Li Jun, Li Dan, Zhang Wenzhi
Department of Ultrasonography, Hangzhou Red Cross Hospital (Integrated Chinese and Western Hospital of Zhejiang Province), Hangzhou, Zhejiang, China.
Front Oncol. 2025 Apr 17;15:1570133. doi: 10.3389/fonc.2025.1570133. eCollection 2025.
To investigate the value of contrast-enhanced ultrasound (CEUS) assisted core needle biopsy (CNB) in the diagnosis of cervical lymph node tuberculosis (LN TB) and improve the positive rate of cervical LN TB.
We retrospectively analyzed 730 samples obtained from July 2010 to January 2025 from patients treated with effective antituberculosis therapy and with microbiologically confirmed and surgical pathologically proven cervical lymph node enlargement who had undergone CEUS- CNB at our hospital. All patients were divided into two groups according to the historical control method. The CEUS group (2017-2025) underwent CEUS- CNB (485 cases), whereas the US group (2010-2018) underwent US-guided CNB (245 cases). The positive rates of pathological diagnosis and Xpert Mycobacterium tuberculosis complex (MTBC) and resistance to rifampin (RIF) (MTB/RIF) assay diagnoses were compared between the groups.
The specimens' integrity was significantly higher after CNB in the CEUS group than in the US group (CEUS group: 72.30%; US group: 45.49%), and visual satisfaction of sampling in the CEUS group was higher (χ2: 47.651, P < 0.001). Histopathological examination sensitivity, specificity, positive predictive value, and negative predictive value were higher in the CEUS group than in the US group. The sensitivity of the Xpert MTB/RIF assay was significantly higher in the CEUS group than in the US group.
The study results support the clinical use of CEUS for improving the diagnostic performance and positive rate for cervical LN TB.
探讨超声造影（CEUS）辅助粗针穿刺活检（CNB）在诊断颈部淋巴结结核（LN TB）中的价值，并提高颈部LN TB的阳性检出率。
回顾性分析2010年7月至2025年1月在我院接受有效抗结核治疗、经微生物学确诊且手术病理证实为颈部淋巴结肿大并接受CEUS-CNB的患者的730份样本。所有患者按照历史对照法分为两组。CEUS组（2017 - 2025年）接受CEUS-CNB（485例），而超声组（2010 - 2018年）接受超声引导下CNB（245例）。比较两组病理诊断、Xpert结核分枝杆菌复合群（MTBC）及利福平耐药（RIF）（MTB/RIF）检测诊断的阳性率。
CEUS组CNB后标本完整性显著高于超声组（CEUS组：72.30%；超声组：45.49%），且CEUS组采样视觉满意度更高（χ2：47.651，P < 0.001）。CEUS组组织病理学检查的敏感性、特异性、阳性预测值和阴性预测值均高于超声组。CEUS组Xpert MTB/RIF检测的敏感性显著高于超声组。
研究结果支持CEUS在临床中用于提高颈部LN TB的诊断效能和阳性率。
