超声造影引导下穿刺活检对前纵膈肿瘤的诊断价值

Clinical value of contrast-enhanced ultrasound-guided biopsy in diagnosis of anterior mediastinal tumor

目的探讨超声造影引导下穿刺活组织检查对前纵膈肿瘤的诊断价值。方法回顾性分析我院经超声引导下穿刺活检取得病理结果的贴胸壁前纵膈肿瘤患者80例,根据术前接受超声造影及未接受造影检查分成2组,将患者的临床资料及活检病理结果进行对照分析。结果80例超声检查可视的前纵膈肿瘤患者中,术前接受超声造影组39例,未接受造影组41例。造影组经超声引导下活检,最终病理结果淋巴瘤18例,胸腺瘤15例,生殖细胞肿瘤4例,肌源性肉瘤1例,类癌1例。非造影组经超声引导下活检,最终病理结果淋巴瘤15例,胸腺瘤13例,生殖细胞肿瘤7例,不能明确诊断分型6例。造影组活检取材成功率100%(39/39),非造影组活检取材成功率85.4%(35/41),差异有统计学意义(P<0.05)。结论超声造影有助于提高超声引导下前纵膈肿瘤穿刺活检取材的准确性,具有较高的临床应用价值,值得临床推广运用。

Objective To evaluate the value of contrast-enhanced ultrasound-guided biopsy in diagnosis of anterior mediastinal tumor.Methods A total of 80 cases of anterior mediastinaltumors closed to the chest wall with pathological results by Ultrasound-guided Fine-needle Aspiration Biopsy(US-FNAB)were analyzed retrospectively.According to undergoing contrast-enhanced ultrasound(CEUS)before US-FNAB or not,all the cases were divided into 2 groups.The clinical data and the results of final diagnostic success rate were collected and statistically analyzed.Results Of all 80 cases,39 cases underwent CEUS before US-FNAB while 41 cases did not.According to pathological findings,in the group of CEUS,18 cases were lymphoma,15 cases were thymoma,4 cases were germinoma,1 case was myogenic sarcoma,and 1 case was carcinoid.In the group of non-CEUS,15 cases were lymphoma,13 cases were thymoma,7 cases were germinoma,and 6 cases were not identified by pathological results.The success rate of contrast-enhanced ultrasound-guided biopsy of 39 cases was 100%(39/39)while of which non-contrast-enhanced ultrasound-guided biopsy of 41 cases was 85.4%(35/41).The difference was statistically significant(P<0.05).Conclusion Contrast-enhanced ultrasound-guided biopsy is helpful to improve the accuracy of US-FNAB and has a high value for the diagnosis of anterior mediastinal tumor.It is worthy of clinical promotion.