不同病因所致胆囊壁增厚的超声图像特征及其临床意义  

Sonographic characteristics of thickened gall bladder wall by varied causes and their clinical significance

作　　者：薛利芳[1] 王雪[1] 赵艺超[1] 张珊珊[1] 

机构地区：[1]北京大学人民医院超声科,100044

出　　处：《中华全科医师杂志》2010年第3期177-180,共4页Chinese Journal of General Practitioners

摘　　要：目的 探讨不同病因所致胆囊壁增厚的超声图像特征及其意义。方法选择2007年1月至2008年12月我院住院胆囊壁增厚患者127例，依据临床资料和部分术后病理结果分为：急性胆囊炎组33例，慢性胆囊炎组24例，心、肝、肾疾病组40例，其他原因组30例。选择2008年3月至12月我院88例无胆囊疾患史及其他能够引起胆囊壁增厚的健康体检者，按照是否禁食分为空腹对照组52例和餐后对照组36例。均测量比较其胆囊壁厚度并分析其声像图特征。结果空腹对照组胆囊壁厚（2．4±0．3）mm，餐后对照组（3．4±0．2）mm，急性胆囊炎组（5．6±0．4）mm，慢性胆囊炎组（4．2±0．3）mm，心、肝、肾疾病组（8．6±0．5）mm，其他原因组（3．4±0．3）mm。餐后对照组及各病变组胆囊壁厚与空腹对照组比较，差异均有统计学意义（P〈0．05或P〈0．01）。慢性胆囊炎组与急性胆囊炎组及心、肝、肾疾病组比较，差异均有统计学意义（P〈0．01）；与其他原因组比较，差异无统计学意义（P〉0．05）。急性胆囊炎超声声像图以内膜改变为重，心、肝、肾疾病胆囊壁呈规则均匀的双边征，这与慢性胆囊炎引起的胆囊壁增厚较易鉴别。而其他原因组部分声像图特点与慢性胆囊炎有类似之处。结论胆囊壁增厚是一种非特异性病理表现，可由胆囊本身及胆囊外疾病引起。超声显示胆囊壁增厚时，应结合临床资料和声像图特点，鉴别引起胆囊壁增厚的原因。Objective To study characteristics of ultrasonic scanning of thickened wall of the gall bladder by varied causes and their clinical significance. Methods Totally, 127 patients with thickened wall of the gall bladder were selected from the People＇s Hospital, Beijing University during January 2007 to December 2008, including 33 cases of acute cholecystitis, 24 cases of chronic eholeeystitis, 40 cases of heart, liver and kidney diseases, and 30 cases with other diseases, according to their clinical data and surgically pathological examinations. Another 88 healthy persons who visited the hospital during March to December 2008 for regular physical cheeks-up, without history of gall bladder illness and other illness that could cause thickening of wall of the gall bladder, were selected as controls, including 52 fasting and 36 non-fasting controls. Thickness of wall of the gall bladder were measured for each of them, and characteristics of their ultrasonographs were analyzed. Results Thickness of wall of the gall bladder was （2.4± 0. 3） mm in fasting controls, statistically significant different from those of non-fasting controls [ （3.4± 0. 2） mm ], those with acute cholecystitis [ （5.6 ±0. 4） mm ], those with chronic cholecystitis [ （4. 2 ±0. 3） mini, those with heart, liver and kidney diseases [ （8.6 ±0. 5） mini, and those with other diseases [ （3.4 ± 0. 3 ）mm ], respectively （ P 〈 0. 05 or P 〈 0. 01 ）. There was statistically significant difference in thickness of wall of the gall bladder between those with chronic cholecystitis and those with acute cholecystitis, those with heart, liver and kidney diseases （P 〈 0. 01 ） , but no significant difference in it was found between those with chronic cholecystitis and those with other diseases （P 〉 0. 05 ） . Ultrasonographs showed more severe changes in the intima of wall of the gall bladder in those with acute cholecystitis and double layer thickened in those with heart, liver and kidney diseases, which could easily be di

关 键 词：胆囊 超声检查 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]