超声造影引导前纵隔病变穿刺活检

Contrast-enhanced ultrasound-guided biopsy in anterior mediastinum lesions

目的评价CEUS引导下前纵隔病变穿刺活检的可行性。方法收集CT或MRI提示为前纵隔病变的患者71例,比较常规超声(n=33)与CEUS引导下(n=38)穿刺活检的取材成功率、病理诊断率、病变内坏死显示率、取材次数和并发症。结果常规超声和CEUS引导穿刺活检取材成功率、病理诊断率分别为84.84%(28/33)、75.76%(25/33)和100%(38/38)、97.37%(37/38),两种方法差异均有统计学意义(P均<0.05)。接受CEUS引导穿刺的38例患者中,病灶内液化坏死显示率常规超声为23.68%(9/38),CEUS为65.79%(25/38),差异有统计学意义(P<0.05)。常规超声和CEUS引导穿刺活检的取材次数为(2.45±0.55)次和(2.03±0.20)次,差异有统计学意义(P<0.05)。无严重并发症发生。结论 CEUS可清晰显示前纵隔病灶内坏死区域,以其引导穿刺活检,可提高取材成功率与病理诊断率。

Objective To evaluate the feasibility of CEUS-guided biopsy of anterior mediastinum lesions. Methods To- tally 71 patients with anterior mediastinum lesions indicated by CT or MRI underwent ultrasound-guided （n= 33） or CEUS- guided （n=38） biopsy. The sampling success rate, pathological diagnosis rate, display rate of interior necrosis, sampling number and complication were compared between the two groups. Results The sampling success rate and pathological diagnosis rate of CEUS-guided biopsy （100% [38/38] and 97.37% [37/38]） were significantly higher than those of ultra- sound-guided biopsy （84. 84% [28/33] and 75.76% [25/33]）, P〈0.05）. Among 38 cases of CEUS-guided biopsy, the display rate of interior necrosis was 23.68% （9/38） using conventional ultrasound, lower than that of CEUS （65.79 %, 25/ 38, P〈0. 05）. The sampling times of ultrasound-guided and CEUYrguided biopsy were （2.45±0.55） and （2.03±0.20）, respectively （P〈0. 05）. No serious complication occurred. Conclusion CEUS can display interior necrosis of anterior me- diastinum lesions, therefore improving the sampling rate and pathological diagnosis rate.