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目的 探讨手动活检结合超声造影在浅表肿大淋巴结诊断中的应用价值.方法 对50例患者颈部、腋窝及腹股沟区常规超声检查后,对肿大淋巴结病变进行超声造影,并在造影不同增强区域进行超声引导下经皮淋巴结手动活检.结果 根据造影剂分布情况分3型,Ⅰ型均匀增强型14例;Ⅱ型不均匀增强型34例;Ⅲ型环状增强型2例.50例患者中,淋巴结手动活检成功48例,手动活检未取出组织改自动活检2例,50例患者(除外2例取材量较少,2例病理无法确定良恶性)均获得明确的组织病理学结果.穿刺活检的病理诊断结果:淋巴结恶性病变25例(淋巴瘤7例,转移癌18例);良性病变21例(反应性增生2例,淋巴结炎17例,不确定2例).结论 根据超声造影显示不同增强区域进行穿刺,提高了穿刺活检的阳性率,为正确指导治疗提供了充分的理论依据.超声引导下手活检具有实时监视、精准、灵活、微创、安全等优点,在肿大淋巴结的定性诊断中具有很大的应用价值.“,”Objective To investigate the application value of manual biopsy combined with ultrasonography in the diagnosis of superficial enlarged lymph nodes.Methods After routine ultrasonography in the neck,armpit and groin area of 50 patients,ultrasonography was performed on the enlarged lymph node lesions,and a manual biopsy was performed in the contrast enhancement area.Results According to the contrast agent distribution points 3,Type Ⅰ evenly enhanced 14 cases;Type Ⅱ uneven enhanced 34 cases;Ⅲ type ring enhanced in 2 cases.Of the 50 patients,48 were successful in manual biopsy,and 2 cases were not taken out by manual biopsy,and the results were obtained from 50 patients (except for 2 cases with low content and 2 cases of benign malignancy).Pathological diagnosis of bi opsy:25 cases of malignant lymphadenopathy (7 cases of lymphoma and 18 metastatic cancers);21 cases of benign lesions (2 cases of reactive hyperplasia) 17 cases of lymphadenitis and 2 cases were not confirmed.Conclusions The ultrasound showed that the different enhanced areas were punctured,increasing the male rate of the biopsy which provided a sufficient theoretical basis for the correct guidance of treatment.Ultrasound-guided manual biopsy has the advantages of real-time monitoring,precision,flexibility,minimally invasive and safety,and is of great value in the qualitative diagnosis of enlarged lymph nodes.