罗-阿氏窦诊断胆囊腺肌增生症的价值  

Importance of the Rokitansky-Aschoff Sinuses in Diagnosing Adenomyomatosis of Gallbladder

作　　者：盛敏[1] 陈正光[2] 高萍[1] 姜英[3] 张立仁[1] 金征宇[1] 

机构地区：[1]中国医学科学院北京协和医院放射科,北京100730 [2]中国医学科学院北京协和医院放射科科,北京100730 [3]中国医学科学院北京协和医院病理科,北京100730

出　　处：《实用放射学杂志》2008年第5期639-641,共3页Journal of Practical Radiology

摘　　要：目的探讨罗-阿氏窦(RA窦)在影像学上诊断胆囊腺肌增生症(GBA)的作用与限度。方法26例术前均行B超检查,6例行CT检查。比较经组织学证实的GBA患者的影像学和病理学资料,结合文献复习,分析RA窦的影像学基础及其GBA影像学诊断依据。结果本组术前明确诊断GBA仅3例,诊断率为11.5%,其中2例由CT诊断,1例由B超诊断,其特征表现为在增厚变形的胆囊壁上显现RA窦,并突入肌层,但对判定其是否已癌变无特异性。结论RA窦可以出现在GBA和胆囊癌的胆囊壁上,也可能出现在正常的胆囊壁上,正确选择影像学检查方法和仔细观察RA窦形态特征是GBA早期诊断和治疗的关键。Objective To assess the value and the limitation of the Rokitansky - Aschoff sinuses （ RA sinus） in diagnosis of adenomyomatosis of gallbladder （ GBA）. Methods Twenty - six patients with surgically proven GBA were retrospectively reviewed. All of cases were undergone ultrasound and 6 cases were undergone CT scan before operation. The imaging and histological features of RA sinus in GBA were compared and analyzed. Results Only 3 cases were diagnosed as GBA before operation in this group, the accuracy was 11.5%. Among 3 cases, two of them were diagnosed by CT,and the other one by ultrasound. The images showed the intramural cyst （ RA sinus） clearly within thickened gallbladder wall, but could make sure whether it had been transformed to malignant tumor. Conclusion RA sinus may be detected either in GBA and adenocarcinoma of gallbladder or in normal gallbladder wall. The key point of imaging diagnosis is to choose correctly the way of imaging technology and the characteristics of RA sinus can be described clearly.

关 键 词：罗-阿氏窦 腺肌瘤 体层摄影术 X线计算机 磁共振成像 超声 

分 类 号：R575.6[医药卫生—消化系统] R814.42[医药卫生—内科学]