壶腹部良恶性病变患者双重超声造影的特征分析  

The characteristic analysis of double contrast ultrasound in 120 patients with ampulla benign and malignant lesions

作　　者：朱冬梅 刘刚[1] 朱林 刘学彬 杨姣 庞露 罗浩 ZHU Dongmei;LIU Gang;ZHU Lin;LIU Xuebin;YANG Jiao;PANG Lu;LUO Hao(Department of Ultrasound Diagnosis,Nanchong Central Hospital,The Second Clinical Medical College of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]南充市中心医院·川北医学院第二临床医学院超声科

出　　处：《西部医学》2019年第12期1930-1934,共5页Medical Journal of West China

基　　金：四川省中医药管理局科研项目(2018QN062);四川省卫健委科技项目(2018PJ149)

摘　　要：目的探讨壶腹部双重超声造影(DCEUS)对壶腹部病变的诊断及鉴别诊断价值。方法回顾性分析2016年1月~2018年6月在我院接受DCEUS检查并经术后病理证实的120例壶腹部良恶性病变患者的临床资料、灰阶超声特征及超声造影增强特点。结果120例病变中,良性组41例,其中壶腹部炎性狭窄10例,胰头部囊腺瘤3例,胆总管下段结石28例;恶性组79例,其中壶腹癌20例,胆总管下段癌26例,胰头癌30例,十二指肠癌3例。良性组发病年龄小于恶性组(P<0.05)。两病灶边界、形态及主胰管扩张方面比较差异有统计学意义(P<0.05);良恶性组边界清楚、形态规则、主胰管扩张比例比较差异有统计学意义(P<0.05)。超声造影显示两组动脉期呈高增强、低增强、无增强比例比较差异有统计学意义(P<0.05);两组静脉期呈等增强、低增强、无增强比例比较差异有统计学意义(P<0.05);两组增强与消退不均匀比例比较差异均有统计学意义(P<0.05);DCEUS诊断壶腹部区域病变的ROC曲线下面积(AUC)、灵敏度、特异度、阳性预测值、阴性预测值分别为0.981、96.2%、100%、100%、93.2%。结论DCEUS能清晰灵敏地显示壶腹部良恶性病变的灰阶超声特征及局部微循环灌注特点,对壶腹部良恶性病变有着较高的诊断及鉴别诊断价值。Objective To analyze the gray scale ultrasonography features and contrast enhanced imaging manifestations of 120 patients with ampulla lesions by double contrast enhanced ultrasound(DCEUS),and judge the diagnostic value of DCEUS for ampulla lesions.Methods Retrospective analysis of clinical data of 120 patients with ampulla benign and malignant lesions received DCEUS from January 2016 to June 2018 in our hospital was performed.The clinical data and characteristics of conventional gray-scale ultrasound and contrast enhancement ultrasound imaging were analyzed.Results The pathological results of 120 cases showed that 79 cases were malignant lesions and 41 cases benign lesions.Among these malignant lesions,there were 20 cases of ampulla carcinoma,26 cases of lower common bile duct carcinoma,30 cases of pancreatic head carcinoma and 3 cases of duodenal carcinoma.Among these benign lesions,there were 10 cases of ampullary inflammatory stenosis,3 cases of pancreatic head cystic adenoma and 28 cases of lower choledocholithiasis.The age of benign group was younger than that of the malignant group(P<0.05).Gray scale ultrasonography showed that there were significant differences between the two groups in terms of lesion boundaries,morphology,and main pancreatic duct expansion(P<0.05).The proportions of clear boundaries,regular morphological and main pancreatic duct expansion in benign and malignant group were 68.3%,73.2%,14.6%and 15.2%,27.8%,59.5%,respectively.The area under ROC curve(AUC),sensitivity,specificity,positive predictive value and negative predictive value of DCEUS in diagnosing ampulla lesions were 0.981,96.2%,100%,100%and 93.2%,respectively.Conclusion DCEUS could clearly and sensitively display the characteristics of ampulla benign and malignant lesions and local microcirculation perfusion and has a high diagnostic value and differential diagnostic value for ampulla benign and malignant lesions.

关 键 词：双重超声造影 壶腹周围癌 超声诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]