Sinh thiết kim dưới hướng dẫn của siêu âm chẩn đoán u sau phúc mạc ở trẻ em: hồi cứu trên 52 bệnh nhân

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Tác giả: Ngoc Thach Hoang, Dinh Cong Le, The Manh Nguyen, Thi Thanh Huong Nguyen, Hong Diep Pho

Ngôn ngữ: vie

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Thông tin xuất bản: Journal of Clinical Medicine – Hue Central Hospital, 2020

Mô tả vật lý: tr.88-94

Bộ sưu tập: Metadata

ID: 379367

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52 BN (25 nam, 27 nữ) được đưa vào nghiên cứu. Siêu âm thường quy cho thấy các khối u có cấu trúc âm không đồng nhất hoặc khối hỗn hợp gồm vôi hóa và hoại tử. 61,5% khối u sau phúc mạc bao quanh mạch máu. Mẫu sinh thiết kim đủ chất lượng để chẩn đoán giải phẫu bệnh chiếm 98,1% (51/52). Có 1 trường hợp mẫu sinh thiết quá nhỏ chủ yếu chứa mô xơ và cơ vân không đủ chẩn đoán. Khả năng chẩn đoán chính xác của sinh thiết kim so với mổ là 76,9 % (10/13). Giải phẫu bệnh u sau phúc mạc đa dạng, 86,3% u nguồn gốc thần kinh (60,8% NB, 11,8% GNB và 13,7 % GN), 5,9 % u vỏ tuyến thượng thận, 4,0% u tế bào mầm (2,0% teratoma và 2,0% u túi noãn hoàng), 3,9% u cơ vân ác tính ngoài thận. Không có biến chứng xảy ra sau sinh thiết kim (chảy máu, nhiễm trùng). Sinh thiết kim dưới hướng dẫn siêu âm là một kỹ thuật có độ chính xác, ít xâm nhập và an toàn giúp chẩn đoán u sau phúc mạc ở trẻ em.Bachground: Ultrasound-guided large core needle biopsy technique has widely been applied in thediagnosis of adult abdominopelvic, mediastinal cavity, breast and neck tumors. There are few reportson ultrasound-guided biopsy using large-core needle in pediatric solid tumor. This study was to evaluate the ultrasound features and the diagnostic value of ultrasound-guided core needle biopsy for pediatricretroperitoneal tumors.Methods: The pediatric patients with retroperitoneal tumor that determined by ultrasound, CT or MRIexamination and underwent ultrasound guided core needle biopsy from October 2018 to January 2020were reviewed at Vietnam National Children’s Hospital. A minimum of five cores in each case was obtained.13 patients were operated and had surgical pathology results. The ultrasound features and the diagnosticaccuracy of ultrasound-guided core needle biopsy were evaluated.Results: Fifty - two patients (25 males, 27 females) were enrolled into the study. Conventionalultrasound examination showed irregular hypoechoic or mixed echo masses and calcification and liquefiednecrosis. The ratio of vascular encased tumors was 61.5%. The quality of tissue sample was enoughto make diagnosis was 98.1% (51/52). Only one case was misdiagnosed because of inadequate tissuesample. The diagnostic accuracy of ultrasound guided core needle biopsy compared to subsequentsurgical histopathology was 76.9 % (10/13). Retroperitoneal tumor pathology varied with neuroblastictumor was 86.3% (60.8% NB, 11.8% GNB and 13.7% GN), ACC was 5.9%, germ cell tumor was 4.0%(2.0% teratoma, 2.0% yolk sac tumor) and extra renal malignant rhadoid tumor was 2.0%. No seriouscomplication, hemorrhage or infection occurred.Conclusions: Ultrasound-guided core needle biopsy seems to be an accurate, minimally invasive, andsafe diagnostic method of pediatric retroperitoneal tumor.

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