Diagnostic Value Of Endoscopic Ultrasonography Guided Fine-needle Aspiration In Mediastinum Diseases

Objectives: Application of endoscopic ultrasonography guided fine-needleaspiration technique (EUS-FNA) of47patients with mediastinum masses checking tostudy on endoscopic ultrasonography guided fine-needle aspiration technique in thediagnosis of this disease.Method: Application of ultrasonic endoscopy (Japan PENTAX EUS-3830UT)guided fine-needle aspiration technique of Dalian City Centre hospitals between January2009and the CT examination found47cases of patients with mediastinum lesionchecks, in which males18female29, between45-82years of age. Check the methodsimilar to the EUS, Observe the pathological changes scope、size、location、 shape、the echo intensity, Under the ultrasonic images suggest to choose the appropriateposition, determine the puncture, avoiding blood vessels, fixed shank, endoscopicbiopsy hole insert the biopsy device, using22G the needle at the lesion to pierce, takingspecimens. Launch of the puncture, smear, fixed, take biopsies. Puncture2-5lesion,considered the specimens is subject enough to puncture, to enhance positive rate.Results:1, Ultrasound gastroscope characteristics of47cases of mediastinal lesions:31cases of simple mediastinal lesions, ultrasound gastroscope shows: lesions size about7.6-2.8cmx5.0-2.5cm, for in the low, and medium, and low echo lesions, echo uniformor not are, the boundary is clear or unclear; which16cases for esophageal wall convexto cavity within,6cases is located in the trachea promontory,3cases is located in leftlung door,5cases is located in tracheal points fork,1case located on the right side ofthe mediastinum.13patients with mediastinal placeholder with lymph node metastasis,EUS shows: hypoechoic lesion, about the size of5.8-3.5cmx6.1-2.5cm, the boundary isclear or unclear, echoes the uneven seen scattered in the lymph nodes around, round orclass circle, the boundary is clear, and part of integration.3cases of patients with simpleenlargement of the lymph nodes, EUS shows: multiple hypoechoic lesion, about the size of1.3-1.6cmx0.6-1.8cm, circle or class circle, the boundary is clear, and someintegration.2, EUS-FNA check result:47cases positive in39cases, positive rate of diagnosisof82.98%. Of31cases with simple mediastinal lesions in patients with confirmed26cases, the positive rate for83.87%;13patients with mediastinal placeholder with lymphnode metastasis with confirmed11cases, the positive rate for84.62%;3cases withsimple EUS-FNA2confirmed cases of patients with mediastinum lymph nodeenlargement, the positive rate for66.67%.39cases puncture out positive results ofpatients of pathology results respectively is: lung cancer33cases (70.21%), whichsmall cell cancer25cases (53.19%), and squamous cell cancer6cases (12.77%), andglands squamous cell cancer1cases (2.13%), and low differentiation glands cancer1cases (2.13%); Lymphoma tumor1cases (2.13%); mediastinal lymph nodetuberculosis1cases (2.13%); thyroid filter bubble epithelial1cases (2.13%);Biopsy results see alien cells in3cases (6.38%);Another8patients failed to puncture(17.02%).3, EUS-FNA in the mediastinum masses in overall sensitivity of74.47%, specificity of100%, positive predictive values are100%,negative predictive value is25%.4,47cases of puncture in patients with postoperative fever occurred only1case,no other complications.Conclusion:1, EUS clearly shows the location of mediastinum lesions, size, scale, shape, echointensity.2, EUS-FNA for mediastinal lesions in the diagnostic positive rate is higher,especially for lung cancer has higher sensitivity.3, EUS-FNA of the mediastinum lesion with high sensitivity, specificity andpositive predictive value, negative predictive value is low.4, EUS-FNA is a safe, simple, and no serious complications of the examinationtechnology, has great development prospects, is suitable for popularization in clinicalapplication.