Vischia Federico, Di Maio Giacomo, Ferrero Simona A I, Rolfo Elio, Scaglione Luca, Cristofori Riccardo, Ruffini Enrico, Lorenzati Bartolomeo, Landi Andrea, Novero Domenico, Capello Simona, Schivazappa Giulia, Limerutti Giorgio, Ferro Arianna, Durazzo Marilena
SCU Internal Medicine 3, Molinette Hospital, Città della Salute e della Scienza, 10126 Turin, Italy.
Department of Medical Sciences, University of Turin, 10124 Turin, Italy.
J Clin Med. 2023 Aug 1;12(15):5070. doi: 10.3390/jcm12155070.
(1) Background: The prompt diagnosis of anterior mediastinal lesions is a challenge due to their often being categorized as malignant tumours. Ultrasound-guided Transthoracic Core Needle Biopsy (US-TCNB) is an innovative technique that is arousing increasing interest in clinical practice. However, studies in this area are still scarce. This study aims to compare the diagnostic accuracy and complication rate of US-TCNB with those of traditional surgical methods-Anterior Mediastinotomy and Video Assisted Thoracoscopic Surgery (VATS)-in patients with anterior mediastinal lesions. (2) Methods: This retrospective study involved patients evaluated between January 2011 and December 2021 who had undergone US-TCNB at the Interdepartmental Unit of Internal and Interventional Ultrasound, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy. Personal data, diagnostic questions, and technical information concerning the bioptic procedure, periprocedural complications and histological reports were collected. (3) Results: Eighty-three patients were included in the analysis. Histological examination was performed in 78 cases, with an overall diagnostic accuracy of 94.0% (sensitivity 94%; specificity 100%). Only in 5 patients was a diagnosis not achieved. Complications occurred in 2 patients who were quickly identified and properly treated without need of hospitalization. The accuracy of US-TCNB was comparable to the performance of the main traditional diagnostic alternatives (95.3% for anterior mediastinotomy, and 98.4% for VATS), with a much lower complication rate (2.4% vs. 3-16%). The outpatient setting offered the additional advantage of saving resources. (4) Conclusions: a US-guided needle biopsy can be considered effective and safe, and in the near future it may become the procedure of choice for diagnosing anterior mediastinal lesions in selected patients.
（1）背景：前纵隔病变常被归类为恶性肿瘤，因此对其进行快速诊断具有挑战性。超声引导下经胸芯针活检（US-TCNB）是一项创新技术，在临床实践中引起了越来越多的关注。然而，该领域的研究仍然很少。本研究旨在比较US-TCNB与传统手术方法——前纵隔切开术和电视辅助胸腔镜手术（VATS）——对前纵隔病变患者的诊断准确性和并发症发生率。（2）方法：本回顾性研究纳入了2011年1月至2021年12月期间在意大利都灵市健康与科学城莫利内特医院内部和介入超声跨部门单位接受US-TCNB检查的患者。收集了患者的个人数据、诊断问题以及与活检程序、围手术期并发症和组织学报告相关的技术信息。（3）结果：83例患者纳入分析。78例患者进行了组织学检查，总体诊断准确率为94.0%（敏感性94%；特异性100%）。只有5例患者未明确诊断。2例患者出现并发症，均迅速得到识别并妥善处理，无需住院治疗。US-TCNB诊断准确性与主要传统诊断方法相当（前纵隔切开术为95.3%，VATS为98.4%），但并发症发生率低得多（2.4% 对 3%-16%）。门诊检查还具有节省资源的额外优势。（4）结论：超声引导下针吸活检可被认为是有效且安全的，在不久的将来，它可能成为部分患者诊断前纵隔病变的首选方法。
