摘要
目的 探讨超声引导经皮网膜穿刺活检术诊断肝硬化和非肝硬化患者中网膜增厚的安全性和有效性.方法 选取本院行超声引导经皮网膜穿刺活检术的 87 例患者资料,其中肝硬化患者为A组 31 例,非肝硬化患者为B组56 例.首先通过CT扫描明确增厚网膜的范围及大致位置,之后行超声引导经皮网膜穿刺活检术获取组织标本进行组织病理学诊断.通过统计学分析比较两组患者的敏感性、特异性、阳性及阴性预测值以及诊断准确率.结果 组织病理学诊断结果显示A组中肉芽肿性炎 13 例,恶性病变 7 例,非特异性炎症 11 例;B组中肉芽肿性炎 15 例,恶性病变 33例,非特异性炎症 8 例.超声引导经皮网膜穿刺活检术A组患者的敏感性、特异性、阳性预测值、阴性预测值及诊断准确率分别为:95.0%、100%、100%、91.6%和 96.7%;B组患者分别为:97.9%、100%、100%、88.8%和 98.2%.结论 超声引导经皮网膜活检术可简便、安全、有效地诊断肝硬化及非肝硬化引起的网膜病变,迅速取得明确的病理诊断,为临床治疗提供指导依据.
Abstract
Objective To evaluate the safety and efficacy of ultrasound-guided(US-guided)omental biopsy in patients with liver cirrhosis and compare these with the noncirrhotic patients.Methods We retrospectively studied the US-guided omental bi-opsies.Patients with biopsy-proven liver cirrhosis(n=31)who underwent omental biopsy were included in Group A,and pa-tients without any features of the chronic liver disease(n=56)were included in Group B.Imaging classification of omental thick-ening by CT scanning,US-guided percutaneous omental biopsy was performed to obtain tissue specimens for histopathological di-agnosis.The sensitivity,specificity,positive and negative predictive values and diagnostic accuracy of the two groups were com-pared by statistical analysis.Results Histopathological results showed that there were 13 cases of granulomatous inflammation,7 cases of malignant pathology and 11 cases of non-specific inflammation in Group A;and that there were 15 cases of granuloma-tous inflammation,33 cases of malignant pathology and 8 cases of non-specific inflammation in Group B.The sensitivity,speci-ficity,positive predictive value,negative predictive value,diagnostic accuracy in Group A were 95%,100%,100%,91.6%and 96.7%,respectively,and these were 97.9%,100%,100%,88.8%and 98.2%in Group B,respectively.Conclusion US-guided percutaneous omental biopsy can easily,safely and effectively diagnose cirrhosis and non-cirrhosis-induced omental le-sions,obtain a clear pathological diagnosis quickly,and provide guidance for clinical treatment.
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