胆囊息肉样病变超声与CT增强扫描的综合诊断  

作　　者：李富 林伟 林丽燕 罗红 钟文滨 袁少青 

机构地区：[1]广东东莞市道滘医院超声科,523176 [2]广西壮族自治区容县都峤山医院,537500 [3]东莞市道滘医院妇产科,523176 [4]东莞市道滘医院放射科,523176

出　　处：《中国社区医师（医学专业）》2012年第23期195-197,共3页

基　　金：东莞市科技局立项(NO:2010105150186)

摘　　要：目的:探讨超声、CT增强扫描对胆囊息肉样病变的综合诊断价值。方法:收集80例经手术病理证实为胆囊息肉样病变(包括胆固醇息肉、炎性息肉、厚壁性胆囊炎、胆囊腺肌症、胆囊腺瘤、胆囊腺癌、小胆囊癌)患者的影像资料。术前均进行了超声、CT增强检查。结果:80例胆囊息肉样病变,超声、CT增强扫描全部显示恶性15例,超声确诊12例,确诊率为80.0%(12/15),漏诊3例;CT增强确诊14例,确诊率为93.3%(14/15),漏诊1例。良性65例,超声确诊55例,确诊率为84.6%(55/65),2例良性病变误诊为恶性;CT增强确诊43例,确诊率为66.2%(43/65),1例良性病变误诊为恶性。结论:超声和CT增强检查均能有效检出胆囊息肉样病变;CT增强扫描鉴别肿瘤性息肉优于超声,而超声对良性胆囊息肉样病变的病理分型明显优于CT增强扫描,二者联合应用对胆囊息肉样病变的诊断更可靠。Objective: To evaluate the value of the combination of Ultrasound examination and contrast-enhanced CT scans in the diagnosis of polypoid lesions of the gallbladder.Methods: Collection of 80 cases proved by operation and pathology were polypoid lesions of the gallbladder(including cholesterol polypus,inflammatory polypus,thick wall cholecystitis,adenomyomatosis of gall-bladder,gallbladder adenoma,adenocarcinoma of the gallbladder,gallbladder cancer) image data of a patient.Preoperative were evaluated by Ultrasound examination and CT enhanced scan.Results: In 80 patients with polypoid lesions of the gallbladder,All foci were detected by Ultrasound examination and contrast-enhanced CT scan.Malignant accounted for 15 cases,Ultrasound diagnosed in 12 patients,qualitative accuracy 80%(12 /15),3 cases were misdiagnosed;Enhanced CT diagnosed in 14 patients,qualitative accuracy 93.3%(14 /15),1 cases were misdiagnosed.Benign accounted for 65 cases,Ultrasound diagnosed 55 cases,qualitative accuracy 84.6%(55 /65),In 2 patients with benign lesions misdiagnosed as malignant;Enhanced CT diagnosed 43 cases,qualitative accuracy 66.2%(43 /65),In 1 patients with benign lesions misdiagnosed as malignant.Conclusion: Ultrasound examination and enhanced CT scan were effective in detecting polypoid lesions of gallbladder;Enhanced CT scan in differential neoplastic polypus is better than Ultrasound,Ultrasound in benign polypoid lesions of the gallbladder pathological type was significantly better than that of CT enhancement scanning,two combined application on polypoid lesions of the gallbladder diagnosis more reliable.

关 键 词：胆囊息肉样病变 X线计算机超声 

分 类 号：R735.8[医药卫生—肿瘤]