CT引导下经皮穿刺腹膜活检对不明原因腹腔积液的诊断价值

Clinical value of CT-guided percutaneous biopsy of peritoneum in diagnosis of patients with unknown ascites

目的探讨CT引导下经皮穿刺腹膜活检对不明原因腹腔积液的诊断价值。方法回顾性分析西南医院2011年5月23日至2016年8月2日常规检查未能明确病因的106例腹腔积液行CT引导下经皮穿刺腹膜活检术患者的临床资料,统计腹膜穿刺活检对诊断腹腔积液的敏感性与特异性,同时收集穿刺活检的并发症,评估穿刺安全性。结果 106例不明原因腹腔积液患者行CT引导下腹膜穿刺活检术,经病理组织学明确诊断有91例,占85.85%,其中恶性60例(56.60%),良性31例(29.25%);非诊断结论组(慢性炎和纤维脂肪组织)15例,占14.15%。CT引导下经皮腹膜穿刺活检术对本研究组人群诊断的敏感性为88.35%,特异度100%,显著优于腹水细胞学及腹水常规、生化等化验。所有患者均未出现严重并发症。结论 CT引导下经皮穿刺腹膜活检对不明原因腹腔积液的确诊率高,是一种安全、有效的诊断方法。

Objective To investigate the diagnostic value of CT-guided percutaneous biopsy of peritoneum for unknown ascites. Methods The clinical data of 106 cases of unknown peritoneum in our hospital were collected retrospectively over the past five years （ May 23,2011 to August 2,2016）. The sensitivity and specificity of the percutaneous biopsy of peritoneum in diagnosis of the patients with un- known etiological aseites were evaluated. Complications were collected to evaluate the safety. Results The 106 patients with unknown ascites were performed with CT-guided percutaneaus biopsy of peritoneum. The diagnoses of 91 patients were coniSrmed pathologically, accounted for 85.85% of the total. Among the 91 patients,there were 60 cases （56.60%） of malignant and 31 cases （29.25%） of benign. The other 15 patients had no clinical diagnosis, which accounted for 14.15% of the total. The diagnostic sensitivity and specificity was 88.35% and 100% respectively, which were significantly superior to cytological examination, biochemical markers and other routine analysis. No severe complica- tions were observed in all patients. Conclusion CT-guided pereutaneous biopsy of peritoneum for unknown ascites plays an important instructive role in diagnosis with high accuracy, and it is a safe and effective method.