Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Eur J Radiol. 2023 Nov;168:111114. doi: 10.1016/j.ejrad.2023.111114. Epub 2023 Sep 27.
To evaluate the effectiveness of contrast-enhanced ultrasound (CEUS) guided core needle biopsy (CNB) in diagnosing soft tissue tumors (STTs) and to identify the conventional ultrasonography (US) features of STTs that are recommended for CEUS-guided CNB.
A retrospective study was conducted on 123 patients with surgically confirmed STTs. Before surgeries, all subjects underwent CNB under the guidance of US or CEUS. The histopathological results of surgical specimens were considered as the gold standards. A successful biopsy diagnosis was defined as the pathological subtypes obtained by biopsy consistent with the gold standard. The diagnostic yields were compared between the US and CEUS groups, and the diagnostic yields based on various conventional US features of STTs were also compared between the two groups.
Sixty-seven cases underwent US-guided CNB and fifty-six cases underwent CEUS-guided CNB. The clinical, biopsy, and conventional US characteristics revealed no significant difference between the two groups. The diagnostic yield of the CEUS group was statistically higher than that of the US group (p = 0.011). In the CEUS group, more STTs with the anechoic areas were identified after CEUS examination (p = 0.031). Furthermore, the diagnostic yields based on the conventional US features of STTs, including deep fascia layer (p = 0.010), a maximum diameter ≥5 cm (p = 0.037), rough margin (p = 0.016), heterogeneous echotexture (p = 0.017), and absence of anechoic area (p = 0.013), were significantly different between the two groups, and the CEUS group exhibited higher diagnostic yields.
CEUS-guided CNB was found to be an efficient method for STTs diagnosis. It is particularly recommended for STTs with the following conventional US features, including location in deep fascia layer, a maximum diameter ≥5 cm, rough margin, heterogeneous echotexture, or absence of anechoic area.
评估超声造影（CEUS）引导下活检在软组织肿瘤（STT）诊断中的有效性，并确定推荐用于 CEUS 引导下活检的 STT 的常规超声（US）特征。
对 123 例经手术证实的 STT 患者进行回顾性研究。所有患者均在 US 或 CEUS 引导下进行 CNB 术前。手术标本的组织病理学结果被认为是金标准。将活检获得的病理亚型与金标准一致定义为成功的活检诊断。比较 US 组和 CEUS 组之间的诊断率，并比较两组之间基于 STT 各种常规 US 特征的诊断率。
67 例患者行 US 引导下 CNB，56 例患者行 CEUS 引导下 CNB。两组患者的临床、活检和常规 US 特征无统计学差异。CEUS 组的诊断率明显高于 US 组（p=0.011）。在 CEUS 组中，CEUS 检查后更多的 STT 被发现存在无回声区（p=0.031）。此外，基于 STT 常规 US 特征的诊断率，包括深筋膜层（p=0.010）、最大直径≥5cm（p=0.037）、粗糙边缘（p=0.016）、不均匀回声（p=0.017）和无无回声区（p=0.013），两组间差异有统计学意义，CEUS 组的诊断率更高。
CEUS 引导下 CNB 是一种有效的 STT 诊断方法。对于位于深筋膜层、最大直径≥5cm、粗糙边缘、不均匀回声或无无回声区的 STT，建议采用该方法。
