标题：超声引导下穿刺活检在增生性肌炎诊断中的应用

      作者：田爱红 1，刘肖莲 1，陈慧敏 2，许家亮 3，张庆林 4    (东莞市桥头医院Ｂ超室 1、药剂科 2、放射科 3、骨科 4，广东 东莞 523538)

      卷次： 2018年29卷18期

      【摘要】 目的 探讨超声引导下穿刺活检对增生性肌炎的临床诊断价值。方法 回顾性分析2014年2月至2017年12月在东莞市桥头医院行超声引导下穿刺活检的12例增生性肌炎患者的临床资料，总结患者的临床病理表现。结果 12例患者均表现为肌层内不均质回声区，病灶内显示正常肌束走行。彩色多普勒(CDFI)显示病灶内血流丰富。12例患者中穿刺成功11例，1例患者因肿块小取材量少诊断不清，转手术切除病理送检，穿刺成功率为91.67%。所有患者均未发生不良反应。穿刺活检病理示“棋盘状”、“片状”分布的大量梭形细胞以及神经节样细胞，排列疏松，细胞胞浆较丰富，核无明显异型及分裂象。免疫组化分析结果显示：波形蛋白(Vimentin)强阳性、CD99阳性、Ki-76阳性。结论 超声引导下穿刺活检法对增生性肌炎操作方便、快捷，穿刺成功率高，可作为常规诊断方法在临床上推广应用。
      【关键词】 超声引导下穿刺活检；超声检查；增生性肌炎；病理
      【中图分类号】 R685.2 【文献标识码】 A 【文章编号】 1003—6350（2018）18—2571—03

Diagnostic value of ultrasound-guided biopsy in patients with proliferative myositis.
TIAN Ai-hong 1, LIU Xiao-lian 1,CHEN Hui-min 2, XU Jia-liang 3, ZHANG Qing-lin 4. B Ultrasonic Room 1, Department of Pharmacy 2, Department ofRadiology 3, Department of Orthopaedics 4, Dongguan Qiaotou Hospital, Dongguan 523538, Guangdong, CHINA
【Abstract】 Objective To evaluate the value of ultrasound-guided biopsy for proliferative myositis. Methods Theclinical data of 12 cases of hyperplastic myositis undergoing ultrasound-guided biopsy in Dongguan Qiaotou Hospitalfrom February 2014 to December 2017 were analyzed retrospectively, and the pathological findings of the patients weresummarized. Results All the 12 patients showed heterogeneous echopattern in muscle layer and normal muscle walk-ing in lesions. Color Doppler flow imaging (CDFI) showed rich blood flow in the lesion. In 12 cases, 11 cases were suc-cessfully diagnosed by biopsy, and 1 case was not because the sample collected from the small lump was not enough(which was later analyzed by pathological examination), with the successful rate of 91.67%. All patients had no adversereactions. Biopsy showed a large number of spindle cells and ganglion like cells distributed in the“chessboard”and“flaky”pattern (loosely arranged), with rich cytoplasm and no obvious heterotypic and mitotic images in the nucleus. Im-munohistochemical analysis showed Vimentin (strong positive), CD99 (positive) and Ki-76 (positive). Conclusion Ul-trasound-guided biopsy is accurate and convenient for the diagnosis of myositis. It has high success rate of puncture andcan be used as a routine diagnostic method in clinical practice.
      【Key words】 Ultrasound-guided biopsy; Ultrasonography; Proliferative myositis; Pathology·论 著·doi:10.3969/j.issn.1003-6350.2018.18.017基金项目：广东省东莞市卫生和计划生育局资助项目(编号：201650715001480)