Pre-operative Localization of a Chest Wall Needle by Ultrasonography: A Case Report

利用超音波進行手術前定位胸壁內的針：病例報告

陳穎萱(Jannie Ying-Syuan Chen) ； 江東懋(Tung-Mao Chiang) ； 吳怡成(Yi-Cheng Wu) ； 黃兆宜(Chao-Yi Huang) ； 許智欽(Chih-Chin Hsu) ； 蔡文鐘(Wen-Chung Tsai)

《台灣復健醫學雜誌》 37卷3期 (2009/09) Pp. 201-206

https://doi.org/10.6315/2009.37(3)07

摘要

高解析度超音波(ultrasound)是定位觸摸不到的異物(foreign body)最有方便且精準的工具。一位二十一歲女性，進行例行性健康檢查時，在胸壁上發現有一輻射線不能透過的線狀異物。異物的位置在左後胸壁中，距第八胸椎棘突四至五公分，形狀似一根針(needle)。由於高度懷疑胸壁中有一根針，有必要藉由手術移除。因沒有任何壓痛點及可觸摸到的腫塊，定位精確的開刀位置有其困難。此時應用高解析度的超音波進行術前精準的定位，結果發現位在皮下脂肪層和肌肉層的交界面清楚呈現一線性，且具高度回音的物體。經過量測，針長約1.94公分、深度在皮下0.62公分。由於應用超音波進行精準的定位並標記，之後隨即進行手術順利將胸壁中的針取出。

關鍵字

超音波 ； 異物 ； 針

並列摘要

High-resolution ultrasonography is a useful tool for the localization of non-palpable soft-tissue foreign bodies. A 21-year-old female underwent a routine health examination, during which chest radiography revealed a radio-opaque linear foreign body. The foreign body was located within left posterior chest wall, 4 to 5 cm lateral to the T8 spinous process. The shape indicated a needle. The possible presence of a needle in the chest wall meant that an operation to remove it was imperative. There was no tender point or palpable mass present on the chest wall and, consequently, there was difficulty determining the precise location of the object. Using high-resolution linear-array ultrasound, a linear hyperechoic focus was clearly demonstrated at the junction of the subcutaneous layer and the muscle layer. The needle was measured as 1.94 cm in length and was located 0.62 cm beneath the skin. After precise ultrasonographic localization and marking of the object's location, the needle was successfully removed immediately by surgery.

並列關鍵字

ultrasound ； foreign body ； needle