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超声造影新技术对胆囊良恶性疾病的鉴别诊断价值 被引量:16

Value of contrast-enhanced ultrasound for differentiation between benign and malignant gallbladder diseases
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摘要 目的探讨超声造影对胆囊疾病良恶性鉴别诊断的临床应用价值。方法采用低机械指数实时超声造影技术检查80例常规超声疑为胆囊占位的病例,包括胆囊癌33例和良性病变47例。分析胆囊病变的增强时间、增强模式以及病变部位胆囊壁层次结构的完整性,评估超声造影鉴别胆囊病变良恶性的诊断性能。结果在CEUS增强早期呈高增强或等增强并在造影剂注射后35s内变低增强者在胆囊癌中占96.8%(30/31)、良性病变中占19.5%(8/41)(P〈0.001)。CEUS增强早期病变呈高增强或等增强变为低增强平均时间胆囊癌为(29.5±9.8)S、良性病变为(58.8±13.9)s(P〈0.001)。病变表现为不均匀增强者在胆囊癌中占78.8%(26/33),良性病变中占27.6%(13/47)(P〈0.001)。病变处胆囊壁完整性破坏者在胆囊癌中占84.8%(28/33),良性病变中占0.0%(0/47)(P〈0.001)。常规超声检查胆囊疾病诊断正确率为72.5%(58/80),超声造影检查胆囊病变诊断正确率为93.8%(75/80)(P〈0.001)。结论超声造影较普通超声能显著改善对胆囊疾病良恶性鉴别诊断能力,值得临床应用推广。 Objective To investigate the clinical value of contrast-enhanced ultrasound in differentiation between benign and malignant gallbladder diseases. Methods Contrast-enhanced ultrasound was performed in eighty patients who were suspicious of gallbladder cancer by conventional ultrasound. Final diagnosis proved that it was gallbladder cancers 33 patients and benign gallbladder disease in 47. Contrast agent SonoVue and low mechanical index imaging mode were applied. The contrast enhancement characteristics of the initial enhancement time, the enhancement pattern and the integrality of gallbladder wall adjacent to lesions were analyzed. Meanwhile, the ability of differentiating diagnosis between benign and malignant gallbladder diseases with contrast-enhanced ultrasound was investi- gated. Results The percentages of those lesions that exhibited hyper-enhancement or iso-enhancement in the early phase and turned to hypo-enhancement within 35s after contrast agent administration were 96.8% (30/31) in gallbladder cancers and 19.5 % (8/41) in benign lesions(P〈0. 001), and the mean time to be hypo-enhaneement was (29.5±9.8)s in gallbladder cancers and (58.8±13.9)s in benign lesions (P〈0. 001). Inhomogeneous enhancement was found in 26 (78.8% ,26/33) gallbladder carcinomas and 13 (27.6% ,13/47) benign lesions (P〈0. 001). Destruction of the integrality of gallblad- der wall was found in 28 (84.8% ,28/33) gallbladder carcinomas and none (0. 0% ,0/47) of benign lesions (P〈0. 001). The accuracies for differential diagnosis between malignant and benign gallbladder diseases were 72.5% (58/80) for conventional ultrasound and 93.8% (75/80) for contrast-enhanced ultrasound (P〈0.001). Conclusion Contrast-enhanced ultrasound can significantly improve the ability of differentiating diagnosis between benign and malignant gallbladder diseases compared with con- ventional ultrasound. The method is deserved to be popularized in clinical practice.
作者 谢晓华 徐辉雄 谢晓燕 吕明德 徐作峰 刘广健 梁瑾瑜 XIE Xiao-hua, XU Hui-xiong, XIE Xiao-yan, et al. (Department of Ultrasonography, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China)
出处 《中华肝胆外科杂志》 CAS CSCD 北大核心 2009年第9期641-644,共4页 Chinese Journal of Hepatobiliary Surgery
基金 基金项目:教育部新世纪优秀人才支持计划(NECT-06-0723)
关键词 超声诊断 胆囊疾病 鉴别诊断 Ultrasonic diagnosis Gallbladder disease Differentiating diagnosis
作者简介 通信作者:徐辉雄
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