摘要
目的总结壶腹部病变双重对比超声造影表现,探讨双重对比超声造影对壶腹部病变的鉴别诊断价值。方法回顾性分析2006年7月至2013年11月中山大学附属第三医院经手术及病理证实的83例患者双重对比超声造影表现,包括壶腹部癌44例、胆总管或壶腹部结石或胆泥30例、十二直肠乳头炎8例、十二直肠乳头腺瘤1例。结果 83例壶腹部病变中,89%(74/83)的病灶显示,病灶直径为(20.7±8.9)mm。所有29例胆总管下段或壶腹部结石或胆泥双重对比超声造影表现为动脉期、静脉期均无增强。67%(29/43)的壶腹部癌双重对比超声造影表现为动脉期高或等增强,静脉期低增强;所有显示的43例壶腹部癌病灶形态均固定。88%(7/8)的十二直肠乳头炎双重对比超声造影未显示病灶。壶腹部良恶性软组织病变间的病灶显示率、病灶形态变化差异有统计学意义(Fisher确切概率法,P值分别为0.000、0.001),而病灶直径、双重对比超声造影增强水平及增强均匀性差异无统计学意义。结论不同壶腹部病变有一定特征性双重对比超声造影表现。双重对比超声造影有助于壶腹周围病变的鉴别诊断。
Objective To summarize the features of periampullary diseases on double-contrast enhanced ultrasonography（DCUS） and evaluate the ultrasound diagnostic value in this disease. Methods The DCUS and clinical data of 83 patients with periampullary diseases confirmed by operation and pathology were reviewed, inculding 44 cases of periampullary carcinoma, 30 cases of bile duct or ampullary stones or biliary sludge, 8 cases of duodunum papillary inflammation and 1 case of adenoma of duodenum papillary. Results In 83 periamupllary abnormality cases, 89%（74/83） lesions were visible on DCUS with lesion size of（20.7±8.9） mm. No enhancement was showed in 29（100%） cases of stones or biliary sludge in common bile duct or periampullary region. Twenty-nine（67%） periampullary carcinoma lesions displayed hyperenhancement or isoenhancement in arterial phase and hypoenhancement in venous phase. In 43（100%） cases, the morphology of lesion didn′ t change along with duodenum movement. No lesion was found in 7（88%） cases of duodenum papillary inflammation. The detection rate of the lesions and morphology changing along with duodenum movement were statistically different between benign and malignant periampullary diseases（P=0.000, 0.001）. The size, enhancement level and enhancement pattern of the periampullary lesions weren′ t statistically different. Conclusion Different periampullary diseases had some different features on DCUS, which is helpful in differential diagnosis.
出处
《中华医学超声杂志（电子版）》
2014年第8期34-37,共4页
Chinese Journal of Medical Ultrasound(Electronic Edition)
关键词
超声检查
造影剂
肝胰管壶腹
胆总管疾病
Ultrasonography
Contrast media
Ampulla of Vater
Common bile duct diseases
