超声引导下胃肠道病变穿刺活检

目的探讨超声引导下胃肠道病变穿刺活检的临床应用价值。方法对30例经肠镜、CT或MRI检查发现但未能明确诊断的胃肠道病变(胃来源2例、小肠4例、结肠4例、直肠18例、肛管2例)进行超声引导下穿刺活检,总结活检方法、成功率及相关并发症。结果 30例中,经腹穿刺10例,经直肠穿刺16例,经肛周穿刺4例。标本取材满意29例,目标病灶穿刺成功率96.67%(29/30)。29例取材成功者中,活检病理提示良性病变11例,恶性病变18例,其中7例手术切除,6例活检病理与手术病理相符,1例活检病理不能鉴别未分化癌与间皮瘤,手术病理证实为未分化癌,其余病例与随访结果相符。穿刺后随访1~18个月,所有患者均未出现穿刺相关并发症。结论对于胃肠道病变,尤其是内镜活检困难或无效的病变,超声引导穿刺活检是安全、有效的诊断方法。

Clinical application of ultrasound-guided biopsy of gastrointestinal lesions

Objective To explore the value of ultrasound-guided biopsy for gastrointestinal lesions. Methods Ultrasound-guided biopsy was performed in 30 patients who were discovered gastrointestinal lesions by CT, MRI or endoscope but could not draw conclusive diagnosis. Lesions located at stomach in 2, small bowel in 4, colon in 4, rectum in 18, and anus in 2, respectively. The success and complication rate was summarized. Results In 30 patients, 10 patients underwent transabdominal biopsy, 16 patients by transrectal biopsy and 4 patients by transanal biopsy. Specimens were adequate for histology in 29 cases (29/30, 96.67%). Of the 29 lesions evaluated, 18 were malignant and 11 were benign. Seven patients received surgical resection and the surgical pathology of 6 patients was consistent with their biopsy pathology. One biopsy pathology could not distinguish undifferentiated carcinoma from mesothelioma, and his surgical pathology finally confirmed undifferentiated carcinoma. The rest of cases were consistent with follow-up results. The results of 1-18 months follow-up showed that no patient had complication. Conclusion Ultrasound-guided biopsy of gastrointestinal lesions is potentially safe and effective method, especially when conventional endoscopic diagnosis is not feasible or unsuccessful.