实时超声造影对胆囊良恶性病变鉴别诊断的价值  

Value of SonoVue-enhanced grey scale ultrasonography for differential diagnosis of benign and malignant neoplasms of the gallbladder

作　　者：袁海霞[1] 王文平[1] 丁红[1] 王敏荣[2] 黄备建[1] 季正标[1] 魏瑞雪[1] 

机构地区：[1]复旦大学附属中山医院超声科,上海200032 [2]浙江省海宁市人民医院超声科

出　　处：《中华超声影像学杂志》2007年第5期412-415,共4页Chinese Journal of Ultrasonography

摘　　要：目的 探讨实时灰阶谐波超声造影技术在胆囊良恶性病变鉴别诊断中的价值。方法 73例经手术病理证实的病变，其中包括胆固醇性息肉25例，胆囊炎7例，腺肌瘤样增生5例，腺瘤6例，胆囊附壁结石7例，胆囊癌23例。观察病灶开始增强时间（t1），达峰时间（t2）及病灶回声低于肝实质时间（t5），并比较不同时相胆囊病灶与肝实质回声强弱。结果 7例始终未出现增强的病变病理证实为胆囊附壁结石或胆泥。其余66例胆囊病变均增强。增强的66例病变中，良性病变组的t3明显晚于恶性组（P＜0．05）；良性组在延迟期病灶回声低于肝实质回声的百分数18．6％（8／43）明显低于恶性组的95．7％（22／23）。若用延迟期病灶回声低于同期肝实质回声作为诊断胆囊恶性肿瘤的指标，其敏感度、特异度及诊断准确率分别为95．7％（22／23），84．0％（42／50）和87．7％（64／73）。结论 灰阶谐波超声造影在鉴别胆囊良恶性病变方面有重要价值。Objective To evaluate the value of SonoVue-enhanced grey scale ultrasonography for differential diagnosis of gallbladder neoplasms. Methods Seventy-three cases underwent SonoVue-enhanced ultrasonography, including 25 cholesterol polypoids, 7 inflammatory diseases, 5 adenomyomas, 6 adenomas, 7 calculuses and 23 carcinomas of the gallbladder. The time of initial enhancement （t1）, peak enhancement （t2）, and the initial decrease （t3） were analyzed according to the digital video of real time ultrasonography. The enhancement intensity in the lesions was compared with that of liver parenchyma in different phases. Results No microbubble signals appeared in seven calculuses of gallbladder. Enhancement appeared in the other 66 cases, t3 was significantly （ P〈0.05） long in benign lesions. The percentage of hypoechogenic lesions during the delayed phase was significantly lower in benign group （18.6%） than that in malignant ones（95.7%）. If hypoechogenicity in the delayed phase was considered as malignancy, the sensitivity, diagnostic specificity and accuracy was 95.7% （22/23）, 84.0% （ 42/50 ） and 87. 7% （ 64/73 ）, respectively. Conclusions SonoVue-enhanced grey scale ultrasonography has an important value in differential diagnosis of gallbladder neoplasms.

关 键 词：超声检查 造影剂 胆囊疾病 

分 类 号：R686[医药卫生—骨科学]