超声误诊黄色肉芽肿性胆囊炎18例分析  

Analysis on Ultrasonic Misdiagnosis of 18 Xanthogranulomatous Cholecystitis

作　　者：吴曙军[1] 刘凤娥[1] 陈迎祯[1] 金慧涵[2] 唐伟[3] 

机构地区：[1]无锡市第二人民医院超声科,江苏省无锡市214002 [2]无锡市第二人民医院肝胆外科,江苏省无锡市214002 [3]无锡市第二人民医院病理科,江苏省无锡市214002

出　　处：《中国超声医学杂志》2011年第12期1131-1133,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的通过分析黄色肉芽肿性胆囊炎(xanthogranulomatous cholecystitis,XGC)超声误诊原因,提高对本病的认识。方法回顾性分析术前超声误诊的18例XGC的超声图像特征,包括:胆囊大小、胆囊壁厚度、胆囊壁团块、胆囊结石等情况。结果 18例均合并胆囊结石,其中5例胆囊颈部结石嵌顿,另有5例胆囊充满结石则超声除提示结石外,均未提示有其他异常;8例胆囊壁弥漫性不规则增厚,超声提示为一般性炎症改变;5例胆囊壁上见结节状肿块,超声均提示胆囊癌可能。结论 XGC在超声图像上虽无特异性表现,但在胆囊颈部发现有结石嵌顿时,若再有胆囊底部胆囊壁弥漫性不规则增厚或有结节状肿块,在考虑胆囊癌的同时,也应考虑患XGC的可能。Objective To improve the understanding of xanthogranulomatous cholecystitis（XGC） by analyzing ultrasonic misdiagnosis of XGC. Methods The sonographic features of 18 XGC misdiagnosised preoperatively were analyzed retrospectively. The features included the size of gallbladder, the thickness of the gallbladder wall, the mass of the gallbladder wall, and the gallbladder stone. Results All 18 cases were complicated with gallstone, 5 of them were with stone incarcerated in neck of gallbladder, and 5 with gallbladder full of stones but without other abnormality. Among all the 18 cases, 8 with diffuse irregular thickening gallbladder wall were diagnosised as inflammation by ultrasound, 5 cases with nodosity mass were diagnosised as carcinoma of gallbladder. Conclusions Although there were no direct sonographic features of XGC, we should consider the possibility of XGC more than carcinoma of gallbladder when there were stone incarcerated in neck of gallbladder complicated with diffuse irregular thickening or nodosity mass on gallbladder wall.

关 键 词：黄色肉芽肿性胆囊炎 超声 诊断 

分 类 号：R657.4[医药卫生—外科学]