Department of Ultrasound, Shandong Public Health Clinical Center, Shandong University Jinan, Shandong, China.
Department of Ultrasound Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Medicine (Baltimore). 2023 Dec 29;102(52):e36344. doi: 10.1097/MD.0000000000036344.
This study aimed to investigate the diagnostic utility of percutaneous ultrasound-guided needle biopsy conjunction with GeneXpert MTB/RIF for epididymal tuberculosis. A retrospective analysis was conducted on the pathological and laboratory examinations of 20 patients with epididymal lesions undergoing ultrasound guided biopsy at Shandong Public Health Clinical Center. Laboratory examination included acid-fast staining, Mycobacterium tuberculosis culture by BACTEC MGIT 960, and GeneXpert MTB/RIF test. Diagnosis and complications were comprehensively analyzed. Among the 20 patients, 15 had epididymal tuberculosis and 5 had non-epididymal tuberculosis. Ten patients had granulomatous inflammation and necrotic tissues. The sensitivity and specificity of acid-fast staining, Mycobacterium tuberculosis culture, and GeneXpert MTB/RIF for the diagnosis of epididymis tuberculosis were 26.67% and 100.00%, 33.33% and 100.00%, and 86.67% and 100.00%, respectively. The diagnostic value analysis of the 3 detection techniques indicated that the GeneXpert MTB/RIF technique (Kappa = 0.765, Area under the curve (AUC) = 0.933) was superior to Mycobacterium tuberculosis culture (Kappa = 0.200, AUC = 0.667) and acid-fast staining (Kappa = 0.154, AUC = 0.633). Ultrasound-guided percutaneous biopsy is a safe procedure. The GeneXpert MTB/RIF test has high sensitivity, specificity, and superior AUC value, which are of great value in the diagnosis of epididymal tuberculosis and rifampicin resistance detection.
本研究旨在探讨经皮超声引导下针吸活检联合 GeneXpert MTB/RIF 对附睾结核的诊断价值。对山东公卫临床中心经超声引导下活检的 20 例附睾病变患者的病理和实验室检查进行回顾性分析。实验室检查包括抗酸染色、BACTEC MGIT 960 分枝杆菌培养和 GeneXpert MTB/RIF 检测。综合分析诊断和并发症。20 例患者中,15 例为附睾结核,5 例为非附睾结核。10 例患者有肉芽肿性炎症和坏死组织。抗酸染色、分枝杆菌培养和 GeneXpert MTB/RIF 对附睾结核的诊断灵敏度和特异度分别为 26.67%和 100.00%、33.33%和 100.00%、86.67%和 100.00%。3 种检测技术的诊断价值分析表明,GeneXpert MTB/RIF 技术(Kappa=0.765,AUC=0.933)优于分枝杆菌培养(Kappa=0.200,AUC=0.667)和抗酸染色(Kappa=0.154,AUC=0.633)。超声引导下经皮活检是一种安全的操作。GeneXpert MTB/RIF 检测具有较高的灵敏度、特异度和优越的 AUC 值,对附睾结核和利福平耐药检测具有重要价值。