胆囊小隆起性病变的临床病理学特点与超声诊断的对比  

Correlation between clinicopathological and ultrasonic diagnosis of small protuberant lesions of the gallbladder

作　　者：张毅[1] 张积华[1] 袁梅[1] 郑淑芳[1] 王正滨[1] 

机构地区：[1]青岛大学医学院附属医院健康体检中心超声科,山东省青岛市266003

出　　处：《世界华人消化杂志》2010年第25期2707-2711,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨胆囊小隆起性病变(small apophysis disease of the gallbladder,SADG)的临床病理学特点与超声诊断中的相关性.方法:采用彩色多普勒超声检查的SADG患者753例,并经手术病理证实,对比研究诊断结果,回顾性分析SADG的临床病理特点与超声图像特征的相关性.结果:本组SADG共753例,超声诊断敏感性98.26%,特异性84.42%,准确性89.77%.阳性预测值89.77%,阴性预测值89.61%.其中胆固醇性息肉与临床病理的阳性预测值达92.72%.在合并胆囊炎和胆囊结石两组中,SADG临床病理组织学差异有显著性意义(t=3.417,P<0.05).SADG≤10mm者占92.30%(695/753),其中良性SADG占99.14%(689/695);恶性SADG为0.86%(6/695).SADG>10mm者占7.70%(58/753),其中良性SADG占56.90%(33/58);恶性SADG为43.10%(25/58).良性与恶性息肉的直径差异有非常显著性意义(t=15.381,P<0.01).结论:超声诊断胆固醇性息肉与临床病理的阳性预测值达90%以上,具有较高的临床实用价值,是诊断SADG的首选方法.AIM：To explore the correlation between clinicopathological and ultrasonic diagnosis of small protuberant lesions of the gallbladder（SPLG）.METHODS：Seven hundred and fifty-three patients who were diagnosed with SPLG by abdominal color Doppler ultrasonography and pathological examination were included in our study.The correlation between clinicopathological characteristics and ultrasonic imaging characteristics of SPLG was retrospectively analyzed.RESULTS：For all the 753 patients with SPLG,ultrasonic diagnosis had a sensitivity of 98.26%,a specif icity of 84.42%,an accuracy of 89.77%,a positive predictive value of 89.77%,and a negative predictive value of 89.61%.For the patients with cholesterol polyps,the positive predictive value of ultrasonic diagnosis was more than 92.72%.Between SPLG patients with cholecystitis and gallstones,a significant difference was found in clinicopathological characteristics（t = 3.417,P 0.05）.Of all the SPLG patients,92.30%（695/753） had SPLG with a diameter ≤10 mm,of which 99.14%（689/695） had a benign disease and 0.86%（6/695） had a malignant disease,and 7.70%（58/753） had SPLG with a diameter 10 mm,of which 56.90%（33/58） had a benign disease and 43.10%（25/58） had a malignant disease.A significant difference was noted in the diameter of benign and malignant polyps（t = 15.381,P 0.01）.CONCLUSION：The positive predictive value of ultrasonic diagnosis of cholesterol polyps is more than 90%.Ultrasonic diagnosis has high clinical value and is the f irst choice for the diagnosis of SPLG.

关 键 词：胆囊小隆起性病变 超声诊断 临床病理学 

分 类 号：R445.1[医药卫生—影像医学与核医学]