European Radiology

, Volume 26, Issue 9, pp 2999–3005 | Cite as

Application of ultrasound-guided core biopsy to minimize the non-diagnostic results and the requirement of diagnostic surgery in extrapulmonary tuberculosis of the head and neck

  • Ue-Cheung Ho
  • Chun-Nan Chen
  • Che-Yi Lin
  • Ya-Ching Hsu
  • Fan-Hsiang Chi
  • Chen-Han Chou
  • Tseng-Cheng Chen
  • Cheng-Ping Wang
  • Pei-Jen Lou
  • Jenq-Yuh Ko
  • Tzu-Yu Hsiao
  • Tsung-Lin YangEmail author
Head and Neck



Head and neck extrapulmonary tuberculosis (ETB) presenting as lymphadenopathy poses a great threat by potentially increasing the deterioration of clinical outcomes. Tissue sampling for diagnostic confirmation of ETB is the only invasive procedure during the entire clinical course. It is, therefore, necessary to establish ETB sampling methods with accuracy and minimal invasiveness.


From 2009 to 2014, consecutive patients suspected of ETB receiving ultrasound-guided core biopsy (USCB), fine needle aspiration (FNA), and open biopsy (OB) were enrolled for comparison.


There were 52 cases in the USCB group, 58 cases in the FNA group, and 78 cases in the OB group. For USCB, FNA, and OB groups, the diagnostic rates were 84.6 %, 8.6 %, and 100 % and the positive rates of acid-fast stain were 28.6 %, 0 %, and 37.5 %, respectively. The diagnostic rates of culture were 9.6 %, 0 %, and 50 %, respectively. For head and neck ETB, USCB procedure is timesaving, without leaving poor-healing wounds, scars, and the need for general anaesthesia and hospitalization.


This study helps to optimize the ETB sampling method in head and neck based on diagnostic accuracy and minimal invasiveness. USCB can serve as the first-line diagnostic tool for ETB by reducing non-diagnostic results and the need for diagnostic surgery.

Key Points

USCB shows higher diagnostic accuracy of ETB than FNA (84.6 % vs. 8.6 %).

USCB diminishes wound complications caused by surgical intervention for ETB.

USCB avoids general anaesthesia and hospitalization for diagnosing ETB.

USCB saves time and reduces the medical costs of diagnosing ETB.


Ultrasound Core biopsy Minimally invasive Extrapulmonary tuberculosis Head and neck 



The authors thank the Ministry of Science and Technology, the National Taiwan University, and the National Taiwan University Hospital for their support. The authors also thank the staff of the Department of Integrated Diagnostics & Therapeutics, and the staff of the Eighth Core Lab, Department of Medical Research, the National Taiwan University Hospital for technical support of this study.

The scientific guarantor of this publication is Dr. Tsung-Lin Yang. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. This data has not been published elsewhere. Methodology: retrospective, case–control study, performed at one institution


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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Ue-Cheung Ho
    • 1
    • 2
  • Chun-Nan Chen
    • 1
    • 3
    • 4
  • Che-Yi Lin
    • 1
    • 5
  • Ya-Ching Hsu
    • 1
    • 3
  • Fan-Hsiang Chi
    • 1
    • 5
  • Chen-Han Chou
    • 1
    • 5
  • Tseng-Cheng Chen
    • 1
  • Cheng-Ping Wang
    • 1
  • Pei-Jen Lou
    • 1
  • Jenq-Yuh Ko
    • 1
  • Tzu-Yu Hsiao
    • 1
  • Tsung-Lin Yang
    • 1
    • 6
    Email author
  1. 1.Department of OtolaryngologyNational Taiwan University Hospital and National Taiwan University College of MedicineTaipeiTaiwan
  2. 2.Department of SurgeryNational Taiwan University Hospital and National Taiwan University College of MedicineTaipeiTaiwan
  3. 3.Department of OtolaryngologyNational Taiwan University Hospital Hsin-Chu BranchHsin-ChuTaiwan
  4. 4.Graduate Institute of Clinical MedicineNational Taiwan University College of MedicineTaipeiTaiwan
  5. 5.Department of OtolaryngologyNational Taiwan University Hospital Yun-Lin BranchYun-LinTaiwan
  6. 6.Research Center for Developmental Biology and Regenerative MedicineNational Taiwan UniversityTaipeiTaiwan

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