超声造影在前纵隔占位穿刺活检中的应用价值

Application value of contrast-enhanced ultrasound in biopsy for anterior mediastinal masses

目的探讨超声造影在前纵隔占位经皮穿刺活检中的应用价值。方法选取我院行穿刺活检的前纵隔占位患者79例,其中39例穿刺活检前接受超声造影检查(超声造影组),40例仅接受常规超声检查(非超声造影组),分析比较两组病灶内坏死显示率、取材次数及诊断准确率。结果超声造影组对病灶内液化坏死显示率为66.67%(26/39),高于非超声造影组的22.50%(9/40),差异有统计学意义(P<0.05);以穿刺病理结果为标准,超声造影组诊断准确率为94.87%(37/39),高于非超声造影组[77.50%(31/40)],差异有统计学意义(P<0.05)。当病灶直径>5 cm时,超声造影组的诊断准确率为97.06%(33/34),高于非超声造影组[75.00%(24/32)],差异有统计学意义(P<0.05)。超声造影组1例患者穿刺后皮下血肿,非超声造影组未见严重并发症。结论超声造影能够准确识别前纵隔占位病灶内坏死区域和活性区域,提高活检穿刺的准确率及成功率,且不良反应少。

Objective To explore the application value of contrast-enhanced ultrasound(CEUS)in percutaneousbiopsy for anterior mediastinum.MethodsA total of 79 patients with anterior mediastinum masses with ultrasound guidedpercutaneous biopsy were enrolled in this study.Before biopsy,39 patients were divided into CEUS group,and 40 patients weredivided into US group.The rate of necrosis display,the number of samples taken and the accuracy of diagnosis in the two groupswere analyzed and compared.ResultsThe rate of necrosis in the CEUS group was 66.67%(26/39),which was significantlyhigher than that in the US group(22.50%,9/40),there was significant difference(P<0.05).According to the pathology,thediagnostic accuracy rate of CEUS group was 94.87%(37/39),which was significantly higher than that of the US group(77.50%,31/40),there was significant differences(P<0.05).In cases of tumors diameter over 5 cm,the diagnostic accuracy rate of CEUSgroup was 97.06%(33/34),which was significantly higher than that of US group(75.00%,24/32),there was significantdifferences(P<0.05).1 patient in CEUS group suffered from subcutaneous hematoma,but no serious complications was found inthe US group.ConclusionCEUS is helpful to identify the necrotic area and alive area in the lesion,thus canbe potentially usedto improve the accuracy and success rate of biopsy,and have fewer adverse reactions.