摘要
目的:探讨胆囊占位性病变超微血管成像(superb microvascular imaging,SMI)的血流特征及其在良恶性鉴别诊断中的应用价值。方法:选取71例胆囊占位性病变患者,所有患者术前均行彩色多普勒血流显像(color Doppler flow imaging,CDFI),并用SMI技术检测血流。采用Adler分级标准,比较CDFI与SMI在胆囊占位性病变中血流分级上的差异。根据血流形态,分析SMI在胆囊占位性病变不同病理学类型中的血流形态差异。结果:71例胆囊占位性病变患者中SMI检出血流56例(78.87%),明显优于CDFI[32例(45.07%)](χ^(2)=17.21,P<0.05)。SMI在胆囊良性占位性病变与恶性占位性病变的Ⅱ、Ⅲ级血流显示均优于CDFI(χ^(2)=5.430,P<0.05)。SMI显示,胆固醇性息肉最常见血流形态为点状(13/25,52.00%),胆囊腺肌症也以点状为主(7/15,46.67%),胆囊腺瘤主要表现为单支状或分支状(9/12,75.00%),胆囊癌以凌乱型为主(8/19,42.11%)。胆囊占位性病变不同病理学类型呈现不同的SMI血流形态(χ^(2)=20.16,P<0.05)。结论:与CDFI相比,SMI能更清晰地显示胆囊占位性病变的血管分布特征,可为胆囊占位性病变的良恶性鉴别诊断提供新的参考依据。
Objective:To investigate blood flow characteristics and the value of superb microvascular imaging(SMI)in the differential diagnosis of gallbladder lesions.Methods:A total of 71 patients with gallbladder lesions were subjected to color Doppler flow imaging(CDFI)and SMI.According to the Adler classification method,the differences in blood flow classification between CDFI and SMI in gallbladder lesions were compared.And then the blood flow morphology differences of SMI in different pathological types of gallbladder lesions were analyzed.Results:Among 71 cases of gallbladder lesions,56 lesions with blood flow were detected by SMI(78.87%)while 32 were detected by CDFI(45.07%).SMI was significantly better than CDFI in detecting the presence of blood flow in gallbladder lesions(χ^(2)=17.21,P<0.05).SMI was superior in displaying gradeⅡandⅢblood flow in benign and malignant gallbladder lesions(χ^(2)=5.430,P<0.05).SMI also showed that the most common blood flow morphology of malignant gallbladder lesions was irregular,while the benign lesions mostly presented with punctate or branched patterns.The blood flow morphology was significantly different between lesion types(χ^(2)=20.16,P<0.05).Conclusion:SMI provides more detailed vascular information for gallbladder lesions than CDFI and may improve the diagnostic efficiency for gallbladder lesions.Moreover,SMI is an effective method to distinguish malignant and benign lesions.
作者
张燕群
陈雪君
俞清
闻捷先
袁海霞
王文平
ZHANG Yanqun;CHEN Xuejun;YU Qing;WEN Jiexian;YUAN Haixia;WANG Wenping(Department of Ultrasound,Xiamen Branch,Zhongshan Hospital,Fudan University,Xiamen 361015,Fujian Province,China;Department of Ultrasound,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Ultrasound,Qingpu Branch,Zhongshan Hospital,Fudan University,Shanghai 201700,China)
出处
《肿瘤影像学》
2022年第1期16-20,共5页
Oncoradiology
基金
上海市临床重点专科项目(shslczdzk03501)
上海市科学技术委员会医学创新研究专项(21Y11911200)
福建省卫生健康科研人才项目(2019-ZQNB-39)
复旦大学附属中山医院厦门医院孵化课题项目(2020ZSXMYS22)。
关键词
胆囊占位性病变
彩色多普勒超声
超微血管成像
超声造影
Gallbladder lesion
Color Doppler flow imaging
Superb microvascular imaging
Contrast-enhanced ultrasound
