超声造影后细针穿刺活检术在颈部淋巴结结核诊断中的应用

发布时间：2018-08-15 17:20

【摘要】：目的探讨超声造影后细针穿刺活检术在颈部淋巴结结核诊断中的应用价值。方法选取2012年1月—2014年3月在杭州市红十字会医院住院因颈部淋巴结肿大、临床疑似淋巴结结核的患者105例,采用掷硬币法将患者分为A组(47例)和B组(58例)。A组进行超声引导下细针穿刺活检术;B组先行超声造影后再行超声引导下细针穿刺活检术。结果 A组患者47枚淋巴结超声表现:18枚(38.3%)为低回声,29枚(61.7%)为低回声伴液化。病理诊断结果:33枚为颈部淋巴结结核,2枚为反应性增生,1枚为转移癌,病理诊断阳性率为76.6%(36/47)。B组患者65枚淋巴结行超声造影:全淋巴结增强型和淋巴结部分增强型58枚(89.2%),7枚(10.8%)为淋巴结边缘增强型和淋巴结无增强型。58枚适合穿刺的淋巴结行超声引导下细针穿刺活检术,病理诊断结果:47枚为颈部淋巴结结核,5枚为反应性增生,3枚为转移癌,病理诊断阳性率为94.8%(55/58)。B组细针穿刺活检术病理诊断阳性率高于A组(χ2=7.47,P0.05)。结论超声造影后细针穿刺活检术应用于颈部淋巴结结核,可明显提高病理诊断阳性率。
[Abstract]:Objective to evaluate the value of fine needle biopsy after contrast-enhanced ultrasonography in the diagnosis of cervical lymph node tuberculosis. Methods from January 2012 to March 2014, 105 patients with suspected lymph node tuberculosis were hospitalized in Hangzhou Red Cross Hospital. Patients were divided into two groups: group A (47 cases) and group B (58 cases). Results the ultrasonic findings of 47 lymph nodes in group A were as follows: 18 lymph nodes (38.3%) were hypoechoic and 29 (61.7%) were hypoechoic with liquefaction. Pathological findings: 33 cases of cervical lymph node tuberculosis 2 cases of reactive hyperplasia, 1 case of metastatic carcinoma, The positive rate of pathological diagnosis was 76.6% (36 / 47) .65 lymph nodes in group B were examined by contrast-enhanced ultrasonography: total and partial enhanced lymph nodes were 58 (89.2%), 7 (10.8%) were lymphaden-marginal enhancement and non-enhanced lymph nodes. 58 lymph nodes were suitable for puncture. Ultrasound guided fine needle biopsy was performed. The positive rate of pathological diagnosis in group B was 94.8% (55 / 58). The positive rate of fine needle biopsy in group B was higher than that in group A (蠂 2 7.47 P 0.05). Conclusion Fine needle biopsy after contrast-enhanced ultrasonography can significantly improve the positive rate of pathological diagnosis in cervical lymph node tuberculosis.
【作者单位】：浙江省杭州市红十字会医院超声科;
【基金】：浙江省医药卫生计划项目(2014KYA183) 杭州市医药卫生科技计划项目(2013A39,2010B028) 杭州市科技计划发展项目(20120633B01)
【分类号】：R445.1;R522

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