高频超声检查对胸壁结核性脓肿的诊断价值

Diagnostic value of high-frequency ultrasonography in chest wall tuberculosis abscess

目的比较胸壁结核性脓肿高频超声与CT表现,探讨高频超声检查对胸壁结核性脓肿的诊断价值。方法回顾性分析2014年11月至2017年5月在杭州市红十字会医院就诊并经手术及病理证实的35例胸壁结核性脓肿患者。所有患者均行高频超声检查及CT平扫检查。采用χ~2检验比较本组35例胸壁结核性脓肿患者高频超声检查及CT检查结果。结果 35例胸壁结核性脓肿,高频超声检查与CT均能100%检出;高频超声显示病变肋骨17根,CT显示肋骨病变15根;超声显示死骨5例,CT显示3例,差异均无统计学意义。超声显示肋骨骨皮质毛糙3根,CT显示1根,差异无统计学意义;超声显示骨质增粗2根,CT显示10根,CT检出率高于超声检查[45.5%(10/22)vs 11.8%(2/17)],且差异有统计学意义(χ~2=6.13,P<0.05);超声显示骨质中断12根,CT显示11根,差异无统计学意义;在病变肋骨中断范围<0.1 cm中,超声显示2根,多于CT的1根,但差异无统计学意义。结论与CT检查比较,高频超声检查能显示胸壁结核性脓肿及肋骨病变,可作为胸壁结核的重要影像学诊断方法。

Objective To compare the characteristics of high-frequency ultrasonography with CT in chest wall tuberculosis, and to explore the diagnostic value of high-frequency ultrasound in chest wall tuberculosis abscess. Methods Retrospective analysis was performed on 35 patients with chest wall tuberculous abscess from November 2014 to may 2017, who were admitted to Hangzhou Red Cross hospital. All case were confirmed by surgery and pathology, and all patients were performed ultrasound and chest CT scan. The Chi square test was uesed to compare the results of high-frequency ultrasound and CT examination in 35 patients with tuberculous abscess of chest wall. Results High-frequency ultrasonography and CT were both 100% sensitive to the 35 cases of chest wall tuberculous abscess. High-frequency ultrasonography showed rib lesions in 17 cases, while CT showed rib lesions in 15 cases. Ultrasonography showed dead bone in 5 cases, while CT showed dead bone in 3 cases, the difference was not statistically significant. The ultrasonography showed the cortical roughness of ribs in 3 cases, while the CT showed that in 1 case, the difference was not statistically significant. The ultrasonography showed the thickened rib in 2 cases, while the CT showed that in 10 cases, the CT detection rate was higher than the ultrasound examinations with significant difference. Ultrasonography showed rib fractures in 12 cases, while CT showed that in 11 cases, the difference was not statistically significant. In the cases of rib lesion 〈0.1 cm, ultrasound identified 2 cases, while CT identified only 1 case, but the difference was not statistically significant. Conclusion Compared with CT, high-frequency ultrasonography can show tuberculous abscess and rib lesions, which can be used as an important imaging diagnostic method for chest wall tuberculosis.