超声造影引导在经皮粗针穿刺活检诊断宫颈结核性淋巴结炎中的应用价值。
Role of contrast-enhanced ultrasound guidance in core-needle biopsy for diagnosis of cervical tuberculous lymphadenitis.
机构信息
Department of Ultrasonography, Zhejiang Integrated Traditional and Western Medicine Hospital, Hangzhou Red Cross Hospital, Tuberculosis Diagnostic and Treatment Center of Zhejiang Province, Hangzhou, Zhejiang, China.
出版信息
Clin Hemorheol Microcirc. 2021;77(4):381-389. doi: 10.3233/CH-201038.
OBJECTIVE
To investigate the diagnostic value of core-needle biopsy (CNB) guided by contrast-enhanced ultrasound (CEUS) in cervical tuberculous lymphadenitis (CTL).
METHODS
178 patients with pathological confirmation of CTL were retrospectively enrolled. All of them had undergone CNB prior to the final surgery. According to the different ways of puncture guidance, they were divided into two groups: conventional ultrasound (US) group (n = 81) and CEUS group (n = 97). The comparison of diagnostic efficacy between two groups was compared and analyzed.
RESULTS
Among the 178 patients, 146 were directly diagnosed as CTL by CNB, including 59 patients in CEUS group and 87 patients in US group. The diagnostic accuracy were 89.7% (87/97) and 72.8% (59/81), respectively (P < 0.01). For subgroup analyses, differences among diagnostic efficacy ascribed to the different guiding methods were significant in medium size group (>2.0 cm and ≤3.0 cm) and large size group (>3.0 cm), 91.7% for CEUS group vs. 69.0% for US group (P < 0.05) and 84.4% for CEUS group vs. 57.7% for US group (P < 0.05), respectively.
CONCLUSIONS
In the diagnosis of CTL, compared with the US-guided CNB, CEUS-guided CNB have certain advantages, especially for larger lymph nodes.
目的
探讨超声造影引导下经皮穿刺活检（CNB）对颈淋巴结结核（CTL）的诊断价值。
方法
回顾性分析经病理证实的 178 例 CTL 患者资料，所有患者均于最终手术前行 CNB，根据穿刺引导方式的不同分为常规超声（US）组（n=81）和超声造影（CEUS）组（n=97），比较两组诊断效能。
结果
178 例患者中，CNB 直接诊断为 CTL 者 146 例，CEUS 组 59 例，US 组 87 例，CEUS 组诊断准确率为 89.7%（59/66），US 组为 72.8%（87/120），差异有统计学意义（P<0.01）。亚组分析显示，不同引导方法的诊断效能差异在中等大小（>2.0 cm 且≤3.0 cm）和较大（>3.0 cm）组中均有统计学意义，CEUS 组分别为 91.7%和 84.4%，US 组分别为 69.0%和 57.7%，差异均有统计学意义（P<0.05）。
结论
在 CTL 的诊断中，与 US 引导的 CNB 相比，CEUS 引导的 CNB 具有一定优势，尤其对较大的淋巴结。
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