超声引导液体隔离法辅助粗针穿刺活检对颈部大血管旁淋巴结转移癌诊断价值.docVIP

超声引导液体隔离法辅助粗针穿刺活检对颈部大血管旁淋巴结转移癌诊断价值 　　[摘要] 目的 评价超声引导液体隔离法辅助粗针穿刺活检对诊断颈部大血管旁淋巴结转移癌的临床应用价值。方法 回顾性分析2013年1月～2016年11月解放军总医院介入超声科24例恶性肿瘤患者的临床资料，共24枚颈部淋巴结转移癌，病灶平均最大径为（0.93±0.16）cm，均位于颈部Ⅳ区大血管旁，在超声引导下通过局部注射生理盐水行液体隔离法，辅助完成18G粗针穿刺活检，标本送组织病理学检查。 结果 100%（24/24）的患者局部注射生理盐水后实现了病灶与相邻大血管的有效分离，并完成了粗针穿刺活检操作。术后无损伤血管及大出血等并发症出现。 结论 超声引导液体隔离法辅助粗针穿刺活检是诊断颈部大血管旁淋巴结转移癌的一种安全有效方法。 　　[关键词]超声引导；液体隔离法；粗针穿刺活检；颈部；淋巴结转移癌 　　[中图分类号] R445.1 [文献标识码] A [文章编号] 1673-7210（2017）04（a）-0131-03 　　[Abstract] Objective To evaluate the clinical value of core needle biopsy （CNB） under hydrodissectionassistanceto diagnose lymph node metastases close to cervicallarge vessels guided by ultrasound （US）. Methods From January 2013 to November 2016，in the Department of Interventional Ultrasound， Chinese PLA General Hospital， the clinical data of 24 patients with 24 lymph node metastases adjacent to large vessels at the fourth region of the neck were retrospectively analyzed. All the lymph node metastases were performed the procedure of US-guided CNB using 18G true-cut biopsy needle under assistance of local saline injection，the samples were givenhistopathological examination. The mean maximal diameter of the nodules was （0.93±0.16） cm. Results Following the effective separation between the lymphnode metastases and the adjacent vessels with hydrodissection of saline injection， the procedures of CNB were completely performed in 100% （24/24） patients and the diagnoses of the lymph node metastases in all cases were verified histopathologically. No major complications including large vessels injury and massive haemorrhage occurred. Conclusion US-guided CNB under assistance of hydrodissection is an effective and safe methodto diagnose cervical lymph node metastases adjacent to large vessels. 　　[Key words] Ultrasound guidance； Hydrodissection； Core needle biopsy； Cervical； Lymph node metastases 　　?i部淋巴结是全身多部位恶性肿瘤的好发转移部位[1]，是恶性肿瘤患者治疗和随访中重点关注的部位之一。超声引导粗针穿刺组织学活检安全性好、确诊率高，已成为颈部淋巴结病变病理诊断的首选方法[2-4]。但目前临床应用的自动活检枪采用组织切割弹射活检方式，弹射深度固