超声造影和常规超声引导下穿刺活检在腹部结内淋巴瘤中的对比研究

Comparative study of contrast-enhanced ultrasound and conventional ultrasound-guided needle biopsy in abdominal intranodal lymphoma

目的:研究超声造影(Contrast-enhanced ultrasound,CEUS)和常规超声(Ultrasound,US)引导下穿刺活检在腹部结内淋巴瘤中的应用价值。方法:回顾性分析2012年5月—2022年5月在本院经穿刺活检病理证实的68例腹部结内淋巴瘤患者的资料,其中行CEUS引导下穿刺活检者36例,行常规US引导下穿刺活检者32例。比较CEUS组和US组的超声图像特征以及穿刺诊断率、并发症、总花费。结果:①腹部结内淋巴瘤常规超声多表现为均匀低回声(86.8%,59/68),超声造影多呈弥漫性均匀高增强(88.9%,32/36),内部明显坏死的少见(11.1%,4/36)。②US组腹部结内淋巴瘤患者的穿刺诊断率为93.8%(30/32),CEUS组腹部结内淋巴瘤患者的穿刺诊断率为97.2%(35/36)。CEUS组的穿刺诊断率较US组略高,但两组患者穿刺诊断率在统计学上无差异,P=0.486。③CEUS组和US组患者均无腹腔或腹膜后出血、腹膜炎、针道种植、大血管损伤等并发症发生;CEUS组每人每病灶总花费约1574.6元,US组每人每病灶总费用约1045.6元,CEUS组比US组每人每病灶总花费约多529元。结论:①腹部结内淋巴瘤常规US和CEUS表现有一定特点。②对于腹部结内淋巴瘤患者而言,CEUS引导下穿刺活检并不能明显提高其穿刺诊断率。③与CEUS引导下相比,常规US引导下对腹部结内淋巴瘤患者进行穿刺活检总花费更少,性价比更高,更符合医保政策要求。

Objective:To investigate the application value of contrast-enhanced ultrasound(CEUS)and conventional ultrasound(US)-guided needle biopsy in the abdominal intranodal lymphoma patients.Methods:Sixty eight cases of abdominal intranodal lymphoma patients pathologically confirmed by needle biopsy from May 2012 to May 2022 in our hospital were analyzed retrospectively,including 36 cases who underwent CEUS-guided needle biopsy,32 cases who underwent conventional US-guided needle biopsy.The features of ultrasound imaging,puncture diagnostic rate,complications,and total cost of CEUS and US groups were compared.Results:①The conventional ultrasound of abdominal intranodal lymphoma mostly showed homogeneous hypoechogenicity(86.8%,59/68),the contrast-enhanced ultrasound mostly showed diffuse homogeneous hyperenhancement(88.9%,32/36),and the interior obvious necrosis of abdominal intranodal lymphoma was rare(11.1%,4/36).②The puncture diagnostic rate of abdominal intranodal lymphoma patients in the US group was 93.8%(30/32),and the puncture diagnostic rate of abdominal intranodal lymphoma patients in the CEUS group was 97.2%(35/36).The CEUS group had a slightly higher puncture diagnostic rate than the US group’s,however,there was no statistical difference among the puncture diagnostic rate of two groups,P=0.486.③Both groups had no complications such as abdominal cavity or retroperitoneum bleeding,peritonitis,needle implantation,major vascular injury after biopsy;The total cost of per lesion was about 1574.6 RMB in the CEUS group,the total cost of per lesion was about 1045.6 RMB in the US group.The total cost of per lesion in the CEUS group was about 529 yuan more than that in the US group.Conclusion:①Conventional ultrasound and contrast-enhanced ultrasound had certain characteristics in abdominal intranodal lymphoma.②For the abdominal intranodal lymphoma patients,CEUS-guided needle biopsy did not obviously improve their puncture diagnostic rate.③Compared with the CEUS-guided,the conventional US-guided needle biopsy for the abdominal intranodal lymphoma patients costed less,was more cost-effective and more suited to the requirements of medical insurance policy.