原发性胆囊癌的超声误诊原因分析

为了提高实时超声显像胆囊癌的诊断准确率,作者回顾分析了29例超声假阴性,22例超声假阳性胆囊癌病例。在假阴性病例中,18例(62.1%)诊断为胆囊结石,6例(200.7%)误诊为急慢性胆囊炎,2例(6.9%)诊断为胆泥,2例(6.9%)诊断为息肉,1例(3.4%)诊断为肝脏肿瘤。在假阳性病例中,7例(31.8%)误诊为胆囊壁肿块但病检证实为息肉(4例)和胆泥(3例);8例(36.4%)误诊为胆囊壁不规则增厚,但组织学显示为急性(3例)和慢性(5例)胆囊炎。7例(31.89%)肝门显示有实质性肿块,超声提示为胆囊癌,其中2例为胆泥形成的肿物,5例为急性胆囊炎并积浓。

Ultrasonographic Misdiagnsis Analysisi in Primary Carcinoma of The Gallbladder

In order to more specifically define gallladdercarinoma with real - time ultrasonography, a retrospective study was perfomed involing 29 sonographically false - negative and 22 sonographically false -posse cases of gallbladder carcinoma. Among the false negative case, 18( 62. 1% ) were diagnosed as gallbladder ston only. 6 ( 20. 7% ) were incorrectly diagonsed as either acute or chronic cholecystitis, 2 casas (6. 9%) were diagonsed as bile sludge, 2 cases (6. 9%) were diagnosed as polyps, and 1 case (3. 4%) was diagnosed as liver tumor, In fasle-positive case, 8 (31. 8%) were erroneously diagnosed as liver tumor. In false - positive cases, 7 (31. 8%) were erroneously diagonsed as mass projecting from the gallbladder wall dut were pathologically proven to de polyps (4 cases) or dile sludge (3 cases); 8 cases (36. 4%) were incorrectly diagosed due to irregular thickening of the gallbladder wall but histology revealed them to acute (3 cases) or chronic (5 cases) cholecystitis . Seven cases (31. 8%) had a solid mass in porta hepatis, indicating gallbladder carcinoma ; of these, 2 cases were lumps of bile sludge and 5 cases were acute cholecystitis with empyzema.