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目的:探讨超声造影(CEUS)在原发性胆囊癌诊断中的应用价值。方法:回顾性分析经手术和病理确诊的46例原发性胆囊癌患者的CEUS图像特征以及同Nevin分期的关系。结果:37病例CEUS检查可见造影增强,病灶较常规超声显示更清晰。病灶与胆囊壁同时显影,开始显影时间为5~16 s,增强达峰值时间为14~30 s,病灶增强达峰值强度均高于自身正常胆囊壁,开始消退时间为20~55 s。胆囊癌肝转移灶表现为动脉期边缘快速环状增强,内部稀疏增强,门脉期快速消退,呈“黑洞征”。在造影后发现更多的转移灶。CEUS对原发性胆囊癌诊断符合率明显高于彩色多普勒血流显像(73.9%vs 50.0%,P<0.05);然而具体至Nevin分期,两种方法差异无统计学意义。结论:CEUS对原发性胆囊癌的诊断具有重要的价值,而对于其早期病例仍须进一步研究。
Objective: To investigate the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of primary gallbladder cancer. Methods: The CEUS features of 46 patients with primary gallbladder carcinoma confirmed by surgery and pathology were analyzed retrospectively. Results: 37 cases of CEUS examination showed enhanced contrast, lesions showed more clearly than conventional ultrasound. The lesion developed simultaneously with the gallbladder wall. The time of onset of development was 5-16 s and the peak time of enhancement was 14-30 s. The intensity of peak enhancement was higher than that of the normal gallbladder wall, and the time to start subsidence was 20-55 s. Gallbladder liver metastases showed rapid annular enhancement at the edge of the arterial phase, internal sparse enhancement, rapid regression of portal phase, was “black hole sign ”. After angiography found more metastases. The coincidence rate of CEUS in the diagnosis of primary gallbladder cancer was significantly higher than that of color Doppler flow imaging (73.9% vs 50.0%, P <0.05). However, there was no significant difference between the two methods in Nevin stage. CONCLUSION: CEUS is of great value in the diagnosis of primary gallbladder cancer, but further study of its early cases is needed.