CT引导下经皮穿刺腹膜活检对不明原因腹腔积液的诊断价值  

Clinical value of CT-guided percutaneous biopsy of peritoneum in diagnosis of patients with unknown ascites

作　　者：李良山 杨丽 李扬[2] 何闯 黄学全 LI Liang-shan YANG Li LI Yang HE Chuang HUANG Xue-quan(Department of Intervention,Southwest Hospital,Third Military Medical University, Chongqing 400038, China Department of Radiology,452th Hospital of PLA, Chengdu Sichuan 610011, China)

机构地区：[1]第三军大学西南医院放射科介入病房,重庆400038 [2]解放军第452医院放射科,四川成都610011

出　　处：《局解手术学杂志》2017年第3期201-203,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨CT引导下经皮穿刺腹膜活检对不明原因腹腔积液的诊断价值。方法回顾性分析西南医院2011年5月23日至2016年8月2日常规检查未能明确病因的106例腹腔积液行CT引导下经皮穿刺腹膜活检术患者的临床资料,统计腹膜穿刺活检对诊断腹腔积液的敏感性与特异性,同时收集穿刺活检的并发症,评估穿刺安全性。结果 106例不明原因腹腔积液患者行CT引导下腹膜穿刺活检术,经病理组织学明确诊断有91例,占85.85%,其中恶性60例(56.60%),良性31例(29.25%);非诊断结论组(慢性炎和纤维脂肪组织)15例,占14.15%。CT引导下经皮腹膜穿刺活检术对本研究组人群诊断的敏感性为88.35%,特异度100%,显著优于腹水细胞学及腹水常规、生化等化验。所有患者均未出现严重并发症。结论 CT引导下经皮穿刺腹膜活检对不明原因腹腔积液的确诊率高,是一种安全、有效的诊断方法。Objective To investigate the diagnostic value of CT-guided percutaneous biopsy of peritoneum for unknown ascites. Methods The clinical data of 106 cases of unknown peritoneum in our hospital were collected retrospectively over the past five years （ May 23,2011 to August 2,2016）. The sensitivity and specificity of the percutaneous biopsy of peritoneum in diagnosis of the patients with un- known etiological aseites were evaluated. Complications were collected to evaluate the safety. Results The 106 patients with unknown ascites were performed with CT-guided percutaneaus biopsy of peritoneum. The diagnoses of 91 patients were coniSrmed pathologically, accounted for 85.85% of the total. Among the 91 patients,there were 60 cases （56.60%） of malignant and 31 cases （29.25%） of benign. The other 15 patients had no clinical diagnosis, which accounted for 14.15% of the total. The diagnostic sensitivity and specificity was 88.35% and 100% respectively, which were significantly superior to cytological examination, biochemical markers and other routine analysis. No severe complica- tions were observed in all patients. Conclusion CT-guided pereutaneous biopsy of peritoneum for unknown ascites plays an important instructive role in diagnosis with high accuracy, and it is a safe and effective method.

关 键 词：腹腔积液 CT引导 腹膜活检 经皮穿刺 

分 类 号：R445.3[医药卫生—影像医学与核医学]