Abstract:

Objective To investigate the application and clinical value of contrast-enhanced ultrasound in puncture biopsy of patients with chest wall tuberculosis (TB). Methods Between April 2017 and June 2019, 78 patients with suspected TB of chest wall were admitted to Integrated Chinese and Western Medicine Hospital of Zhejiang Province,among them 31 were male patients, 47 were female cases, ages ranged from 18 to 67 years, mean age (33.8±4.7) years. According to the time control method, patients were divided into two groups: Group A of 42 cases, the suspected chest wall TB patients admitted between April 2017 and May 2018 to our hospital, on the basis of the results of ultrasound scanning, ultrasound-guided histological puncture biopsy was performed and line puncture pumping fluid were performed in the anechoic area; Group B of 36 cases, the suspected chest wall TB patients admitted between January 2018 and June 2019 to our hospital. Contrast-enhanced ultrasonography (CEUS) was performed first, and ultrasound-guided piercing or histological biopsy was performed according to the findings of CEUS. The ultrasound manifestations and pathological results of all patients were retrospectively analyzed. Tissue samples of the two groups of patients were sent for pathologic examination, at the same time for MTB, ordinary culture and GeneXpert MTB/RIF examination. Results Group A: the success rate with piercing out pus was 77.4% (24/31) in 42 cases, the success rate for obtaining biopsy tissue samples was 88.1% (37/42);Group B: the success rate with piercing out pus was 100.0% (23/23) in 36 cases, the success rate for obtaining biopsy tissue samples was 100.0% (36/36). Group B was obviously improved (χ ² values were 4.132 and 2.814, respectively, P values were 0.001 and 0.003). The positive rate of two groups of patients with all disease diagnosis was 83.3% (35/42, 33 cases diagnosed as chest wall TB) and 100.0% (36/36, 34 cases diagnosed as chest wall TB) respectively, group B was significantly higher than group A (χ ²=4.713, P=0.001). Conclusion The clinical application value of contrast-enhanced ultrasound in biopsy patients with suspected chest wall TB is important to improve the diagnostic positive rate.

Key words: Tuberculosis,pleural, Thoracic wall, Ultrasonography,interventional, Biopsy,needle, Comparative study, Contrast-enhanced ultrasound