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超声引导下软组织异物的定位和取出。

US-guided Localization and Removal of Soft-Tissue Foreign Bodies.

机构信息

From the Department of Radiology, Donostia University Hospital, Donostia-San Sebastian, Spain (J.L.d.C.), and Department of Radiology, Basurto University Hospital, Ave Montevideo 18, 48013 Bilbao, Spain (I.A., R.M.Z., M.S., I.K.).

出版信息

Radiographics. 2020 Jul-Aug;40(4):1188-1195. doi: 10.1148/rg.2020200001. Epub 2020 May 29.

Abstract

US-guided foreign body removal is a nonsurgical highly effective technique used to manage symptomatic foreign bodies and should be considered as a first-line treatment procedure. The authors describe a technique used for US detection and US-guided removal of various types of foreign bodies and discuss the efficacy of the procedure. Soft-tissue foreign bodies can result from accidents or medical procedures, and they are a relatively frequent reason that patients obtain medical consultation. Foreign body objects include vegetal, metallic, and glass objects, and they may be medical devices such as contraceptive implants. Frequently, physical examination is not sensitive enough to detect the presence of a foreign body, and imaging is necessary. US has demonstrated high specificity and moderate sensitivity for detection of foreign bodies, and it has the advantage of depicting all types of materials. Thus, US has become the imaging technique of choice for evaluating suspected foreign bodies. Although the US features are dependent on the foreign body type and shape, all foreign bodies are echogenic and frequently demonstrate posterior shadowing or reverberation artifact. US has an added value in that it can be used to plan the removal of a foreign body and also guide the entire percutaneous removal procedure. Through a small incision in the skin, just wide enough for the foreign body to pass through, surgical forceps can be inserted and directed under US guidance to reach the foreign body and remove it. The effectiveness of US-guided percutaneous removal can be near 100%. RSNA, 2020.

摘要

US 引导下的异物取出术是一种非手术的高效技术,用于治疗有症状的异物,应被视为一线治疗程序。作者描述了一种用于 US 检测和 US 引导下取出各种类型异物的技术,并讨论了该程序的疗效。软组织异物可由意外或医疗程序引起,是患者寻求医疗咨询的一个相对常见的原因。异物包括植物性、金属性和玻璃性物体,也可能是避孕植入物等医疗器械。通常情况下,体格检查对检测异物的存在不够敏感,需要进行影像学检查。US 对异物的检测具有很高的特异性和中等的敏感性,并且具有描绘所有类型材料的优势。因此,US 已成为评估疑似异物的首选影像学技术。尽管 US 的特征取决于异物的类型和形状,但所有异物都是超声增强的,并且经常表现出后方阴影或反射伪影。US 的一个附加价值在于它可用于规划异物的取出,也可引导整个经皮取出过程。通过皮肤的小切口,只需足够宽让异物通过,就可以插入手术钳,并在 US 引导下将其引导至异物处并取出。US 引导下经皮取出的有效性接近 100%。RSNA,2020 年。

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