The diagnostic value of ultrasound guided aspiration biopsy in unexplained refractory ascites / 解放军医学杂志

ABSTRACT

Objective To explore the diagnostic value of ultrasound-guided aspiration biopsy in patients with unexplained refractory ascites.Methods The data of 25 cases of unexplained refractory ascites were retrospectively analyzed.For all the cases the diagnosis was based on the examination of contrast enhanced CT or ultrasound.Ultrasound-guided aspiration biopsy of locally thickened peritoneum or ti- ny masses in ascites was performed.Reults Ultrosonographic image of all cases was as follows.10 cases,with locally thickened peritone- um,were isoechoic or hypoechioc.In 2 of 10 cases contrast enhanced ultrasound examination was done,and the images were characterized by an obvious enhancement in arterial phase and quick wash-out in veinous phase.In 7 cases there was irregularly thickened peritoneum, accompanied by adhesion and caking of the omentum.Cystic formation in ascites or in peritoneum was found in 5 cases.Solid mass in asci- tes was found in 2 cases,and splenomegaly and enlarged pancreas were found in 1 case.Ultrasound-gnided aspiration biopsy was perfomed in all the patients.Among them 4 patients were operated on later.Histopathologic examination showed malignency in 20 patients.Among them,malignant peritoneal mesothelioma accoumted for 6 cases,pancreatic cystoadenoma in 2,mestastic adenocarcinoma in 9,malignant schwannoma in 1,lymphoma in 1,and histiocytoma in 1 patient.In the other 5 cases the lesion was benign,and it was verified by follow- up for about 6 months.Among them there were 3 cases of tuberculosis,1 case of inflammatory disease and 1 case of retroperitonesl fibro- sis.Conclusion Ultrasound-guided aspiration biopsy is valuable in the diagnosis of locally thickened peritoneum and tiny mass in ascitic fluid,and is valuable for diagnosis of unexplained refractory ascites.