良恶性胆囊占位性病变超声表现特征分析  

Ultrasound imaging features of benign and malignant gallbladder space-occupying lesions

作　　者：贾芳 尚丰 宋涛[1] Jia Fang;Shang Feng;Song Tao(Department of Abdominal Ultrasound,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830011,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆医科大学第一附属医院腹部超声诊断科,乌鲁木齐市830011

出　　处：《实用肝脏病杂志》2023年第4期592-595,共4页Journal of Practical Hepatology

基　　金：新疆维吾尔自治区科技厅《适宜技术推广-乡村振兴》项目(编号:SYTG-(国)202137)。

摘　　要：目的分析总结良恶性胆囊占位性病变超声特征,以便于诊断。方法2020年6月~2022年6月我院诊治的胆囊占位性病变患者120例,术前均行彩色多普勒超声检查,测量病灶血管收缩期最大流速(Vmax)和阻力指数(RI),分析其影像学特征。所有患者接受腹腔镜下胆囊切除术,术后取组织行病理学检查。结果在120例胆囊占位性病变患者中,术后组织病理学检查诊断良性病变78例(65.0%),包括胆囊息肉37例、胆囊腺瘤23例和胆囊腺肌症18例,和胆囊腺癌42例(35.0%);良性病变大小、Vmax和RI分别为(1.3±0.3)cm、(19.2±3.8)cm/s和(0.5±0.1),显著小于恶性病变【分别为(3.2±0.6)cm、(42.4±8.1)cm/s和(0.8±0.2),P<0.05】,良性病变基底宽、与囊壁分界清和有穿支血流占比分别为26.9%、93.6%和9.0%,与恶性病变显著不同(分别为100.0%、7.1%和66.7%,P<0.05);良性胆囊占位性病变Adler血流2~3级仅占7.7%,而恶性胆囊占位性病变占88.1%,差异有统计学意义(P<0.05)。结论良、恶性胆囊占位性病变超声表现各有特点,为鉴别病变性质提供了依据,具有较高的临床应用价值。Objective The aim of this study was to summarize the ultrasound imaging features of benign and malignant gallbladder space-occupying lesions.Methods A total of 120 patients with gallbladder space-occupying lesions were encountered in our hospital between June 2020 and June 2022,and all patients underwent color Doppler ultrasonography to measure the maximum velocity(Vmax)and resistance index(RI)of vessels inside the lesions.The laparoscopic cholecystectomy(LC)was performed in all patients and the diagnosis was proven by histopathological examination after operation.Results The postoperative histopathological examinations showed that out of the 120 patients with gallbladder space-occupying lesions,there were 78 cases(65.0%)with benign lesions,including gallbladder polyps in 37 cases,gallbladder adenoma in 23 cases and gallbladder adenomyosis in 18 cases,and gallbladder adenocarcinoma in 42 cases(35.0%);the lesion size,Vmax and RI in patients with benign lesions were(1.3±0.3)cm,(19.2±3.8)cm/s and(0.5±0.1),significantly less than[(3.2±0.6)cm,(42.4±8.1)cm/s and(0.8±0.2),respectively,P<0.05]in malignant lesions,and the percentages of wide base,clear boundary with cyst walls and branch vessels with blood flow in benign lesions were 26.9%,93.6% and 9.0%,significantly different compared to 100.0%,7.1% and 66.7%(P<0.05)in malignant lesions;the percentage of Adler’s blood flow grade 2/3 accounted for 7.7% in benign lesions,much lower than 88.1%in malignant lesions(P<0.05).Conclusion The ultrasound imaging features are different between benign and malignant gallbladder space-occupying lesions,which could guide the clinicians to make the correct diagnosis.

关 键 词：胆囊占位性病变 良性 恶性 超声 诊断 

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