胆囊管结石声像图分析及其诊断价值

目的 探讨胆囊管结石的声像图表现，总结超声诊断的检查方法。方法 回顾性分析15例经手术或ERCP证实的胆囊管结石患，对其声像图表现和探测方法进行研究。结果 超声确诊胆囊管结石4例，疑诊9例，漏诊2例。扩张的胆囊管内出现强回声团，后方伴声影，是胆囊管结石直接征象，但其超声检查的敏感性不高；急性胆囊炎和胆囊肿大是其重要的间接征象，可提示胆囊管结石的存在。除常规探测方法之外，饮水法、脂餐法等特殊方法在胆囊管结石诊断中非常重要。结论 多种检查方法联合应用，注意超声检查中出现的各种间接征象，可明显提高胆囊管结石的检出率。

Sonographic Analysis and Diagnostic Value of Cystic Duct Lithes

Objective To investigate the sonographic appearances of cystic duct lithes and to summarize the examination methods of ultrasonic diagnosis.Methods Totally 15 patients with cystic duct lithes confirmed by operation or ERCP were analyzed retrospectively.The sonographic appearances and examination methods were studied.Results Four cases were definitely diagnosed as cystic duct lithes,nine cases were doubtfully diagnosed and two cases were misdiagnosed.Strong echoes in the dilated cystic ducts with shadows in posterior were the direct sign of the cystic duct lithes,but the sensitivity was very low.Acute cholecystitis and gallbladder swelling were important indirect appearances,which were clues to the cystic duct lithes.Besides the routine examination methods,it was important that some special ways,such as drinking water,fatty meal etc,should be used to diagnose cystic duct lithes.Conclusions Combination of some examination methods and paying attention to all indirect appearances may make the diagnosic sensitivity of cystic duct lithes improved.