胆囊壁增厚的声像图特征及诊断价值

目的　研究各型胆囊壁增厚的声像图特征及诊断价值。方法　应用B超检测分析 2 40例胆囊壁增厚的声像图并按照不同程度表现分为弥漫型、节段型、局限型三种类型。结果　 12 0例胆囊疾病引起胆囊壁增厚轻度 2 3例( 19.2 % ) ,中度 3 3例 ( 2 7.5 0 % ) ,重度 64例 ( 5 3 .3 1% )。 12 0例非胆囊疾病引起胆囊壁增厚 ,轻度 62例 ( 5 1.7% ) ,中度 41例 ( 3 4.12 % ) ,重度 17例 ( 14 .1% )。胆囊疾病组与非胆囊疾病组的胆囊壁增厚按轻度、中度、重度三组相比较有显著性差异 (P <0 .0 5 )。结论　单纯的胆囊壁增厚伴有弱回声带 ,并非是胆囊本身病变的特异性指征 ;胆囊壁内多发的弱回声带即“条纹征”是急性胆囊炎的最有力指征。胆囊壁内缘强回声带的模糊或者呈弱回声带以及整个胆囊壁回声均匀减低是诊断胆囊炎有价值的特征。胆源性疾病、慢性心衰以及慢性肾炎等引起的胆囊壁增厚 ,因有低蛋白血症 ,胆囊声像图改变是继发性的 ,且随着病变的好转或进展 ,发生相应的变化

Ultrasonic Features and Diagnostic Value of Gallbladder Wall Thickening

Objective To study the ultrasonic features and diagnostic value of gallbladder wall thickening. Methods Ultrasonic features of 240 cases with gallbladder wall thickening were analyzed retrospectively, and were classified into 3 types (diffused, segmental and restricted) in terms of its thickness.Results In 120 thickening cases caused by native cholecystic diseases, 19.16%, 27.50%, 53.34% were scored as mild, moderate and severe wall thickening. In the other 120 cases caused by non-cholecystic diseases, 51.66%, 34.17%, 14.17% of them were classified as mild, moderate and severe wall thickening respectively. There were a significant statistic difference between cholecystic and non-cholecystic diseases group(P<0.05) concerning the degrees of wall thickness.Conclusion Simple gallbladder wall thickening with hypoechoic layer was not a specific feature of native gallbladder diseases. Multiple hypoechoic layers sign within gallbladder wall, or so-called"stripes"sign, was a characteristic feature of acute cholecystitis. The blur or hypoechoic changes of wall linear edge were also valuable in cholecystitis diagnosis. In case of non-cholecystic diseases, the wall thickening was usually followed by hypoproteinemia caused by hepatitis, congestive heart failure, chronic glomerulonephritis, etc. and the gallbladder wall changes were secondary. The wall thickening varied along with the recovery of hepatic diseases.