胆总管腺瘤的内镜超声表现  

Endoscopic ultrasonographic performance of common bile duct adenomas

作　　者：李焕喜[1] 王震宇[1] 李伟志[1] 张莉[1] Li Huanxi;Wang Zhenyu;Li Weizhi;Zhang Li(Department of Endoscopy Center,Tianjin Nankai Hospital,Tianjin 300100,China)

机构地区：[1]天津市南开医院内镜中心,300100

出　　处：《中华消化内镜杂志》2021年第3期222-225,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨胆总管腺瘤的内镜超声(endoscopic ultrasonography,EUS)下特征性表现。方法回顾性研究2015年1月-2020年1月天津市南开医院收治的经病理证实的15例胆总管腺瘤患者的临床资料,对其EUS特点进行总结分析。结果胆总管腺瘤EUS下表现为均质中等或中低回声软组织团块,边界清晰,动态观察可见腺瘤于胆管内漂浮,但不可移动。15例患者EUS与病理诊断符合14例,诊断符合率为93.3%。1例患者由于胆汁淤积误以为病变可移动而被EUS诊断为胆泥团。1例患者胆总管有2处孤立腺瘤,分别位于胆总管中段及下段,其余均为单发腺瘤。腺瘤位于胆总管下段9处,位于壶腹部4处,位于胆总管上段2处,位于胆总管中段1处;病理为绒毛状腺瘤伴高级别上皮内瘤变7处,局部恶变4处;绒毛管状腺瘤伴高级别上皮内瘤变6处,局部恶变3处;绒毛管状腺瘤伴低级别上皮内瘤变2处;乳头状腺瘤1处。结论EUS有助于胆总管腺瘤的定性诊断,可作为提高胆总管腺瘤诊断准确率的重要技术方法。Objective To investigate the features of common bile duct adenoma under endoscopic ultrasonography(EUS).Methods Clinical data of 15 patients with common bile duct adenomas confirmed by pathology from January 2015 to January 2020 in Tianjin Nankai Hospital were analyzed retrospectively.The patients'EUS features were summarized.Results The common bile duct adenoma was characterized by homogeneous soft tissue mass with medium or low echo and clear boundary,floating in the bile duct with no movement under EUS.EUS diagnosis of 14 out of 15 patients was consitent with the pathology,and the diagnostic consistency was 93.3%.One patient with a movable lesion was misdiagnosed as cholestasis by EUS.One patient had two solitary adenomas,located in the middle and lower part of the common bile duct,and 14 others had single adenoma.There were 9 adenomas in the lower part,4 in the ampulla,2 in the upper part,and 1 in the middle of the common bile duct.The pathological findings were 7 cases of villous adenoma with high-grade intraepithelial neoplasia,4 cases of local malignant changes;6 villous tubular adenoma with high-grade intraepithelial neoplasia,3 local malignant changes;2 villous tubular adenoma with low-grade intraepithelial neoplasia;and 1 papillary adenoma.Conclusion EUS,helpful for the qualitative diagnosis,can be used as an important technique to improve the diagnosis of common bile duct adenoma.

关 键 词：胆总管 腺瘤 腔内超声检查 

分 类 号：R735.8[医药卫生—肿瘤]