超声对结核性腹膜炎的诊断价值

The Value of ultrasound on tuberculous peritonitis

目的探讨结核性腹膜炎的超声声像图特点和诊断价值。方法对69例经临床、超声介入活检、腹腔镜和手术病理证实的结核性腹膜炎患者采用低频与高频超声分别对腹腔病变、腹膜和大网膜进行扫查,同时应用三维超声对腹膜及腹腔病变进行观察,并对声像图结果进行分析。结果腹水型32例(46.37%),团块型14例(20.28%),混合型23例(33.33%)。超声诊断正确64例,误诊3例,漏诊2例,超声诊断符合率92.75%,误漏诊率7.25%;其中低频超声适合对腹腔病变腹水及团块的诊断;高频超声对腹膜及大网膜病变诊断准确率较高;三维超声从多角度观察腹腔获得病变整体形态及分布特征,增加了诊断信息量。结论应用不同频率超声与三维成像对结核性腹膜炎进行检查,诊断符合率可达92.75%,说明超声对结核性腹膜炎的诊断具有重要的临床应用价值,而且超声检查操作简便,重复性好,尤其对临床早期治疗具有非常重要的意义。

Objective To evaluate the sonographic features and diagnostic value of tuberculous peritonitis with ultrasound. Methods 69 patients with tuberculous peritonitis were diagnosed with low- and high- frequency and 3D ultrasound and proved comprehensively with clinical antituberculotic treatment, interventional ultrasound biopsy and postoperation pathology. Results Of the 69 patients, 32 cases （46.37%） were ascites, 14 cases （20.28%） were gobbets, and 23 cases （33.33 %） were mixture. The accuracy rate of diagnosis was 92.75% （64/69）. The misdiagnosis rate was 4.35% （3/69）. The missed diagnosis rate was 2.90% （2/69）. Conclusions Tuberculous peritonitis can be diagnosed and differential diagnosed using low-and high- frequency and 3D ultrasound, which may be the best selection for the diagnosis of tuberculous peritonitis,