超声造影在腹壁结核性脓肿穿刺活检中的应用价值  

Role of contrast-enhanced ultrasound in biopsy for tuberculous abscess of the abdominal walls

作　　者：张文智[1] 杨高怡[1] 裴宇[2] 徐建平[1] 

机构地区：[1]浙江省中西医结合医院超声科,浙江杭州310003 [2]杭州市第三人民医院儿科,浙江杭州310009

出　　处：《中华全科医学》2016年第7期1193-1195,共3页Chinese Journal of General Practice

基　　金：浙江省杭州市医药卫生科技计划项目(2013A39);浙江省医药卫生计划项目(2014KYA183);杭州科技计划发展项目(20120633B10)

摘　　要：目的探讨超声造影应用于腹壁结核性脓肿穿刺活检术,对提高穿刺活检取材完整率和病理诊断阳性率的价值。方法选取2013年9月—2015年11月因腹壁肿块在浙江省中西医结合医院结核科住院的患者66例,男性24例,女性42例,分为2组,A组23例,男性8例,女性15例,为2013年9月—2014年2月住院的腹壁肿块患者,知情同意并签字后进行超声引导下穿刺活检术;B组43例,男性16例,女性27例,为2014年2月—2015年11月住院的腹壁肿块患者,知情同意并签字后首先行腹壁肿块超声造影,根据超声造影选择穿刺活检区,并确定取材目标区:1腹壁肿块部分增强型取造影剂充填的增强区+小部分无增强区;2肿块完全增强型取造影剂增强区。后行超声引导下穿刺活检术。所有数据采用SPSS 13.0统计学软件包进行统计分析,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果 A组23例患者:转移性癌1例,血肿1例,余为腹壁结核,活检取材完整率为47.8%(11/23),病理结果的阳性率为82.6%(19/23);B组43例患者:转移性癌2例,腹壁皮脂腺囊肿伴感染1例,余为腹壁结核,所有患者超声造影提示腹壁肿块全增强型8例,腹壁肿块部分增强型35例,活检取材完整率为90.7%(39/43),病理诊断阳性率为100%(43/43),B组活检取材完整率和病理诊断阳性率较A组明显提高,χ2值分别为15.00及5.20,P均<0.05。结论超声造影应用于腹壁结核性脓肿穿刺活检术,可明显提高穿刺活检取材完整率和病理诊断阳性率。Objective To study the application value of contrast-enhanced ultrasound in biopsy for tuberculous abscess of the abdominal walls and improve the rate of intact tissue and positive pathology results. Methods The 66 hospitalized patients （24 male cases ,42 female cases）with abdominal mass in our hospital were selected in September, 2013 to Novem- ber,2015 and divided into 2 groups. The group A（23 patients including 8 male and 15 female cases） received the real- time uhrasound guided biopsy between September,2013 and February,2014. The group B （43 patients including 16 male and 27 female cases ） received contrast-enhanced ultrasound to determine the materials area and then the ultrasound guided biopsy between February 2014 and November 2015. Target areas were contrast enhanced filling area and small part of no enhance area for abdominal mass part enhanced;contrast enhancement area for bump completely enhanced. All data was analyzed using SPSS version 13.0 software. The qualitative data were analyzed with chi-square test;P values less than 0.05 were reported as statistically significant. Results Group A included 1 case of metastatic carcinoma, 1 case of hema- toma, 21 cases of abdominal wall tuberculosis, the rate of intact tissue was 47.8 % and the positive results of pathology ex- amination was 82.6% ; Group B included 2 cases of metastatic carcinoma, 1 cases of abdominal wall sebaceous glands cyst with infection, and 40 cases of abdominal wall tuberculosis;The contrast-enhanced ultrasound prompted the abdominal masses enhanced all in 8 cases,abdominal mass enhanced partly in 35 cases. The rate of intact tissue was 90.7% and the positive results of pathology examination was 100%, which was obviously improved as compared with group A. Chi square value were 15.00 and 5.20,P 〈 0.05. Conclusion The application of contrast-enhanced ultrasound before the biopsy for tuberculous abscess of the abdominal walls can obviously improve the rate of intact tissue and positive pathology results.

关 键 词：超声造影 结核性脓肿 穿刺活检 

分 类 号：R445.1[医药卫生—影像医学与核医学] R656.3[医药卫生—诊断学]