Clinical Studies Of Ultrasound And Related Images In The Diagnosis Of Chest Wall Tuberculosis

Objective:Color doppler ultrasound imaging technology, to check on the clinical diagnosis of chest wall tuberculosis,147cases of patients with lesion sites, analysis of image features, and with computer tomography and chest X-ray diagnosis, color Doppler ultrasound the clinical value of imaging techniques in the diagnosis of chest wall tuberculosis.Methods:1. The application of color Doppler ultrasound scanning of patients with chest wall lesions.2.147cases of patients with chest CT, chest DR examination.3. Statistically Ultrasound diagnosis with chest CT and chest DR diagnosis of the results of comparative analysis of the data using the X2test, P<0.05was considered statistically significant.Results:1. Ultrasonographic features of normal chest wall:the skin was a line like echo, subcutaneous fat as a weak echo of the external intercostal muscle intercostal muscle intercostal muscle showed a continuous bundle hypoechoic, pleural was a line like echo, lung tissue was a strong echo reflection and lung structure can not be displayed. The rib bone plate was smooth and strong echo with the rear with acoustic shadow2. Chest wall tuberculosis ultrasonography:2.1The distribution and size of chest wall tuberculosis:tumor diameter of1.6～8.4cm,1.6～1.9cm in21cases,2.0～4.9cm in68cases,5.0～8.4cm58cases. Lesions in the left anterior chest wall of49cases,12cases of left chest wall, left posterior chest wall five cases, the right anterior chest wall of55cases,18cases of the right chest wall, right after the chest wall in7cases, right shoulder one cases. 2.2Chest wall tuberculosis ultrasonography compared with surgical findings:147cases in accordance with internal echoes were divided into three types:①solid echo type,29cases of chest wall subcutaneous soft tissue and/or the intercostal within the organization solid hypoechoic, surgery and pathologyconfirmed not liquefied caseous lesions and tuberculous granuloma formation,②liquid dark area type,46cases, the performance of echo-free zone, diamond-shaped or irregular shape of the lesion with clear surrounding tissue boundaries, visible dim echo, point-like echoes a sense of movement with the probe pressure, pathologically confirmed as liquefied abscess, caseous necrotic material.③liquid real mixed echoic,72cases, the lesions were round, oval or irregular-shaped liquid solid echo area, District of liquid and solid distinction community is unclear, shape is not fixed, and pathologically confirmed necrosis tuberculosis cheese suppuration and granulation and fibrous tissue hyperplasia coexist.2.3Ultrasound rib involvement,49cases were detected, the performance of the rib bone plate smooth echogenic band discontinuity; detection of the Crab-like "sinus64cases, the performance of the detected lesion within the chest wall soft tissue tortuous tubular strips weak echoes;calcification in38cases, calcification in diameter>0.1cm.3. Chest wall tuberculosis ultrasound diagnosis with chest CT diagnosis:①64cases seen in the Crab-like "sinus ultrasound, CT found29cases (X2=19.27P <0.05); calcification in38cases of ultrasound-visible lesionsCT18cases (X2=8.82, P<0.05), two imaging studies a statistically significant difference.②preoperative ultrasound diagnosis of chest wall tuberculosis,141cases, the CT diagnosis of chest wall tuberculosis (n=138), although the two sets of results, but the difference was not statistically significant (X2=0.63, P>0.05).③CT detection of bone destruction in94cases, ultrasound detected49cases of the two imaging studies a statistically significant difference (X2=27.57, P<0.05).4. Chest wall tuberculosis ultrasound diagnosis and chest X-ray diagnosis:DR failed to preoperative diagnosis, DR findings of86cases of rib destruction, and ultrasound found49cases of the two imaging studies the difference was significant (X2=18.75P<0.05). Conclusions:1.Ultrasound can clearly show the relationship of the chest wall abscess and surrounding organs on the chest wall tuberculosis have very good detection rate and the diagnosis rate2. Ultrasound can provide accurate preoperative lesions spread to the chest depth and scope of the spread of the elimination of clinical lesion significance.3. Advantages of ultrasound, CT, two methods was statistically no difference can be used for the diagnosis of chest wall tuberculosis, but the ultrasound course, distribution of sinus clear display, while its non-invasive, inexpensive, and good repeatability,as an effective way to check the chest wall tuberculosis.