胆囊CEUS联合肝脏MRI检查对胆囊息肉样病变患者的诊断价值  

Diagnostic value of gallbladder CEUS combined with liver MRI on patients with polypoid lesions of gallbladder

作　　者：魏亮 孙继忠[2] 张荣国[3] 王颖[3] 李天明[1] 林艺[1] 李永秀[4] 曹宏[5] WEI Liang;SUN Ji-zhong;ZHANG Rong-guo;WANG Ying;LI Tian-ming;LIN Yi;LI Yong-xiu;CAO Hong(Department of Hepatobiliary and Pancreatic Surgery,Meihekou Central Hospital,Meihekou 135000;Department of Ultrasound,Meihekou Central Hospital,Meihekou 135000;Department of Magnetic Resonance,Meihekou Central Hospital,Meihekou 135000;Department of General Surgery,Meihekou Central Hospital,Meihekou 135000;Department of General Surgery III,Xinmin Campus,China-Japan Union Hospital of Jilin University,Changchun 130000,Jilin,China)

机构地区：[1]梅河口市中心医院肝胆胰外科,吉林梅河口135000 [2]梅河口市中心医院超声科,吉林梅河口135000 [3]梅河口市中心医院磁共振科,吉林梅河口135000 [4]梅河口市中心医院普外科,吉林梅河口135000 [5]吉林大学中日联谊医院新民院区普外三科,吉林长春130000

出　　处：《川北医学院学报》2023年第9期1187-1190,共4页Journal of North Sichuan Medical College

基　　金：吉林省卫生与健康青年科技骨干培养计划(2020Q035)。

摘　　要：目的:探讨胆囊超声造影(CEUS)联合肝脏核磁共振成像(MRI)检查对胆囊息肉样病变(PLG)患者的诊断价值。方法:选取122例PLG患者为研究对象,依据组织病理检测结果分为良性病变组(n=55)和恶性病变组(n=67)。比较两组患者CEUS及MRI检查结果,分析胆囊CEUS与肝脏MRI单独、联合检查对胆囊息肉良恶性病变的诊断效能。结果:CEUS检查结果显示,恶性病变组胆囊壁厚度大于良性病变组(P<0.05);胆囊壁不连续、高增强占比高于良性病变组(P<0.05);始增时间、达峰时间、消退时间短于良性病变组(P<0.05)。MRI检查结果显示,恶性病变组弥散加权成像(DWI)信号强度高于良性病变组(P<0.05);表观弥散系数(ADC)值低于良性病变组(P<0.05)。以组织病理结果为“金标准”,胆囊CEUS联合肝脏MRI诊断PLG恶性病变的敏感度、特异度、准确度分别为92.54%、90.91%、91.80%,一致性检验Kappa值为0.83。结论:胆囊CEUS联合肝脏MRI在PLG良恶性病变的鉴别诊断中具有较高的诊断效能。Objective:To explore the diagnostic value of gallbladder contrast-enhanced ultrasound(CEUS)combined with liver magnetic resonance imaging(MRI)on patients with polypoid lesions of gallbladder(PLG).Methods:122 patients with PLG were selected as the research subjects.They were divided into benign lesion group(n=55)and malignant lesion group(n=67)according to the results of histopathological examination.The CEUS and MRI examination results were compared between the two groups,and the diagnostic efficacy of gallbladder CEUS and liver MRI alone or in combination for benign and malignant lesions of gallbladder polyps were analyzed.Results:The CEUS examination results showed that the thickness of gallbladder wall in malignant lesion group was greater than that in benign lesion group(P<0.05),the proportions of gallbladder wall discontinuity and hyperenhancement were higher than those in benign lesion group(P<0.05),and the initial enhanced time,peak time and regression time were shorter than those in benign lesion group(P<0.05).The MRI examination results showed that the signal intensity of diffusion weighted imaging(DWI)in malignant lesion group was higher than that in benign group(P<0.05),while the apparent diffusion coefficient(ADC)value was lower than that in benign group(P<0.05).Taking histopathological result as the“gold standard”,the sensitivity,specificity and accuracy in the diagnosis of PLG malignant lesions were 92.54%,90.91%and 91.80%of gallbladder CEUS combined with liver MRI respectively,and the Kappa value of consistency test was 0.83.Conclusion:Gallbladder CEUS combined with liver MRI has a high diagnostic efficiency in the differential diagnosis of benign and malignant PLG lesionss.

关 键 词：胆囊超声造影 肝脏核磁共振成像 胆囊息肉样病变 诊断价值 

分 类 号：R445.1[医药卫生—影像医学与核医学]