McIvor N P, Freeman J L, Salem S, Elden L, Noyek A M, Bedard Y C
Department of Otolaryngology, Mount Sinai Hospital, University of Toronto, Ontario, Canada.
Laryngoscope. 1994 Jun;104(6 Pt 1):669-74. doi: 10.1288/00005537-199406000-00005.
A head and neck ultrasound-guided fine-needle aspiration clinic was set up to determine the role of ultrasound and ultrasound-guided fine-needle aspiration in the evaluation of patients with lesions in this region. One hundred ninety-five lesions were biopsied by ultrasound-guided fine-needle aspiration in 203 patients. Ultrasound detected 2 or more lesions in 14 (48%) of 29 patients with a clinically solitary thyroid nodule. Three (8.8%) of 34 lesions thought to be within the parotid gland were determined to be external. A pronounced learning curve was evident in the technique of ultrasound-guided fine-needle aspiration, particularly for nonpalpable disease. Adequacy of sampling for each 3-month period was 71%, 89%, and 94%, respectively. Seventy-four percent of central aspirations were satisfactory compared to 54% of peripheral aspirations. Ultrasound-guided fine-needle aspiration did not alter the clinical staging of metastatic neck disease in 8 patients having 10 neck dissections but proved useful in detecting nodal recurrence in 3 irradiated necks that did not proceed to surgery. The smallest node to harbor malignancy had 4-mm maximal axial diameter. We conclude that ultrasound and ultrasound-guided fine-needle aspiration are valuable adjuncts to the clinical examination.
设立了头颈超声引导下细针穿刺门诊，以确定超声及超声引导下细针穿刺在评估该区域病变患者中的作用。203例患者中的195个病变通过超声引导下细针穿刺进行活检。在29例临床诊断为孤立性甲状腺结节的患者中，超声检测到其中14例（48%）有2个或更多病变。在34个被认为位于腮腺内的病变中，有3个（8.8%）被确定位于腮腺外。超声引导下细针穿刺技术存在明显的学习曲线，尤其是对于不可触及的病变。每3个月的采样充足率分别为71%、89%和94%。中央穿刺的满意度为74%，而外周穿刺的满意度为54%。超声引导下细针穿刺并未改变8例接受10次颈部清扫术患者颈部转移性疾病的临床分期，但在检测3例未进行手术的放疗颈部的淋巴结复发方面被证明是有用的。含有恶性肿瘤的最小淋巴结最大轴向直径为4毫米。我们得出结论，超声及超声引导下细针穿刺是临床检查的有价值辅助手段。
