高频超声鉴别合并胆胰管阻塞的胰头肿块型胰腺炎和胰头癌的价值  

Differential diagnosis between chronic pancreatitis with mass in pancreas head and carcinoma of pancreas head by high-frequency ultrasound

作　　者：孙凤芝 李永杰 李东 

机构地区：[1]聊城市传染病医院超声科,山东聊城252056

出　　处：《临床荟萃》2009年第4期290-292,共3页Clinical Focus

摘　　要：目的探讨高频超声对合并胰胆管阻塞的胰头肿块型胰腺炎和胰头癌的鉴别诊断价值。方法对病理证实的16例胰头肿块型胰腺炎(胰腺炎组)与38例胰头癌(胰头癌组)进行高频超声检查,对比观察两组二维声像图和彩色多普勒声像特征及其间的差异。结果病变的形态、边界、内部回声后方衰减及血流信号分级,两组间差异无统计学意义(P>0.05)。胆总管胰腺段和近端主胰管,胰腺炎组出现"鼠尾征",检出率分别为93.8%(15/16)和100%(16/16),胰头癌组则以"截断征"为特征,检出率分别为94.7%(36/38)和97.4%(37/38),两种征象在两组间差异具有统计学意义(P<0.001)。结论腹部高频超声可清晰显示胰头病变部位及病变周围的细微变化,在胰头肿块型胰腺炎与胰头癌鉴别诊断中是一种可行且有效的检查方法。Objective To investigate the differential diagnosis value between chronic pancreatitis with mass in pancreas head and carcinoma of pancreas head by comprehensive analysis of multiple parameters on high-frequency ultrasound. Methods The manifestations or characteristics on high-frequency ultrasound were analyzed in 16 cases with chronic pancreatitis with mass in pancreas head and 38 cases with carcinoma of pancreas head. Results There was no difference between two groups at the appearance, magnitude, internal echo, active return loss and haemodynamics respectively （ P 〉0.05）. In the adjacent tissue,the ratio of the rat-tail sign showing in the inferior common bile duct in the chronic pancreatitis group was 93.8% （15/16）,while it was 100%（16/16） in the subterminal pancreatic duct,the ratio of the cut off sign in the inferior common bile duct in the carcinoma of pancreas head group was 94.7% （36/38）, while it was 97.4%（37/38） in the subterminal pancreatic duct. As for the two signs, the differences between two groups were statistically significant （P 〈 0. 001）. Conclusion High-frequency ultrasound is a valuable and new technique in differentiating chronic pancreatitis with mass in pancreas head and carcinoma of pancreas head.

关 键 词：胰腺炎 慢性 胰腺肿瘤 超声检查 

分 类 号：R735.9[医药卫生—肿瘤]