Department of Radiology, Medical University Innsbruck, Innsbruck, Austria.
Ultraschall Med. 2011 Jun;32(3):307-10. doi: 10.1055/s-0029-1245713. Epub 2010 Oct 11.
We report on a novel approach to the work-up of musculoskeletal lesions with addition of an ultrasound contrast agent followed by focal ultrasound-guided biopsy.
In this pilot study 25 patients (age: 12-75) with unclear musculoskeletal tumors underwent grayscale ultrasound, color Doppler, contrast-enhanced ultrasound and subsequent ultrasound-guided biopsy. Grayscale and color Doppler ultrasound were performed with a 12-5 MHz broadband linear transducer and contrast-enhanced ultrasound with a 9-3 MHz broadband linear transducer (iU22®, Philips, USA) using a second-generation contrast agent (SonoVue®, Bracco, Italy). After the definition of the target area by contrast-enhanced ultrasound, guided biopsies were performed with a spring-loaded tru-cut™ biopsy needle using the coaxial technique.
The definition of enhancing and viable tumor regions resulted in a diagnostic yield of the subsequent biopsy of 100%. Seventeen tumors were classified as malignant and eight as benign, which was finally confirmed by histological work-up or the further clinical follow-up.
This pilot study with a limited series of patients improved the diagnostic yield of ultrasound-guided biopsy to 100%, which is at least rather promising. Our easy-to-use algorithm should reduce the rate of inconclusive histology results mainly caused by sampling errors to an unrivaled minimum.
我们报告了一种新的方法，即在进行肌肉骨骼病变的检查时添加超声造影剂，然后进行焦点超声引导下活检。
在这项初步研究中，25 名（年龄：12-75 岁）不明原因的肌肉骨骼肿瘤患者接受了灰阶超声、彩色多普勒、对比增强超声检查，随后进行了超声引导下活检。灰阶和彩色多普勒超声检查使用 12-5 MHz 宽带线性探头进行，对比增强超声使用 9-3 MHz 宽带线性探头（iU22 ® ，Philips，美国）和第二代造影剂（SonoVue ® ，Bracco，意大利）进行。在通过对比增强超声定义目标区域后，使用带有弹簧加载 tru-cut ™活检针的同轴技术进行引导活检。
增强和存活肿瘤区域的定义使随后的活检诊断率达到 100%。17 个肿瘤被分类为恶性，8 个为良性，最终通过组织学检查或进一步的临床随访得到证实。
这项初步研究中，患者数量有限，但将超声引导活检的诊断率提高到了 100%，这至少是很有前途的。我们易于使用的算法应将主要由取样误差引起的不确定组织学结果的发生率降低到前所未有的最低水平。
