The Value Of Contrast Enhanced Ultrasound-guided Core Needle Biopsy In The Diagnosis Of Abdominal And Pelvic Tumors

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The value of contrast enhanced ultrasound-guided core needle biopsy in the diagnosis of gastrointestinal stromal tumorsObjectiveTo study the value of contrast enhanced ultrasound(CEUS}guided core needle biopsy in the diagnosis of gastrointestinal stromal tumors(GISTs).Materials and methodsBetween November 2011 and June 2015,53 GIST patients underwent 61 conventional ultrasound(US)guided or CEUS guided core needle biopsy at the Cancer Hospital and Institute,Peking Union Medical College and Chinese Academy of Medical Sciences.The outcomes of the biopsy were analyzed.Results1.The diagnostic accuracy of conventional US guided biopsy was 78.8%(26/33),and the accuracy rate of CEUS guided biopsy was 96.2%(27/28).The accuracy of CEUS guided biopsy group was higher than conventional US guided biopsy group.The difference was statistically significant(P<0.05).2.Because of the small amount of biopsy tissue,9 cases of conventional US guided biopsy group and 2 cases of CEUS guided biopsy group can't been accurately evaluate the risk of GIST.CEUS guided biopsy is more accurate than conventional US guided biopsy in evaluating the biological behavior of GIST.The difference was statistically significant(P<0.05).ConclusionsCompared with conventional US guided biopsy,CEUS guided core needle biopsy improved the preoperative diagnosis accuracy and contribute to the risk assessment of GIST.The inclusion of CEUS guided biopsy in the diagnostic work-up of advanced or metastatic GIST is recommended.Part ? The value of contrast enhanced ultrasound-guided core needle biopsy in the diagnosis of abdominal and pelvic lymphoma OObjectiveTo study the value of CEUS guided core needle biopsy in the diagnosis of abdominal and pelvic lymphoma.Materials and methodsBetween January 2013 and November 2016,61 lymphoma patients underwent 64 conventional US guided or CEUS guided core needle biopsy at the Cancer Hospital and Institute,Peking Union Medical College and Chinese Academy of Medical Sciences.The outcomes of the biopsy were analyzed.Results1.In the diagnosis of abdominal and pelvic lymphoma,the diagnostic accuracy of the conventional US guided biopsy with less than or equal to three punches was 58.3%(12/24),and the accuracy rate of conventional US guided biopsy with no less than 3 punches was 86.4%(19/22).The accuracy of conventional US guided biopsy with no less than 3 punches group was higher than conventional US guided biopsy with less than or equal to three punches group.The difference was statistically significant(P<0.05).2.The accuracy rate of CEUS guided biopsy with no less than 3 punches was 94.4%(17/18)in the diagnosis of abdominal and pelvic lymphoma.When the biopsy was not less than 3 punches,there was no significant difference in the diagnosis rate of abdominal cavity and pelvic cavity by CEUS guided biopsy and conventional US guided biopsy(P=0.383).3.The accuracy rate of conventional US guided biopsy with no less than 3 punches was 60%(12/20)in the diagnosis of abdominal and pelvic lymph lesions,while the The accuracy rate of biopsy with no less than 3 punches was 83.3%(15/18).There was no statistically significant difference,P=0.160.The accuracy rate of CEUS guided biopsy with no less than 3 punches was 90%(9/10)in the diagnosis of abdominal and pelvic lymph lesions.Compare with the conventional US guided biopsy,The difference was no statistically significant(P=0.615).4.The accuracy rate of conventional US guided biopsy with less than 3 punches was 50%(2/4)in the diagnosis of small intestinal lymphoma,while the accuracy rate of no less than 3 punches was 100%(4/4).The accuracy rate of CEUS guided biopsy was 100%(9/9).Conclusions1.Compared with the conventional US guided biopsy,CEUS guided biopsy did not significantly improve the diagnosis rate of abdominal and pelvic lymphoma.However,the increase in the number of punches in conventional US guided biopsy can significantly improve the diagnosis accuracy rate and tissue typing of abdominal and pelvic lymphoma.2.Increasing the punches of conventional US guided biopsy or applying the CEUS guided biopsy can improve the diagnosis rate of abdominal and pelvic lymph nodes,but it is not statistically significant.3.Increasing the punches of conventional US guided biopsy and applying the CEUS guided biopsy both can improve the diagnosis rate of small intestinal lymphoma.Part ? The value of conventional ultrasound combined with contrast enhanced ultrasound in the diagnosis of abdominal and pelvic rare tumorsObjectiveTo study the value of conventional ultrasound combined with contrast enhanced ultrasound in the diagnosis of abdominal and pelvic rare tumors.Materials and methodsBetween May 2013 and July 2016,53 abdominal and pelvic rare tumor patients underwent conventional US guided or CEUS guided core needle biopsy at the Cancer Hospital and Institute,Peking Union Medical College and Chinese Academy of Medical Sciences.The outcomes of the biopsy were analyzed.Results1.In this study,25 cases of metastatic tumors,15 cases of sarcoma,4 cases of malignant mesothelioma,4 cases of neuroendocrine tumors,3 cases of solitary fibrous tumors and 2 cases of neurilemmoma were included.2.The diagnostic accuracy of the conventional US guided biopsy was 86%(37/43)in the diagnosis of abdominal and pelvic rare tumors.The diagnosis of CEUS guided biopsy was 90%(9/10).There was no significant difference,P=0.739.3.Except for 1 case of metastatic lesions can't clear the origin of tumor by conventional US guided biopsy with 3 punches,the rest were diagnosed.The cases with no definite diagnosis were confirmed as seminoma metastasis by pathology.4.The accuracy of conventional US and CEUS guided biopsy in the diagnosis of soft tissue sarcoma was low,which both were 66.7%.Conclusions1.There was no significant difference between the diagnostic accuracy of conventional US guided biopsy and CEUS guided biopsy in the diagnosis of rare abdominal and pelvic tumors.However,there were many kinds of abdominal and pelvic tumors.We should enlarge the sample and stratify the study,in order to design a individualized biopsy strategy.2.Conventional US guided biopsy has a high diagnostic accuracy in the diagnosis of abdominal and pelvic metastatic tumors.A small number of punches still have a high diagnostic accuracy.3.The diagnostic accuracy of soft tissue tumors by biopsy was low.Pathological morphology is still the basis of diagnosis.