資源描述:
《超聲引導(dǎo)下穿刺活檢診斷小兒肝母細(xì)胞瘤》由會(huì)員上傳分享,免費(fèi)在線閱讀,更多相關(guān)內(nèi)容在行業(yè)資料-天天文庫。
1、·142·中華醫(yī)學(xué)超聲雜志(電子版)2012年2月第9卷第2期ChinJMedUltrasound(ElectronicEdition),F(xiàn)ebruary2012,Vol9,No.2·腹部超聲影像學(xué)·超聲引導(dǎo)下穿刺活檢診斷小兒肝母細(xì)胞瘤顧勝利朱云開【摘要】目的探討超聲引導(dǎo)下穿刺活檢在小兒肝母細(xì)胞瘤診斷中的應(yīng)用價(jià)值。方法對(duì)2008年1月至2010年12月上海交通大學(xué)醫(yī)學(xué)院附屬新華醫(yī)院收治的19例小兒肝臟腫塊進(jìn)行超聲檢查,根據(jù)聲像圖特點(diǎn)在超聲引導(dǎo)下對(duì)肝臟腫塊進(jìn)行穿刺活檢病理組織學(xué)檢查。結(jié)果19例小兒肝臟腫塊巨大,為74mm×63mm×68mm~105mm×
2、83mm×87mm,平均(89.9±8.3)mm,位于肝右葉14例,同時(shí)累及肝左右葉5例;肝內(nèi)腫瘤多呈單個(gè)球形(12例)或分葉狀融合的實(shí)性腫塊(7例);邊界清,回聲多不均勻(等回聲6例,低回聲3例,強(qiáng)回聲5例,混合回聲5例,8例伴有鈣化,6例伴有出血壞死);腫瘤周邊肝實(shí)質(zhì)正常。超聲引導(dǎo)下腫塊穿刺獲取病變組織均為一次成功(19/19),無并發(fā)癥發(fā)生。病理分型診斷:胎兒型9例,胚胎型5例,胎兒型與胚胎混合型5例。結(jié)論根據(jù)超聲聲像圖特點(diǎn),在超聲引導(dǎo)對(duì)小兒肝臟腫塊進(jìn)行穿刺活檢安全有效,可對(duì)小兒肝母細(xì)胞瘤作出明確診斷,對(duì)指導(dǎo)小兒肝母細(xì)胞瘤的臨床手術(shù)和治療有重要應(yīng)
3、用價(jià)值?!娟P(guān)鍵詞】超聲檢查;肝母細(xì)胞瘤;活檢Clinicalvalueofultrasound-guidedcoreneedlebiopsyindiagnosisofhepatoblastomainchildrenGUSheng-li,ZHUYun-kai.DepartmentofUltrasound,XinhuaHospitalAffiliatedtoShanghaiJiaotongUniversitySchoolofMedicine,Shanghai200092,China【Abstract】ObjectiveToevaluatethevalueo
4、fultrasoundguidedcoreneedlebiopsyindiagnosisofhepatoblastomainchildren.MethodsAtotalof19childrenwithlivermasseswereunderwentultrasonographybetweenJanuary2008andDecember2010.Meanwhile,ultrasoundguidedcoreneedlebiopsywasperformedforpathologicaltissuesacquirement.ResultsThesizeofli
5、vermasseswasintherangefrom74mm×63mm×68mmto105mm×83mm×87mm,themeandiameterwas89.9±8.3mm.Among19childrenwithlivermasses,14caseslocatedonrightliverlobe,and5caseslocatedonbothrightandleftliverlobes;12casesweresimplespheroid,while7caseswerelobular,circumscribed,inhomogeneousecho(6cas
6、esofisoechoicpattern,3casesofhypoechoicpattern,5casesofhyperechoicpattern,5casesofmixedechopattern,8caseswithcalcifications,6caseswithnecrosis).Thelivertissuearoundthetumorwasnormal.Allchildrenwereperformedultrasoundguidedcoreneedlebiopsy.Theprocedureofpuncturewassuccessfulinall
7、children(19/19),nocomplicationwashappened.Accordingtopathologystaging,9caseswerebaby’stype,5caseswereembryotype,5caseswerehybridtype.ConclusionHepatoblastomacouldbediagnosedaccordingtoultrasonographyappearanceandultrasoundguidedcoreneedlebiopsy.Ultrasoundguidedcoreneedlebiopsyis
8、asafeandreliablemethodforthediagnosisoflivermas