高频彩超在引导颈部包块活检中的临床价值

The clinical value of high frequency color ultrasound-guided biopsy in neck mass

目的探讨影响高频彩超引导颈部包块穿刺活检取材成功率的因素及其安全性。方法回顾性分析我科450例高频彩超引导颈部包块经皮穿刺活检资料，依据病理学诊断结果，分析影响取材成功率的因素；记录出现的并发症。结果颈部包块越小，取材成功率越低，直径〈1cm包块与1～2cm包块间比较（86．27％w96．93％），差异有统计学意义（P〈0．05）；但直径1—2cm包块与直径〉2cm包块间比较（96．93％似97．08％），差异无统计学意义（P〉0．05）。15mm组织条长度取材成功率（88．62％）与22mm组织条长度取材成功率（98．47％）比较，差异有统计学意义（P〈0．05）。16G活检针取材成功率（96．68％）和18G活检针取材成功率（94．41％）比较，差异无统计学意义（P〉0．05）。本组病例穿刺过程中有部分患者感觉胀痛，无一例出现大出血及其他严重并发症。结论高频彩超引导颈部包块自动活检是一种安全、简便、价廉、微创取材方法，对颈部包块的诊断与治疗具有重要的应用价值。

Objective To explore the biopsy success rate and safety of high frequency color ultrasoundguided biopsy in neck mass. Methods Four hundred and fifty cases of high frequency color ultrasound-guided biopsy in neck mass were analyzed retrospectively. According to histopathologic results, the biopsy success rate was discussed, and complications were recorded. Results （1）Biopsy success rate was lower in smaller mass. Biopsy success rate of three groups were：86. 27% in group A（ 〈 1 em）,96. 93% in group B（ 1 -2 cm）,and 97.08% in group C（ 〉 2 cm）. There was significant difference between group A and group B （86. 27% vs 96.93% ,X2 = 7. 818, P = 0. 005 ）, and there was no significant difference between group B and group C （96. 93% vs 97.08% ,X2 = 0. 007,P = 0. 933 ）. （2）There was significant difference between 15 mm and 22 mm sample（88.62% vs 98.47% ,X2 = 21. 457 ,P 〈 0. 001 ）. （3）There was no significant difference between 16G and 18G needle（96. 68%vs 94. 41% ,X2 = 1. 368 ,P =0. 242）. （4）The complication was pain slightly in part of patients, and no severe complication was found. Conclusion High frequency color ultrasound-guided biopsy in neck mass is a safety, easy, inexpensive and minimally invasive sampling method. It can provide important information in the diagnosis and treatment of the neck mass.