摘要
目的 比较胆道钳夹与毛刷活检的诊断敏感率 ,探索胆道疾病病理学检查新途径。方法 连续 92例阻塞性黄疸接受经皮肝穿胆道造影 (PTC)和经皮肝穿胆道引流 (PTCD)治疗。PTCD过程中 ,影像监测下经皮经肝胆道穿刺 ,向胆道内引入活检钳和毛刷对梗阻段钳夹和毛刷活检 ,行组织病理学和细胞检查。结果 92例钳夹活检患者 90例成功获得组织块 ,技术成功率 97.8% (90 92 )。钳夹活检敏感率较毛刷活检敏感率高 (88.0 %比 76 .2 % ,χ2 =4 .2 5 1,P =0 .0 39)。结论 PTC下胆道钳夹活检操作简单 ,创伤小 ,敏感度高 ,是一种值得推广的胆道病理学诊断新途径 ,毛刷活检在胆管癌的诊断方面也具有较高的应用价值。
Objective To compare the sensitivity between forceps biopsy and brushing, and to explore a feasible approach to pathological diagnosis of the obstructive jaundice.Methods 92 consecutive patients with obstructive jaundice underwent transluminal foreceps biopsy and brushing during percutaneous transhepatic cholangiography and percutaneous transhepatic cholangiodrainage. The technique was performed through an preexisting percutaneous transhepatic tract with multiple specimens obtained after passing the forceps biopsy or brush into a 8-French sheath. Finally the specimens were fixed with formalin for pathologic or cytologic diagnosis. Results The histopathologic diagnosis was acquired in 81 out of 92 patients with forceps biopsy reaching the successful rate of 97.83%. Sensitivity of forceps biopsy in 92 patients was higher than that of brush in 84 patients(88.04% vs 76.19%,χ 2=4.251,P=<0.05). Conclusions Percutaneous transhepatic cholangiobiopsy is a simple technique with minimal invasion, high sensitivity and worthy to be used spread extensively. Percutaneous transluminal brush cytology is also an useful method for establishing a diagnosis of cholangiocarcinoma.
出处
《介入放射学杂志》
CSCD
2004年第6期536-539,共4页
Journal of Interventional Radiology
关键词
活检
钳夹
胆道造影
诊断
阻塞性黄疸
敏感率
经皮穿刺
治疗
对比研究
经皮肝穿
Percutaneous transhepatic cholangiography
Obstructive jaundice
Bile-ducts neoplasm
Bile-ducts biopsy
Histopathology
