B型超声诊断原发性胆囊癌八例错误原因分析

本文报告经手术、病理证实,B型超声错误诊断的8例原发性胆囊癌情况。其中4例误诊的主要原因是胆囊炎合并周围组织粘连、大网膜包裹胆囊,致胆囊形态失常、囊壁不规则增厚,超声图像酷似原发性胆囊癌;1例漏诊,为胆囊缩小。局部囊壁增厚而未被认出;2例误诊是由于囊壁上有乳头状或息肉状回声,且突入囊腔;1例由于肝脏右前叶与左内叶癌肿浸润性生长,将整个胆囊包埋其内,造成判断错误。本文重点在于分析少见原因造成的误诊,以吸取教训,供超声诊断借鉴。

DIAGNOSTIC ERROR WITH B-MODE ULTRASOUND IN 8 CASES OF PRIMARY CARCINONA OF GALLBLADDER

Among 316 cases of bilary disorders diagnosed with B-mode ultrasonography there were eight misdiagnosed cases which were confirmed consequently by operation and pathological study. The causes of misdiagnosis were analysed and were reported here. 4 cases were misdiagnosed because cholecystitis was accompanied by tissue adhesion around gallbladdr, gallbladder was surroun- ded by omentum, outline of gallbadder was irregular, and it's wall was irregular thick, so that echoes looked like primary carcinoma of gallbadder, 1 case was mistaken as shrunken gallbladder and local wall thickness. 2 cases diag nostic error were resulted from papillara or polypid echoes on gallblad- der wall and protruding into cavity of gallbladder. 1 case was misjudged because the gallbladde was buried by carcinoma of left medial lobe and right anterior lobe of liver. We put emphasis on analysing the rare causes of diagnostic error and introduce our unsuccessful experience.