超声胆道造影技术的初步应用  

Application of contrast-enhanced ultrasonography in biliary tract

作　　者：李颖如[1] 樊静[1] 蒋晓春[1] 苏金媚[1] 

机构地区：[1]浙江金华市中心医院超声诊疗科,金华321000

出　　处：《新医学》2013年第6期382-384,共3页Journal of New Medicine

摘　　要：目的探讨超声胆道造影(USC)新技术在评估胆道梗阻疾病中的应用可行性及其临床价值。方法 31例梗阻性黄疸患者[行经皮肝穿刺胆道引流(PTCD)的患者15例,留置T管的患者16例]经引流管注射SonoVue行USC。以手术、经皮经肝胆管造影(PTC)或T管造影为金标准,分析各类病变的胆管超声造影表现和诊断的准确性。结果 15例PTCD置管患者均清晰显示胆管树结构,16例经T管造影3例梗阻患者可显示胆管树结构,13例下段通畅患者三级胆管未能显示。行USC对胆道梗阻部位和病因诊断的18例患者,与PTC或T管造影对照,符合率均为100%(18/18)。常规超声检查判断胆道梗阻病因的总符合率为61%(11/18),对于下段胆总管梗阻病因的诊断符合率为46%(6/13),两组胆道梗阻病因的总符合率、下段胆总管梗阻病因的诊断符合率比较差异均有统计学意义(χ2=8.69,χ2=9.58,P均﹤0.01)。结论 USC作为一种新的胆管造影方法,简便有效,对于梗阻性胆道疾病的梗阻部位和病因诊断方面,可在一定程度上替代PTC或T管造影,优于常规超声。Objective To evaluate the feasibility and clinical value of ultrasonic eholangiography （USC） in biliary obstruction. Methods Thirty one cases of obstructive jaundice （15 cases treated by percu-taneous transhepatic cholangial drainage （PTCD） and 16 cases with T-tube drainage） were injected with SonoVue from drainage tube and underwent percutaneous transhepatie cholangiography （FFC）. Using surgery, FFC or T-tube cholangiography as golden standard, the manifestations of USC and diagnostic accuracy were an-alyzed. Results Fifteen cases treated by PTCD clearly showed the biliary tree. Among 16 cases with T-tube drainage, 2 cases with obstructive jaundice showed bilialT tree and 13 cases unobstructed in lower segment didn＇t show the 3-grade bile duct. Comparing with PTC or T-tube cholangiography, USC could clearly display the bile duct level and reveal the etiology in all 18 patients with obstructive jaundice （ 100% , 18/18）. Diag-nositic rate via routine ultrasound examination in the cause of bilial7 obstruction rate was 61% （ 11/18 ） , the common bile duct obstruction 46% （6/13）, with statistical significance （X^2 = 8.69, X^2 = 9.58, all P 〈 0. 01 ）. Conclusions As a new and feasible method, USC is comparable to FFC or T-tube cholangiography in disolaving the biliarv tree clearly and evaluating the level and finding the cause of obstructive jaundice.

关 键 词：超声检查 微气泡 黄疸 梗阻性 胆管造影术 

分 类 号：R445.1[医药卫生—影像医学与核医学]