经皮穿刺含坏死胸部病变超声造影与增强CT引导比较  

Contrast-enhanced ultrasound-guided versus enhanced CT-guided percutaneous puncture of chest lesions containing necrotic components

作　　者：周青[1] 董亮[2] ZHOU Qing;DONG Liang(Department of Obstetrics and Gynecology Ultrasound,Central Hospital of Shengli Oil Field,Dongying,Shandong Province 257034,China)

机构地区：[1]胜利油田中心医院妇产超声科,山东东营257034 [2]胜利油田中心医院超声检查科,山东东营257034

出　　处：《介入放射学杂志》2020年第12期1249-1253,共5页Journal of Interventional Radiology

摘　　要：目的比较超声造影与增强CT引导下经皮穿刺活检在穿刺成功率、病理诊断符合率、并发症发生率的差异并分析其相关影响因素。方法收集2015年1月至2018年6月增强CT显示含坏死组织胸部病变162例,病变内含有无增强区,且病变与皮肤之间无骨、无肺气遮挡,具有良好的透声窗。将病变分为超声造影组76例(超声实时造影引导下穿刺)和增强CT组86例(结合术前增强CT并在CT引导下穿刺),比较两组穿刺成功率、病理诊断符合率及并发症发生率。结果超声造影组穿刺成功率97.4%(74/76)、病理诊断符合率94.7%(72/76)高于增强CT组的87.2%(75/86)、79.1%(68/86),并发症发生率2.6%(2/76)低于增强CT组的16.3%(14/86),差异均有统计学意义(P均<0.05)。结论超声造影引导经皮穿刺活检定性诊断含坏死胸部病变较增强CT引导下更加安全、有效。Objective To compare the success rate of puncturing, coincidence rate of pathological diagnosis, incidence of complications of contrast-enhanced ultrasound-guided percutaneous puncture with those of enhanced CT-guided percutaneous puncture in diagnosing chest lesions containing necrotic components, and to analyze its influencing factors. Methods A total of 162 patients with chest lesions containing enhanced CT-proved necrotic components, who were admitted to authors’ hospital during the period from January 2015 to June 2018, were enrolled in this study. There was no enhancement area within the lesion. Between the lesion and the thoracic skin, there was no bone or lung air to obstruct ultrasound examination. And ideal ultrasound transmission window could be easily found on the body surface. The patients were divided into contrast-enhanced ultrasound group(n=76, receiving real-time contrast-enhanced ultrasound-guided puncture) and enhanced CT group(n=86, receiving CT-guided puncture based on preoperative enhanced CT images). The success rate of puncture, coincidence rate of pathological diagnosis and incidence of complications were compared between the two groups. Results In the contrast-enhanced ultrasound group the success rate of puncture and the coincidence rate of pathological diagnosis were 97.37%(74/76) and 94.74%(72/76) respectively, which were higher than 87.21%(75/86) and 79.07%(68/86) respectively in the enhanced CT group;in the contrast-enhanced ultrasound group the incidence of complications was 2.63%(2/76), which was lower than 16.28%(14/86) in the enhanced CT group;and all the differences in the above items between the two groups were statistically significant(P<0.05 in all). Conclusion For qualitative diagnosis of chest lesions containing necrotic components by percutaneous biopsy method, contrast-enhanced ultrasound-guided technique is more safe and effective than enhanced CT-guided technique.

关 键 词：超声造影 增强CT 含坏死胸部病变 经皮肺穿刺术 

分 类 号：R256.19[医药卫生—中医内科学]