超声造影在粗针活检诊断颈部较大结核性淋巴结中应用价值

Application of contrast-enhanced ultrasound in the diagnosis of large tuberculous lymph nodes in neck by thick needle biopsy

目的探讨超声造影在颈部较大结核性淋巴结粗针活检中的应用价值。方法选取自2014年1月至2019年12月在北部战区总医院因颈部淋巴结肿大接受穿刺活检的71例患者为研究对象。根据淋巴结穿刺引导方式将患者分为常规超声组(n=38)与超声造影组(n=33)。常规超声组患者行超声引导下粗针穿刺活检。超声造影组患者应用SonoVue行超声造影后,对超声造影增强区域进行粗针活检。比较两组患者的取材成功率、病理诊断阳性率及并发症发生率。结果超声造影组的取材成功率、病理诊断阳性率分别为100.0%(33/33)、90.9%(30/33),均高于常规超声组的78.9%(30/38)、71.1%(27/38);超声造影组的并发症发生率为3.0%(1/33),低于常规超声组的13.2%(5/38);组间比较,差异均有统计学意义(P<0.05)。结论超声造影能够清晰分辨较大结核性淋巴结的内部坏死区域,可提高穿刺病理诊断的准确率,且并发症少,在较大结核性淋巴结粗针活检中有较高的临床价值。

Objective To investigate the application value of contrast-enhanced ultrasound in coarse needle biopsy of large tuberculous lymph nodes in the neck.Methods A total of 71 patients who received puncture biopsy for cervical lymph node enlargement in the General Hospital of Northern Theater Command from January 2014 to December 2019 were selected as the research subjects.Patients were divided into conventional ultrasound group(n=38)and contrast-enhanced ultrasound group(n=33)according to lymph node puncture guidance.Patients in conventional ultrasound group received ultrasound-guided coarse needle aspiration biopsy.Patients in the contrast-enhanced ultrasound group received contrast-enhanced ultrasound with SonoVue,and coarse needle biopsy was performed on the contrast-enhanced ultrasound group area.The success rate of sampling,positive rate of pathological diagnosis and incidence of complications were compared between the two groups.Results The success rate of sampling and positive rate of pathological diagnosis in contrast-enhanced ultrasound group were 100.0%(33/33)and 90.9%(30/33),respectively,which were higher than those in conventional ultrasound group(78.9%,30/38)and 71.1%(27/38),P<0.05.The complication rate of contrast-enhanced ultrasound group was 3.0%(1/33),which was lower than that of conventional ultrasound group(13.2%,5/38),P<0.05.Conclusion Contrast-enhanced ultrasoundcan clearly distinguish the internal necrotic areas of large tuberculous lymph nodes,which can improve the accuracy of puncture pathological diagnosis with fewer complications,and has high clinical value in coarse needle biopsy of large tuberculous lymph nodes.