超声引导经皮穿刺活检在大网膜病变诊断中的价值

目的 探讨超声引导经皮穿刺活检在大网膜病变诊断中的价值。方法63例腹胀和（或）腹水原因待查患者，超声显示大网膜增厚，用BARD自动活检枪和18G活检针行超声引导下经皮穿刺活检。结果大网膜病变穿刺活检成功率100％，取材满意率92．1％。60例获得明确病理诊断，包括结核病变21例，转移性腺癌31例，恶性间皮瘤3例，腹膜假性黏液瘤4例，原发渗出性淋巴瘤1例；3例因组织标本量少未提示病理诊断。本组诊断准确性95．2％，无严重并发症发生。结论超声引导经皮穿刺大网膜病变活检是一种简便、安全、有效、诊断准确性高的方法，可使一些不明原因的腹胀腹水患者获得明确的病理诊断，为临床治疗提供依据。

Diagnostic role of ultrasound guided percutaneous biopsy in omental lesions

Objective To evaluate the role and safety of ultrasound guided percutaneous biopsy in omental lesions. Methods Sixty three patients with ascites and/or abdominal distention without clear reasons underwent ultrasound guided percutaneous biopsy in BARD auto-biopsy gun and 18 guage biopsy needle, after ultrasonography showed the abnormalities of greater omentum. Results The successful rate of percutaneous biopsy was 100%, with the 92.1% of satisfactional rate of the tissue samples. Conclusive histopathologic diagnosis was made on 60 cases, including 21 cases with tuberculosis, 31 cases with metastatic adenocarcinoma, 3 cases with malignant mesothelioma, 4 cases with pseudomyxoma peritonei and 1 case of primary effusional lymphoma. Only 3 cases failed to get clear pathologic diagnosis, because of less tissue sample. The diagnostic accuracy was 95.2%, no serious complications occured. Conclusions Percutaneous biopsy with ultrasound guidance can be used briefly, safely and efficiently to diagnose omental lesions. It makes some patients with unknown etiogenic ascites and/or abdominal distention get accurate diagnosis, and offers a remarkable help for clinical therapy.