超声造影引导下经皮胃肠道黏膜下肿瘤穿刺活检的应用  

Application of Contrast-Enhanced Ultrasound Guided Biopsy in Percutaneous Gastrointestinal Submucosal Tumor

作　　者：马丽园[1] 席海银 姜韬[3] 马乾凤[1] 米成嵘[1] 杨光飞[1] MA Liyuan;XI Haiyin;JIANG Tao;MA Qianfeng;MI Chengrong;YANG Guangfei(Department of Ultrasound,General Hospital of Ningxia Medical University,Yinchuan 750004,China;不详)

机构地区：[1]宁夏医科大学总医院超声科,宁夏银川750004 [2]宁夏回族自治区中医医院功能科B超室,宁夏银川750004 [3]宁夏医科大学总医院结直肠外科,宁夏银川750004

出　　处：《中国医学影像学杂志》2022年第8期809-813,815,共6页Chinese Journal of Medical Imaging

基　　金：宁夏自然科学基金(2020AAC03401,2020AAC03402)。

摘　　要：目的 探讨超声造影(CEUS)引导下经皮胃肠道黏膜下肿瘤穿刺活检的应用价值。资料与方法 回顾性分析2018年1月—2021年1月在宁夏医科大学总医院超声科就诊的79例胃肠道黏膜下肿瘤行超声引导穿刺活检术的病例,根据穿刺引导方式的不同,分为常规超声组22例、CEUS组57例。CEUS组观察并记录肿瘤内造影剂增强模式及造影剂未灌注区显示情况,选择造影增强区域实施穿刺。比较两组穿刺取材成功率、病理诊断符合率、未灌注区显示情况及术后并发症。结果 CEUS组CEUS检查液化坏死区显示率为57.9%(33/57),高于常规超声检查显示率19.3%(11/57),差异有统计学意义(χ^(2)=17.91,P<0.001);常规超声组和CEUS组穿刺活检取材成功率分别为69.6%、93.3%,病理诊断符合率分别为68.2%、100%,两组差异均有统计学意义(χ^(2)=17.58,P<0.001;χ^(2)=19.90,P<0.001);穿刺术后患者无明显严重并发症。结论 CEUS能清晰地显示胃肠道黏膜下肿瘤内液化坏死区,精准引导穿刺提高了穿刺取材的成功率和病例诊断符合率,对术前定性诊断、指导治疗方案的选择具有一定的临床应用价值。Purpose To explore the value of contrast-enhanced ultrasound(CEUS) guided percutaneous gastrointestinal submucosal tumor biopsy. Materials and Methods A total of 79 patients received ultrasound guided percutaneous gastrointestinal submucosal tumors biopsy were gathered from January 2018 to January 2021 at Department of Ultrasound of General Hospital of Ningxia Medical University. Depending on punctures, 22 cases and 57 cases were examined under ultrasonographic guidance and CEUS, respectively. The contrast-enhanced area was selected for puncture and the parameters of enhanced patterns of contrast agent in tumor. The success rate of puncture, pathological diagnosis rate, no contrast agent perfusion status and postoperative complications were analyzed. Results In CEUS group, the display rate of the liquefactive necrosis area for CEUS in tumor was 57.9%(33/57), which was significant higher than conventional ultrasound in tumor 19.3%(11/57), the difference was statistically significant(χ^(2)=17.91, P<0.001). The success rate of conventional ultrasound and CEUS biopsy was 69.6% and 93.3%, respectively. The coincidence rate of pathological diagnosis was 68.2% and 100%, respectively. The difference between the two groups was statistically significant(χ^(2)=17.58,P<0.001;χ^(2)=19.90, P<0.001). No severity complications were observed in all patients. Conclusion CEUS accurately estimates the area of necrosis which can prove success ratio of puncture and coincidence rate of pathological diagnosis. Furthermore, it provides strong support for the value of precise acquire pathological information, clear preoperative diagnosis and guide standard therapy.

关 键 词：胃肠道 胃肠道间质瘤 淋巴瘤 超声检查 介入性 造影剂 病理学 临床 

分 类 号：R735[医药卫生—肿瘤] R445.1[医药卫生—临床医学]