彩色多普勒超声引导下粗针穿刺活检在涎腺肿块中的应用

Abstract

目的 分析彩色多普勒超声引导下粗针穿刺活检在涎腺肿块中的诊断价值.方法 回顾性分析56例涎腺肿块经彩色多普勒超声引导下粗针穿刺活检资料.活检病理诊断结果如果为恶性可定为真阳性;如果为良性或未见恶性,结合其他影像学检查并临床随访6个月以上最终确定诊断.计算穿刺活检的成功率、敏感度和特异度,并比较涎腺良、恶性肿块穿刺前的彩色多普勒超声表现.结果 彩色多普勒引导下粗针穿刺活检的56例涎腺肿块,穿刺次数l～3次.确诊良性病灶32例,恶性肿瘤23例;1例穿刺病理诊断不明确,后经切除活检确诊为B细胞淋巴瘤.穿刺成功率、敏感度、特异度和假阴性率分别为98.21％(55/56)、95.83％(23/24)、100％(32/32)、4.17％(1/24).无严重并发症发生.56例良恶性涎腺肿块彩色多普勒超声表现中,肿块的边界、形态、回声均匀性、包膜完整性和血流分级差异均有统计学意义(P均＜0.05).结论 彩超引导下粗针穿刺活检具有安全、准确、并发症少的优点,可避免不必要的手术,对涎腺病变的诊断有重要作用.

Objective To investigate the value of color Doppler ultrasound guided core needle biopsy in the diagnosis of salivary gland masses.Methods All consecutive color Doppler ultrasound guided core needle biopsies data in 56 patients with salivary gland masses were collected retrospectively.The pathological diagnosis was considered definitive if the biopsy results was malignant.If the initial biopsy results was benign or negative for malignancy,the final results was confirmed based on other imaging examinations or clinical follow-up over 6 months.The successful rate,sensitivity,specificity,and complication rates of core needle biopsy were analyzed.The performance of the color Doppler ultrasound between benign and malignant salivary gland mass was compared.Results In 56 patients with salivary gland masses,the number of puncture attempts were 1-3 times.Post biopsy pathological examination confirmed 32 patients with benign masses and 23 patients with malignant tumors,And 1 patient of indefinite diagnosis was performed by biopsy,who was diagnosed as B cell lymphoma later.The successful puncture rate was 98.21％ (55/56),the sensitivity was 95.83％ (23/24),the specificity was 100％ (32/32),and the false negative rate was 4.17％ (1/24).And no serious complication was observed.There were significant differences of the boundary,shape,homogenization,capsule integrity and blood flow classification between benign and malignant salivary gland mass by comparing the performance of the color Doppler ultrasound (all P＜0.05).Conclusion Color Doppler ultrasound guided core needle biopsy of salivary gland masses is a safe and feasible method for preoperative diagnosis with less invasive and less complication,which plays an important role in the diagnosis of the salivary gland masses.