25例黄色肉芽肿性胆囊炎的临床特点及与胆囊癌影像学表现的鉴别  

Clinical characteristics of 60 cases of yellow granulomatous cholecystitis and imaging manifestation differentiation from gallbladder cancer

作　　者：王斌[1] 华星 周陈 WANG Bin;HUA Xing;ZHOU Chen(Department of Radiology,Taizhou Second People’s Hospital Affiliated to Yangzhou University,Jiangsu 225500,China;Department of Ultrasound Diagnosis,Eastern Theater Command General Hospital,Nanjing 210000,China)

机构地区：[1]扬州大学附属泰州第二人民医院放射科,江苏225500 [2]东部战区总医院超声诊断科,江苏210000

出　　处：《肝脏》2024年第10期1269-1273,共5页Chinese Hepatology

基　　金：江苏省卫生健康委医学科研项目(S202006A)。

摘　　要：目的分析25例黄色肉芽肿性胆囊炎的临床特点及与胆囊癌影像学表现的鉴别。方法2019年5月—2023年5月我院经手术病理检查确诊的25例黄色肉芽肿性胆囊炎和35例胆囊癌患者,分为胆囊炎组和胆囊癌组。比较两组临床特征、影像学表现,采用受试者工作特征曲线(ROC)分析影像学表现在鉴别黄色肉芽肿性胆囊炎及胆囊癌中的价值。结果胆囊炎组体质量指数下降幅度、食欲下降占比分别为(14.1±0.4)kg/m^(2)、36.0%,均低于胆囊癌组[(16.2±0.1)kg/m^(2)、80.0%,P<0.05];胆囊炎组胆囊结石、胆囊壁弥漫性增厚、黏膜线连续完整性、邻近肝实质动脉期一过性强化的发生率分别为72.0%、60.0%、80.0%、76.0%,均高于胆囊癌组[分别为28.6%、28.6%、34.3%、42.9%,P<0.05];ROC曲线分析结果显示,胆囊结石、胆囊壁弥漫性增厚、黏膜线连续完整性、邻近肝实质动脉期一过性强化在鉴别黄色肉芽肿性胆囊炎及胆囊癌中具有较高的价值。结论黄色肉芽肿性胆囊炎临床常表现为体质量、食欲下降,胆囊结石、胆囊壁弥漫性增厚、黏膜线连续完整性、邻近肝实质动脉期一过性强化在鉴别黄色肉芽肿性胆囊炎及胆囊癌中具有较高的价值。Objective To analyze the clinical features of 25 cases of yellow granulomatous cholecystitis and differentiate their imaging manifestations from those of gallbladder cancer.Methods Sixty patients with surgically and pathological diagnoses of yellow granulomatous cholecystitis and gallbladder cancer,admitted to our hospital between May 2019 and May 2023,were divided into the cholecystitis and gallbladder cancer groups.We compared the clinical features and imaging manifestations of the two groups and analyzed the diagnostic value of imaging manifestations in distinguishing yellow granulomatous cholecystitis from gallbladder cancer using the receiver operating characteristic(ROC)curve.Results The decrease in body mass index(BMI)in the cholecystitis group was(14.1±0.4)kg/m^(2),and the proportion of patients with decreased appetite was 36.0%,both lower than those in the gallbladder cancer group,which had values of 16.2±0.1 kg/m^(2)and 80.0%,respectivey(P<0.05).The incidence of gallbladder stones,diffuse thickening of the gallbladder wall,continuous integrity of the mucosal line,and transient enhancement in the arterial phase of adjacent hepatic parenchyma was 72.0%,60.0%,80.0%,and 76.0%,respectively,in the Cholecystitis group,all higher than in the gallbladder cancer group[28.6%,28.6%,34.3%,and 42.9%,respectively;P<0.05].ROC curve analysis indicated that gallbladder stones,diffuse thickening of the gallbladder wall,continuous integrity of the mucosal line,and transient enhancement in the arterial phase of adjacent liver parenchyma are valuable for differentiating yellow granulomatous cholecystitis from gallbladder cancer.Conclusion Yellow granulomatous cholecystitis often clinically manifests as decreased body weight,appetite,gallstones,diffuse thickening of the gallbladder wall,continuous integrity of the mucosal lining,and transient enhancement in the arterial stage adjacent to liver parenchyma which is highly valuable for differentiating yellow granulomatous cholecystitis from gallbladder cancer.

关 键 词：黄色肉芽肿性胆囊炎 临床特点 胆囊癌 影像学 

分 类 号：R735.8[医药卫生—肿瘤] R575.61[医药卫生—临床医学]