超声诊断胆囊管螺旋型变异的临床价值  

The clinical value of diagnosing cystic duct varation of spiral-type by ultrasound

作　　者：李恂[1] 董磊[2] 戴萍[1] 钱孝纲[1] 邵明焕[1] 

机构地区：[1]江苏省常熟市第二人民医院,215500 [2]第二军医大学

出　　处：《上海医学影像》2006年第3期223-224,共2页Shanghai Medical Imaging

摘　　要：目的探索超声诊断胆囊管螺旋型变异及其对降低术中胆管损伤发生率的重要价值。方法收集2005年4月～2006年2月行胆囊切除术患者242例,在超声常规检查肝胆的同时,观察胆囊颈和肝总管的解剖关系、胆囊颈长轴与胆总管长轴形成夹角的开口方向。胆囊颈位于肝总管的前方、胆囊颈长轴与胆总管长轴形成夹角的开口向下呈倒“V”字型诊断为胆囊管前螺旋型变异,胆囊颈位于肝总管的后方、胆囊颈长轴与胆总管长轴形成夹角的开口向上呈“V”字型诊断为胆囊管后螺旋型变异,并与手术结果对照。结果超声诊断胆囊管螺旋型变异的正确指数为0.645、一致率为96.7%、阳性预测值为54.5%。超声诊断胆囊管螺旋型变异前后胆囊管损伤的发生率分别为70.6%和44.4%,两者间差异有显著性(P<0.05〉。结论术前超声诊断胆囊管走行是降低术中胆道损伤发生率的重要方法。Objective To discuss the value of ultrasound in the diagnosis eystic duct variation of spiral-type, and in degrading the incidence of duct danage in operation.Methods We collected 242patients who undewent cholecystectomy.Ultrasonographic features of anatomic relation between gallbladder neck and common bepatic duct ,and direction of angle between long axis of gallbladder neck and common bike duct wrer evaluated .When gallbladder neck located anterion of common hepatic duck and the angle between long axis of gallbladder neck and commom bile duct was downward ,gallbladder duct variation of fore spiral-type was diagnosed.When gallbladder neck located postioeor of common hepatic duct and the angle between long axis of gallbladder neck and common bile duct was upward cystic duct variation of meta spiral-type was digenoosed.Results The correct index.concordance and positive predoctive value of diagnosing spiral-trpe cystic duct by altrasond was 0.645,96.7%and 54.5% respectively.The incidence of duct damage was sigificantly lower with the diagnosis of cystic duet variation of piral-type by ultrasound when compared to that of before（P〈0.05）.Conclusion ultrasomic diagnosing variation of cystic duet is an important method to cut down the incidence of biliary ducts damage.

关 键 词：胆囊管 解剖变异 超声诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]