28例腱鞘结核高频超声诊断分析

Diagnostic analysis of 28 cases of tendon sheath tuberculosis by High-frequency ultrasound

目的探讨腱鞘结核的超声表现特点,为正确及时诊断该病提供依据。方法选择病理检查确诊的28例腱鞘结核为研究对象,结合临床病史,回顾性分析其超声表现特征。结果 3例为囊性病变,无血流信号,肌腱无受侵;25例低弱回声或不均质回声团块,肌腱包绕其中,有粘连、受侵,其中20例病灶内见少许血流信号,5例病灶内见丰富血流信号。超声准确诊断18例,漏诊10例,符合率64.3%。结论腱鞘结核的超声表现复杂多变,缺乏特征性,极易漏诊,应结合临床病史,对包绕、侵蚀肌腱的病变提高警惕。

Objective To investigate the ultrasonic imaging features of tendon sheath tuberculosis and provide experience to diagnose the disease correctly and timely. Methods 28 cases that pathologically diagnosed of tendon sheath tuberculosis were adopted. Ultrasonic features were analyzed retrospectively combined with clinical history. Results Three cases of cystic lesions without tendon invasion showed no blood flow signal. 25 cases presented as low weak echo or heterogeneous echogenie masses, in which tendons were involved, in some cases adhesion and invasion of tendons occurred. There were 20 cases of the total showed slight blood flow signal, the other five cases showed rich blood flow signal. 18 cases had been exactly diagnosed by ultrasound, 10 cases had been missed. According to pathological result, the diagnostic accuracy of ultrasound is 64. 3%. Conclusion The ultrasound image of the tendon sheath tuberculosis were complex and changeable. It was extremely prone to misdiagnose for lack of characteristic. So we should learn the clinical history carefully and pay attention to the lesions surrounding and/or invading the tendons.