Magoon Stephanie, Peters Vanessa, de Souza Felipe Ferreira, Chen David, Owens Patrick, Pretell-Mazzini Juan, Fullerton Natalia, Jose Jean, Rosenberg Andrew, Subhawong Ty K
Leonard M. Miller School of Medicine, University of Miami Miami Florida USA.
Department of Radiology University of Miami Miller School of Medicine and the Sylvester Comprehensive Care Center Miami Florida USA.
Australas J Ultrasound Med. 2023 Oct 24;26(4):243-248. doi: 10.1002/ajum.12365. eCollection 2023 Nov.
INTRODUCTION/PURPOSE: To determine the diagnostic accuracy and complication rates of ultrasound-guided, percutaneous core needle biopsies of soft tissue masses in the hand and fingers.
Reports from all ultrasound-guided procedures between 21 May 2014 and 17 March 2022 were queried for keywords including "hand", OR "finger", AND "biopsy". Patient demographics, lesion size and location, biopsy needle gauge and the number of cores obtained were recorded. The final pathology of the mass excision was then compared with the core needle biopsy (CNB) for each patient.
Sixty-six records were reviewed, and 37 patients met inclusion criteria. Maximum lesion diameter averaged 1.45 cm with a range between 0.4 and 4.3 cm. The frequency of needle gauges used was 14G (14%), 16G (24%), 18G (38%), 20G (11%) and 'not reported' (14%). The mean number of tissue cores obtained was 2.9 (SD 1.2; range 1 to 6), excluding nine cases that reported 'multiple'. The frequency of CNB diagnoses included tenosynovial giant cell tumour (TGCT) at 30%, ganglion cyst at 11% and epidermal inclusion cyst at 5%. CNB was 100% sensitive in detecting the three (8%) malignancies. Of the 37 tumours biopsied, 16 were surgically excised. One angiomyoma was originally diagnosed as a haemangioma on CNB, but all other histologic results were concordant for a diagnostic accuracy of 97%.
Small soft tissue masses in the hands and fingers, even those less than 1 cm, are often amenable to ultrasound-guided CNB. Performance under image guidance facilitates retrieval of core specimens adquate for histologic diagnosis with relatively few passes using higher gauge needles.
Overall, ultrasound-guided CNB of the hand and fingers is safe and highly accurate in diagnosing soft tissue tumours. The accuracy is unrelated to the needle's gauge, the number of passes and the size of the lesions.
引言/目的：确定超声引导下经皮穿刺手部和手指软组织肿块芯针活检的诊断准确性和并发症发生率。
查询2014年5月21日至2022年3月17日期间所有超声引导手术的报告，查找关键词，包括“手”或“手指”以及“活检”。记录患者人口统计学信息、病变大小和位置、活检针规格以及获取的芯数量。然后将每个患者肿块切除的最终病理结果与芯针活检（CNB）结果进行比较。
回顾了66份记录，37例患者符合纳入标准。最大病变直径平均为1.45厘米，范围在0.4至4.3厘米之间。使用的针规格频率为14G（14%）、16G（24%）、18G（38%）、20G（11%）和“未报告”（14%）。获得的组织芯平均数量为2.9个（标准差1.2；范围1至6），不包括9例报告为“多个”的病例。CNB诊断频率包括腱鞘巨细胞瘤（TGCT）占30%、腱鞘囊肿占11%和表皮样囊肿占5%。CNB在检测三种（8%）恶性肿瘤方面的敏感性为100%。在接受活检的37个肿瘤中，16个进行了手术切除。1例血管平滑肌瘤在CNB时最初被诊断为血管瘤，但所有其他组织学结果一致，诊断准确性为97%。
手部和手指的小软组织肿块，即使那些小于1厘米的肿块，通常也适合超声引导下的CNB。在图像引导下操作有助于使用较高规格针通过相对较少的穿刺次数获取足够用于组织学诊断的芯标本。
总体而言，超声引导下手部和手指的CNB在诊断软组织肿瘤方面是安全且高度准确的。准确性与针的规格、穿刺次数和病变大小无关。
