 patients. Patient demographics, procedure characteristics, and pathologic diagnoses were recorded.
Of the 124 patients, 73 were female (mean age, 51.4 years). Biopsies were performed twice in 8 patients. A significant 200% increase from 2000 through 2002 to 2003 through 2004 and from 2003 through 2004 to 2005 through 2006 was found (P < .05). The most biopsied location was in the lymph nodes (34.8%), followed by perithyroid soft tissue masses (28.0%). A 25-gauge needle was used most frequently (97.7%). A total of 41 biopsies were diagnostic for thyroid diseases (31.1%), with the most common being thyroid papillary carcinoma. We found metastases in 31 biopsies (23.5%). Following these 2 were 29 lymph node biopsies. No major complications were noted. Of the 132 neck masses biopsied, 8 were pathologically nondiagnostic (93.9% diagnostic yield), yielding sensitivity, specificity, and accuracy of greater than 95% (97.1%, 95.2%, and 95.8%, respectively).
Ultrasound-guided FNC of neck masses is highly diagnostic. The diagnostic yield is especially high for detection of malignancy, including metastases. Together with a high clinical suspicion, ultrasound-guided needle biopsy should be performed to form a correct diagnosis and make appropriate management plans.
本研究旨在评估超声引导下颈部肿块活检（细针毛细取样活检 [FNC] 技术）的诊断价值。
经机构审查委员会批准，从超声数据库中检索了 2000 年 1 月至 2006 年 12 月期间进行的所有超声引导下颈部肿块 FNC 活检患者。对 124 例患者的 132 例颈部肿块活检进行了回顾性分析。记录患者的人口统计学资料、操作特点和病理诊断。
124 例患者中，女性 73 例（平均年龄 51.4 岁）。8 例患者接受了 2 次活检。2000 年至 2002 年与 2003 年至 2004 年、2003 年至 2004 年与 2005 年至 2006 年的活检次数显著增加（P<0.05）。最常进行活检的部位是淋巴结（34.8%），其次是甲状腺周围软组织肿块（28.0%）。最常使用的是 25 号针（97.7%）。共有 41 例活检诊断为甲状腺疾病（31.1%），最常见的是甲状腺乳头状癌。我们发现 31 例活检有转移（23.5%）。其次是 29 例淋巴结活检。未发现主要并发症。在 132 例颈部肿块活检中，8 例病理结果无法诊断（93.9%的诊断率），敏感性、特异性和准确性均大于 95%（分别为 97.1%、95.2%和 95.8%）。
超声引导下 FNC 对颈部肿块具有高度诊断价值。对于恶性肿瘤，包括转移瘤的检测，诊断率尤其高。结合高度的临床怀疑，应进行超声引导下的针吸活检，以做出正确的诊断并制定适当的治疗计划。
