子宫良性病变经腹超声导引病理活检的可行性研究

The feasibility of trans-abdominal biopsy by ultrasound guiding during uterine artery embolization for benign diseases of uterus

目的探讨经腹超声导引病理穿刺活检诊断子宫良性病变的可行性。方法对62例诊断为子宫肌瘤和子宫腺肌症患者行经腹B超引导下穿刺病理活检。对于单发病灶,行病灶多点穿刺活检。对于多发病灶,行各病灶的多点穿刺活检。诊断主要根据临床症状和超声、磁共振检查。比较病理活检与临床诊断的符合率,观察并发症。结果60例患者成功进行穿刺病理活检,穿刺成功率为96.8%(60/62),病理诊断率为100%(60/60),诊断子宫肌瘤52例,子宫腺肌症8例。2例临床诊断为子宫肌瘤穿刺不成功。活检过程无不良反应。结论子宫肌瘤和子宫腺肌症的经腹穿刺病理活检是可行和安全的。

Objective To investigate the feasibility of trans-abdominal biopsy by ultrasound guiding during uterine artery embolization （UAE） for uterine fibroids and adenomyosis. Methods Trans-abdominal biopsies by ultrasound guiding were performed in 62 cases of uterine fibroids or adenomyosis diagnosed pre-UAE. Muhi-points in focus were punctured in single lesion and multi-points in every focus of multiple lesions were punctured. The diagnosis before UAE was made according to clinical symptoms, pelvic ultrasound and pelvic magnetic resonance imaging（MRl）. The pathological diagnosis by biopsy was comparative to its clinical diagnosis before biopsy. The complications were also observed. Results Biopsies were performed successfully in 60 cases with pathological examination, including 52 uterine fibroids and 8 adenomyosis cases. The clinical diagnosis of uterine fibroids or adenomyosis was coincident with the pathology exccpt 2 cases of fibroids diagnosed before biopsy were failed to puncture. Conclusion Trans-abdominal biopsy by ultrasound guiding in uterine artery embolization for benign diseases of uterus is safe and feasible. （J Intervent Radiol, 2006, 15： 466-468 ）