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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 investigate the value of contrast-enhanced ultrasound in the diagnosis of abdominal tuberculosis abscess biopsy, and to improve the diagnostic accuracy of biopsy specimens obtained by biopsy. Methods From September 2013 to November 2015, 66 patients were hospitalized in Department of Tuberculosis and Tuberculosis, Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine, 24 cases were male and 42 cases were female. They were divided into two groups: 23 cases in group A and 8 cases in males , 15 females, and the patients with abdominal mass who were hospitalized from September 2013 to February 2014, underwent ultrasound-guided biopsy with informed consent and signed. Group B, 43 patients, 16 males and 27 females, were in 2014 February - November 2015 hospitalized patients with abdominal mass, informed consent and signed after the first line of abdominal ultrasound contrast, according to the choice of ultrasound biopsy biopsy area and draw the target area: a part of the abdominal mass enhancement contrast agent filled Enhanced area + small part of no enhancement area; 2 lumps completely enhanced contrast agent enhanced area. Posterior ultrasound guided biopsy. All data using SPSS 13.0 statistical software package for statistical analysis, count data using χ2 test, P <0.05 for the difference was statistically significant. Results Twenty-three patients in group A had metastatic carcinoma and one hematoma, the others were abdominal wall tuberculosis. The positive rate of biopsy was 47.8% (11/23) and the positive rate of pathological findings was 82.6% (19/23). B Group 43 patients: metastatic carcinoma in 2 cases, abdominal wall sebaceous cyst with infection in 1 case, the remaining abdominal wall tuberculosis, ultrasound imaging in all patients prompted abdominal full enhancement in 8 cases, partial abdominal mass enhancement in 35 cases, biopsy drawing complete rate 90.7% (39/43), the positive rate of pathological diagnosis was 100% (43/43). The positive rate of biopsy specimens and pathological diagnosis in group B was significantly higher than that in group A (χ2 = 15.00 and 5.20, P <0.05 respectively) . Conclusion Contrast-enhanced ultrasound (CEUS) was used in the biopsy of abscess in abdomen tuberculosis, which could significantly improve the positive rate of biopsy specimens and pathological diagnosis.