VAI TRÒ CỦA SINH THIẾT BẰNG KIM LÕI DƯỚI HƯỚNG DẪN SIÊU ÂM TRONG ĐÁNH GIÁ HẠCH CỔ BẤT THƯỜNG

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Tác giả: Huy Thái Lê, Thị Hằng Nguyễn, Việt Hà Nguyễn, Thị Hoa Vũ, Thị Thu Lan Vũ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Điện quang và Y học hạt nhân Việt Nam, 2023

Mô tả vật lý: tr.60-66

Bộ sưu tập: Metadata

ID: 372379

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Mục tiêu: Đánh giá hiệu quả và các yếu tố ảnh hưởng đến kỹ thuật sinh thiết bằng kim lõi dưới hướng dẫn siêu âm (Ultrasound- guided core needle biopsy– US-CNB). Đối tượng và phương pháp: Nghiên cứu mô tả cắt ngang trên 201 bệnh nhân (BN) có hạch nghi ngờ và có đường kính ngang ≥5mm, được US-CNB tại Bệnh viện Trung ương Quân đội 108 từ tháng 01 năm 2022 đến tháng 09 năm 2023. Kết quả: Trong 201 hạch cổ được US-CNB, hạch di căn chiếm phần lớn (52,2%), theo sau là u lympho (15,9%) và hạch lành tính (31,9%). Mẫu bệnh phẩm đủ điều kiện chẩn đoán và phân týp mô bệnh học với 126 ca (62,6%), nhóm cần làm thêm xét nghiệm là 51 ca (25,4%), nhóm không đủ điều kiện là 7 ca (3,5%) và nhóm phân vân cần mổ là 17 ca (8,5%). Độ nhạy, độ đặc hiệu và độ chính xác của US-CNB so với kết quả chẩn đoán cuối cùng của BN lần lượt là 93,4%, 100% và 95,5%. Trong 32 hạch u lympho, chẩn đoán qua US-CNB là 21 ca, còn lại 11 ca cần mổ. Độ chính xác chẩn đoán hạch u lymho bằng US-CNB là 65,6%. Trong nhóm không đủ điều kiện, hạch u lympho chiếm tỷ lệ cao hơn so với hạch di căn và hạch lành tính có ý nghĩa thống kê với p<
0,05, còn theo chiều rộng, đặc điểm hoại tử và kích cỡ kim thì sự khác biệt không có ý nghĩa thống kê. Không gặp ca nào có biến chứng nặng sau US-CNB. Kết luận: US-CNB là một phương pháp chẩn đoán hạch bất thường vùng cổ có hiệu quả với độ chính xác cao và ít xâm lấnObjective: To evaluate the effectiveness and associated factors of ultrasound-guided core needle biopsy (US-CNB). Subjects and Methods: A cross-sectional descriptive study was conducted on 201 patients with suspected cervical lymphadenopathy, having a transverse diameter ≥ 5mm, who underwent US-CNB at the Diagnostic Ultrasound Department of 108 Military Central Hospital from January 2022 to September 2023. Results: Among 201 biopsied nodes, metastatic lymph nodes were the majority (52.2%), followed by lymphoma (15.9%) and benign lymph nodes (31.9%). Adequate diagnostic and histopathological subtyping specimens constituted the majority with 126 cases (62.6%), specimens requiring additional tests for diagnosis were 51 cases (25.4%), specimens deemed inadequate were 7 cases (3.5%), and equivocal specimens requiring surgical excision were 17 cases (8.5%). The sensitivity, specificity, and accuracy of cervical lymphadenopathy US-CNB were 93.4%, 100%, and 95.5%, respectively. Among 32 cases of lymphomas, 21 were diagnosed through US-CNB, and the remaining 11 cases required surgery, resulting in an overall accuracy of 65.6% for diagnosing lymphoma. Inadequate lymphadenopathy specimens were more common in the lymphoma group compared to metastatic and benign lymph nodes, and this difference was statistically significant with p <
0.05. Differences in transverse diameter, necrotic features, and needle size between the two groups were not statistically significant. No complications were encountered post-US-CNB. Conclusion: US-CNB is a safe and effective method for diagnosing cervical lymphadenopathy with high accuracy and minimal invasiveness.

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