超声造影对胆囊内实性占位病变的鉴别诊断价值  

Value of contrast-enhanced ultrasound in differential diagnosis of solid occupying lesion in gall bladder

作　　者：刘学[1] 姚延峰[1] 杜瑛[1] 张东竹[1] 

机构地区：[1]重庆医科大学附属永川医院超声科,重庆市永川区402160

出　　处：《临床超声医学杂志》2014年第3期167-170,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨超声造影鉴别诊断胆囊内实性占位病变的临床价值。方法选取我院接受常规超声和超声造影检查的35例胆囊占位病变患者,分析其超声造影的表现,并比较常规超声及超声造影在其鉴别诊断中的价值。结果超声造影下胆泥主要表现为无增强。胆囊息肉及胆囊腺肌增生症增强早期呈高增强分别占62.5%及50.0%,晚期增强模式保持不变。胆囊癌早期呈高增强占75.0%,晚期消退为低增强。常规超声和超声造影对胆囊实性占位病变的诊断符合率分别为57.1%、82.9%,两者比较差异有统计学意义(P=0.004)。超声造影在胆囊实性占位病变中对胆囊胆泥诊断价值最高(Youden指数为1.00)。结论与常规超声比较,超声造影能显著提高胆囊内实性占位性病变的诊断准确率。Objective To evaluate the clinic value of contrast-enhanced ultrasound （CEUS） in differential diagnosis of solid occupying lesions in gall bladder. Methods Thirty-five patients with occupying lesions in gall bladder who had taken baseline ultrasound （BUS） and contrast-enhanced ultrasound （CEUS） examination were studied. The image features of all the lesions on CEUS were analyzed. Then the value in differential diagnosis was compared between BUS and CEUS. Results In CEUS, the biliary sludge showed non-enhancement. Hyper-enhancement was found in 62.5% of gallbladder polyp and 50.0% of adenomyomatosis in the early phase and continued to be hyper-enhanced in the late phase. Hyper-enhancement was found in 75.0% of gallbladder carcinoma and turned to be hypo-enhancement in the late phase. The diagnostic accuracy of CEUS in solid occupying lesions in gall bladder was 82.9%, which was significantly different from that of BUS （57.1%, P=0.004）. CEUS had the best diagnostic value for the biliary sludge formation （Youden index was 1.00）. Conclusion Compared with BUS, CEUS can significantly improves the diagnosis rate of solid occupying lesion in gall bladder.

关 键 词：超声检查 造影剂 胆囊 实性占位病变 

分 类 号：R735.8[医药卫生—肿瘤] R445.1[医药卫生—临床医学]