Department of Radiology, Keck School of Medicine of USC, 1500 San Pablo St, Second Floor Imaging, Los Angeles, CA 90033, USA.
Radiology. 2011 May;259(2):471-8. doi: 10.1148/radiol.11101087. Epub 2011 Mar 1.
To determine whether ultrasonography (US)-guided fine-needle aspiration (FNA) is an effective technique for diagnosing masses in the salivary gland and adjacent lymph nodes.
The institutional review board waived the requirement to obtain informed consent and approved this HIPAA-compliant retrospective study. Radiology records of 50 patients (28 female patients aged 25-85 years [median age, 58 years], 22 male patients aged 11-82 years [median age, 62 years]) who underwent 52 consecutive US-guided FNA procedures from 2004 to 2009 were reviewed. In 46 cases, lesions were sampled for biopsy under real-time US guidance by means of three passes with a 25-gauge needle. In six cases, two subsequent passes were performed with a 22-gauge needle after the first pass showed minimal or no aspirate. Findings from cytopathologic analysis, clinical follow-up, and surgery were evaluated and compared.
A diagnostically adequate biopsy specimen was obtained in 48 of the 52 cases (92%). Among the 20 patients who underwent surgical intervention after diagnostic US-guided FNA findings, results of surgical-pathologic analysis helped confirm the cytologic diagnosis in 19 (95%). Twenty of the 50 patients (40%) were spared surgical intervention on the basis of findings from US-guided FNA. US-guided FNA did not result in any intra- or postprocedural complications.
The diagnostic accuracy of US-guided FNA is similar to that of core needle biopsy, and there were no complications in this study. Information yielded with FNA cytology plays an integral role in clinical decision making in the management of masses in the major salivary glands and adjacent structures.
确定超声引导下细针抽吸（FNA）是否是诊断涎腺及相邻淋巴结肿块的有效方法。
机构审查委员会豁免了获得知情同意的要求，并批准了这项符合 HIPAA 规定的回顾性研究。回顾了 2004 年至 2009 年期间 50 例患者（28 例女性，年龄 25-85 岁[中位年龄 58 岁]；22 例男性，年龄 11-82 岁[中位年龄 62 岁]）的 52 例连续超声引导下 FNA 操作的放射学记录。在 46 例中，通过实时超声引导下 25 号针进行三次穿刺以进行活检取样。在 6 例中，在第一次穿刺显示很少或没有抽吸物后，用 22 号针进行了两次后续穿刺。评估并比较了细胞学分析、临床随访和手术的结果。
在 52 例中有 48 例（92%）获得了诊断性充分的活检标本。在接受诊断性超声引导 FNA 检查后进行手术干预的 20 例患者中，手术病理分析结果帮助确认了 19 例（95%）的细胞学诊断。基于超声引导 FNA 的结果，50 例患者中有 20 例（40%）免于手术干预。超声引导 FNA 未导致任何术中或术后并发症。
超声引导 FNA 的诊断准确性与核心针活检相似，本研究中无并发症发生。FNA 细胞学提供的信息在管理大涎腺及其相邻结构肿块的临床决策中发挥着重要作用。
