CT引导下口腔颌面部肿瘤穿刺活检的价值分析

宗开洋; 刘若宇; 张传敏; 郭蕴; 许操; 李建成

doi:10.16766/j.cnki.issn.1674-4152.002579

CT引导下口腔颌面部肿瘤穿刺活检的价值分析

doi: 10.16766/j.cnki.issn.1674-4152.002579

1.
蚌埠医学院第一附属医院口腔颌面外科，安徽蚌埠 233004
2.
蚌埠医学院第一附属医院放射科

基金项目:

安徽省高校自然科学研究项目 KJ2019A0374

详细信息

通讯作者:
李建成, E-mail: ljc7426@163.com

中图分类号: R739.8
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- 被引次数: 0
出版历程
- 收稿日期: 2021-09-11
- 网络出版日期: 2022-09-26

Value analysis of CT-guided puncture biopsy for oral and maxillofacial tumours

1.
Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

摘要: 目的研究CT引导下穿刺活检对口腔颌面部肿瘤的诊断及其临床应用价值，探讨其相较于常规超声引导下穿刺活检的优缺点以及在临床应用中的适应证和注意事项。方法选取蚌埠医学院第一附属医院2019年1月—2020年5月收治的42例口腔颌面部肿瘤患者进行CT引导下穿刺活检，然后将所取的活组织送检、观察并分析。统计穿刺成功率、并发症的发生情况以及病理结果的准确率。结果 42例患者定位成功率为100.00%，一次穿刺成功患者41例，成功率为97.62%，1例患者进行二次穿刺。穿刺后有22例患者出现穿刺部位疼痛表现，1例患者出现发热症状。42例患者中，21例患者术前穿刺病理诊断结果为恶性肿瘤，术后病理诊断结果为恶性肿瘤的患者有23例；15例患者术前病理诊断结果为良性肿瘤，术后病理诊断结果为良性肿瘤的患者有17例；6例患者术前穿刺病理诊断结果为非肿瘤性变，术后穿刺病理诊断结果为非肿瘤性变2例。灵敏度为90.00%，特异度为100.00%，准确率为90.48%，具有很好的临床指导与参考作用。结论 CT相较于超声具有图像清晰、层面连续等优点，同时还可以借助造影剂拍摄增强片以显现某些软组织结构(肌肉、血管)出现的不同密度的变化，更便于判断病变累及范围、大小和性质。口腔颌面部肿瘤在CT引导下穿刺活检后行病理检查准确率高、损伤小、速度快，对于临床治疗具有重要的参考作用，值得临床推广使用。
- CT引导 /
- 口腔肿瘤 /
- 穿刺活检
Abstract: Objective To study the diagnostic value and clinical application of CT-guided needle biopsy for oral and maxillofacial tumours and discuss its advantages and disadvantages compared with conventional ultrasound-guided needle biopsy, as well as its indications and precautions in clinical application. Methods A total of 42 patients admitted to our hospital from January 2019 to May 2020 were selected for CT-guided puncture biopsy. The biopsies were submitted for examination, observation and analysis. The success rate of puncture, the incidence of complications and the accuracy of pathological results were determined. Results The success rate of localization was 100.00% in 42 patients, and the success rate of one puncture was 97.62% in 41 patients. One patient received two punctures. After puncture, 22 patients showed pain at the puncture site, and 1 patient presented with fever. Amongst the 42 patients, 21 patients were diagnosed with a malignant tumour by preoperative puncture pathology, and 23 patients were diagnosed with a malignant tumour by postoperative pathology. The preoperative pathological diagnosis results of 15 patients were benign tumours, and the postoperative pathological diagnosis results of 17 patients were conscience tumours. The preoperative pathological diagnosis of 6 patients was non-neoplastic, and the postoperative pathological diagnosis was 2 cases. The sensitivity was 90.00%, specificity was 100.00% and accuracy rate was 90.48%, demonstrating good clinical guidance and reference function. Conclusion Compared with ultrasound, CT has the advantages of clear images and continuous layers. CT involves the use of a contrast agent to capture enhancement films to show the changes in different densities in some soft tissue structures (muscle and blood vessels), which is more convenient to judge the scope, size and nature of lesion involvement. CT-guided puncture biopsy for oral and maxillofacial tumours has high accuracy, small injury and fast speed. Hence, it has an important reference role in clinical treatment and is worthy of clinical promotion and use.
- CT guidance /
- Oral tumour /
- Biopsy

HTML全文

图 1 病例1术前、术中影像及病理图片

注：A为增强CT显示病灶；B为金属光栅定位；C为CT下穿刺；D为术中摄图；E为Bcl-6(免疫组化法，×400)；F为CD21(免疫组化法，×400)。

Figure 1. Preoperative and intraoperative imaging and pathological images of case 1

下载: 全尺寸图片幻灯片

图 2 病例2术前、术中影像及病理图片

注：A为增强CT示病灶；B为金属光栅定位；C为CT下穿刺；D为术中摄图；E为术前穿刺病理图片(HE染色，×100)；F为术后病理图片(HE染色，×100)。

Figure 2. Preoperative and intraoperative imaging and pathological images of case 2

下载: 全尺寸图片幻灯片

表 1 42例口腔颌面部肿瘤患者术前穿刺结果与术后病理结果(例)

Table 1. 42 patients with oral and maxillofacial tumors were preoperative biopsy results with postoperative pathologic results (cases)

穿刺	病理		合计
穿刺	阳性	阴性	合计
阳性	36	0	36
阴性	4	2	6
合计	40	2	42

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