超声在婴幼儿囊肿型胆道闭锁及胆总管囊肿鉴别诊断中的应用  

Application of ultrasound in differential diagnosis of cystic biliary atresia and choledochal cyst in infants

作　　者：胡玉杰 肖婷[2] 项飞翔[1] 邓尧[1] 陈云超 谢明星[1] 余铖[1] Hu Yujie;Xiao Ting;Xiang Feixiang;Deng Yao;Chen Yunchao;Xie Mingxing;Yu Cheng(Department of Ultrasound Medicine,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Department of Ultrasound Medicine,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430023,China;Department of Ultrasound Medicine,Xiamen Branch,Zhongshan Hospital,Fudan University,Xiamen 361015,China)

机构地区：[1]华中科技大学同济医学院附属协和医院超声医学科,武汉430022 [2]华中科技大学同济医学院附属同济医院超声医学科,武汉430023 [3]复旦大学附属中山医院厦门医院超声科,厦门361015

出　　处：《中国医师杂志》2024年第10期1456-1459,1463,共5页Journal of Chinese Physician

基　　金：2023华中科技大学同济医学院附属协和医院自由创新预研基金(2023XHYN029)。

摘　　要：目的探讨超声在婴幼儿囊肿型胆道闭锁(CBA)与胆总管囊肿(CC)鉴别诊断中的应用价值。方法收集2015-2023年间华中科技大学同济医学院附属协和医院经手术确诊的年龄<3个月的CBA或CC患儿,回顾性分析CBA组与CC组患儿一般情况及超声表现差异。结果55例患儿中,CBA组患儿30例,CC组患儿25例。CBA组囊肿的长径、宽径均值分别为(1.45±1.05)cm、(1.04±0.73)cm,明显小于CC组的(5.41±2.98)cm、(3.21±2.90)cm(均P<0.001)。CBA组纤维斑块(50.0%,15/30)及胆囊形态异常(73.3%,22/30)发生率明显高于CC组[分别为4.0%(1/25),16.0%(4/25)]。CC组囊肿内胆泥沉积(52.0%,13/25)及肝内胆管扩张(64.0%,16/25)发生率明显高于CBA组[分别为0,3.3%(1/30)]。结论CBA与CC患儿在超声表现上具有一定差异。CC患儿囊肿长径及宽径明显大于CBA患儿,且囊肿内可见胆泥沉积或伴有肝内胆管扩张。CBA患儿纤维斑块、胆囊形态异常的发生率明显高于CC患儿。Objective To evaluate the value of ultrasonography in the differential diagnosis of cystic biliary atresia(CBA)and choledochal cyst(CC)in infants.Methods CBA or CC children<3 months of age diagnosed by surgery in Union Hospital,Tongji Medical College,Huazhong University of Science and Technology from 2015 to 2023 were collected,and the differences in general conditions and ultrasound manifestations between CBA group and CC group were retrospectively analyzed.Results Among the 55 children,30 were in CBA group and 25 were in CC group.The mean length diameter and width diameter of cysts in the CBA group were about(1.45±1.05)cm and(1.04±0.73)cm,respectively,which were significantly smaller than those in the CC group(5.41±2.98)cm and(3.21±2.90)cm(P<0.001).The incidence of fibrous plaque(50.0%,15/30)and abnormal gallbladder morphology(73.3%,22/30)in the CBA group was significantly higher than that in the CC group[4.0%(1/25)and 16.0%(4/25),respectively].The incidence of intrahepatic biliary mud deposition(52.0%,13/25)and intrahepatic biliary duct dilation(64.0%,16/25)in the CC group was significantly higher than that in the CBA group[0,3.3%(1/30),respectively].Conclusions There are some differences in ultrasonography between CBA and CC children.The length and width of cysts in children with CC are significantly larger than those in children with CBA,and biliary mud deposits or intrahepatic bile duct dilatation are seen in the cysts.The incidence of fibrous plaque and abnormal gallbladder morphology in CBA children is significantly higher than that in CC children.

关 键 词：超声检查 囊肿型胆道闭锁 胆总管囊肿 

分 类 号：R445.1[医药卫生—影像医学与核医学] R726.5[医药卫生—诊断学]