| 摘要: |
| 目的 探讨超声造影引导下骨肿瘤穿刺活检的临床应用价值。方法 选取105例拟行骨肿瘤穿刺活检的患者，根据引导方式不同分为二维超声组和超声造影组，分别于二维超声及超声造影引导下穿刺活检，比较两组的穿刺时间、穿刺次数。以术后病理结果或临床综合诊断为金标准，计算并比较两组的诊断敏感性、特异性、阳性预测值、阴性预测值及准确率，绘制二维超声及超声造影引导下穿刺活检诊断骨肿瘤的受试者工作特征（ROC）曲线并计算其曲线下面积。结果 最终成功行超声引导下骨肿瘤穿刺患者105例。其中二维超声组52例，超声造影组53例，两组在性别、年龄、病灶直径、肿瘤位置等比较差异均无统计学意义。两组间穿刺时间及穿刺次数比较差异均无统计学意义（P=0.913、0.854）。超声造影组的诊断特异性与准确率（95.45%、98.11%）均明显高于二维超声组（76.92%、86.54%），差异均有统计学意义（均P＜0.05）。超声造影组的诊断敏感性、阳性预测值及阴性预测值（100%、96.88%、100%）高于二维超声组（96.15%、80.65%、95.24%），但差异无统计学意义。超声造影引导下穿刺活检的ROC曲线下面积为0.987，二维超声引导下穿刺活检的ROC曲线下面积为0.908。结论 超声造影引导下较二维超声引导下对骨肿瘤伴周围软组织肿块的穿刺活检有更高的特异性及诊断准确率。 |
| 关键词: 超声造影,骨肿瘤,超声引导穿刺 |
| DOI： |
| 投稿时间：2021-05-10修订日期：2021-06-30 |
| 基金项目: |
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| Clinical study of bone tumor biopsy guided by contrast-enhanced ultrasoundPu Wei1,2,Lu Man2*,Wu Xiao-bo2,Dai Jiu-long2,Tan Bo2,Zhang Chun-mei2,Zhang Si-qi2 |
| Puwei,Lu Man,Wu xiaobo,Dai jiulong,Tanbo,Zhang siqi,Zhangchunmei |
| (Sichuan Cancer Hospital) |
| Abstract: |
| Objective To determine the clinical value of bone tumor biopsy guided by contrast-enhanced ultrasound(CEUS).Methods A total of 105 patients with bone tumor intended undergo core needle biopsy were divided into two groups, two-dimensional ultrasound guide core need biopsy(US-CNB) group and contrast-enhanced ultrasound guide core need biopsy group(CEUS-CNB), compared the operating time and biopsy number. Pathological results or clinical comprehensive diagnosis were regarded as the gold standard, compared the diagnostic sensitivity and specificity, positive predictive value, negative predictive value and diagnostic accuracy between the two groups. Receiver operating characteristic(ROC) curves of US-CNB group and CEUS-CNB group were drawn and the area under the curve was calculated. Results There was no significant difference in operating time and biopsy number between the two groups（P=0.913，P=0.854）.The diagnostic specificity and accuracy of the CEUS-CNB group were higher than that of the US-CNB group（P=0.038，P=0.031），and the diagnostic sensitivity，positive predictive value and negative predictive value of the CEUS-CNB were higher than the US-CNB group，but there were no statistical differences（P=0.419，P=0.053，P=1.000）.In the ROC curve analysis of the CEUS-CNB group was 0.977，and the US-CNB group was 0.865.Conclusion CEUS can achieve higher diagnostic specificity and accuracy than US guided biopsy for bone tumors with soft mass. |
| Key words: Contrast-enhanced ultrasonography(CEUS),Bone tumor ,Ultrasound-guided biopsy |
