超声引导下穿刺活检在增生性肌炎诊断中的应用  

Diagnostic value of ultrasound-guided biopsy in patients with proliferative myositis

作　　者：田爱红[1] 刘肖莲[1] 陈慧敏[2] 许家亮[3] 张庆林[4] TIAN Ai-hong;LIU Xiao-lian;CHEN Hui-min;XU Jia-liang;ZHANG Qing-lin(B Ultrasonic Room1.Department of Pharmacy;Department of Radiology;Department of Orthopaedics4,Dongguan Qiaotou Hospital,Dongguan 523538,Guangdong,CHINA)

机构地区：[1]东莞市桥头医院B超室,广东东莞523538 [2]东莞市桥头医院药剂科,广东东莞523538 [3]东莞市桥头医院放射科,广东东莞523538 [4]东莞市桥头医院骨科,广东东莞523538

出　　处：《海南医学》2018年第18期2571-2573,共3页Hainan Medical Journal

基　　金：广东省东莞市卫生和计划生育局资助项目(编号:201650715001480)

摘　　要：目的探讨超声引导下穿刺活检对增生性肌炎的临床诊断价值。方法回顾性分析2014年2月至2017年12月在东莞市桥头医院行超声引导下穿刺活检的12例增生性肌炎患者的临床资料,总结患者的临床病理表现。结果 12例患者均表现为肌层内不均质回声区,病灶内显示正常肌束走行。彩色多普勒(CDFI)显示病灶内血流丰富。12例患者中穿刺成功11例,1例患者因肿块小取材量少诊断不清,转手术切除病理送检,穿刺成功率为91.67%。所有患者均未发生不良反应。穿刺活检病理示"棋盘状"、"片状"分布的大量梭形细胞以及神经节样细胞,排列疏松,细胞胞浆较丰富,核无明显异型及分裂象。免疫组化分析结果显示:波形蛋白(Vimentin)强阳性、CD99阳性、Ki-76阳性。结论超声引导下穿刺活检法对增生性肌炎操作方便、快捷,穿刺成功率高,可作为常规诊断方法在临床上推广应用。Objective To evaluate the value of ultrasound-guided biopsy for proliferative myositis. Methods The clinical data of 12 cases of hyperplastic myositis undergoing ultrasound-guided biopsy in Dongguan Qiaotou Hospital from February 2014 to December 2017 were analyzed retrospectively, and the pathological findings of the patients were summarized. Results All the 12 patients showed heterogeneous echopattern in muscle layer and normal muscle walking in lesions. Color Doppler flow imaging（CDFI） showed rich blood flow in the lesion. In 12 cases, 11 cases were successfully diagnosed by biopsy, and 1 case was not because the sample collected from the small lump was not enough（which was later analyzed by pathological examination）, with the successful rate of 91.67%. All patients had no adverse reactions. Biopsy showed a large number of spindle cells and ganglion like cells distributed in the＂chessboard＂and＂flaky＂pattern（loosely arranged）, with rich cytoplasm and no obvious heterotypic and mitotic images in the nucleus. Immunohistochemical analysis showed Vimentin（strong positive）, CD99（positive） and Ki-76（positive）. Conclusion Ultrasound-guided biopsy is accurate and convenient for the diagnosis of myositis. It has high success rate of puncture and can be used as a routine diagnostic method in clinical practice.

关 键 词：超声引导下穿刺活检 超声检查 增生性肌炎 病理 

分 类 号：R685.2[医药卫生—骨科学]