Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, People's Republic of China.
Diagn Interv Radiol. 2019 Mar;25(2):122-126. doi: 10.5152/dir.2019.18166.
We aimed to evaluate the safety and effectiveness of ultrasonography (US) guided core needle biopsy (CNB) with hydrodissection to diagnose small lymph node metastases adjacent to cervical large vessels.
From January 2013 to October 2017, 31 patients with 31 cervical lymph node metastases adjacent to large vessels presented for US-guided CNB. The mean maximal diameter of lymph nodes was 0.93±0.16 cm (range, 0.6-1.2 cm). All patients underwent US-guided CNB with 18-gauge true-cut biopsy needle after hydrodissection with saline. The separation success rate (SSR) of the hydrodissection, technical success rate (TSR) of CNB, histopathologic success rate (HST), and complications were assessed.
The SSR of hydrodissection was 100% (31/31). After effective separation between the lymph node metastases and the adjacent large vessels with saline injection, the procedures of CNB were performed with a TSR of 100% (31/31). The HST of the lymph node metastases was 100% (31/31). Two patients complained of mild cervical swelling sensation during saline injection. No major complications such as injury of the large vessels or massive hemorrhage occurred.
Hydrodissection can facilitate safely and effectively US-guided CNB of subcentimeter cervical lymph nodes adjacent to large vessels, potentially impacting further therapeutic decisions.
我们旨在评估超声引导下核心针活检（CNB）联合水分离术诊断毗邻大血管的小颈部淋巴结转移的安全性和有效性。
2013 年 1 月至 2017 年 10 月，31 例毗邻大血管的 31 个颈部淋巴结转移患者接受了超声引导下 CNB。淋巴结最大直径的平均值为 0.93±0.16cm（范围，0.6-1.2cm）。所有患者均在水分离后接受 18 号真切活检针行超声引导下 CNB。评估水分离的分离成功率（SSR）、CNB 的技术成功率（TSR）、组织病理学成功率（HST）和并发症。
水分离的 SSR 为 100%（31/31）。在盐水注射有效分离淋巴结转移与毗邻大血管后，CNB 的 TSR 为 100%（31/31）。淋巴结转移的 HST 为 100%（31/31）。2 例患者在盐水注射时诉轻微颈肿胀感。无大血管损伤或大出血等严重并发症发生。
水分离术可安全有效地辅助超声引导下对毗邻大血管的亚厘米级颈部淋巴结进行 CNB，可能影响进一步的治疗决策。
