首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到17条相似文献,搜索用时 234 毫秒
1.
胆囊结石并发急性胰腺炎的超声诊断价值   总被引:3,自引:0,他引:3  
目的探讨胆囊结石并发急性胰腺炎的超声诊断价值。方法采用超声检查37例胆囊结石并发急性胰腺炎患者,观察胆囊内结石大小与数量并进行比较,同时观察胰腺大小形态、实质回声及周围情况。结果胆囊结石中83.8%(31/37)为多发性结石,其中80.6%(25/31)为直径小于0.9cm的小结石。结论多发性且直径小的胆囊结石患者急性胰腺炎的发病率明显增高。超声检查胆囊结石可为临床提供急性胰腺炎的可能病因,并为胆囊结石患者选择性地施行胆囊切除术提供影像学诊断依据。  相似文献   

2.
目的:观察彩色多普勒超声诊断胆囊结石并发急性胰腺炎的效果。方法:选择2019年1月-2019年12月间我院收治的68例胆囊结石并发急性胰腺炎患者,利用彩色多普勒超声观察胆囊内结石和胰腺表现。结果:胆囊结石以多发性结石居多,占比为88.24%(60/68);结石直径小于0.9cm的患者有62例,占比为91.18%(62/68);结石直径为0.9cm及以上的患者有6例,占比为8.82%(6/68)。结论:多发性、小直径结石易引发急性胰腺炎,彩色多普勒超声检查可清晰观察胆囊和胰腺情况,判断胆囊结石并发急性胰腺炎的病因,为选择性实施胆囊切除术提供影像学依据。  相似文献   

3.
目的:探究胆囊结石并发急性胰腺炎患者采用超声诊断的价值.方法:选取2020年1月—2021年6月绵阳市中心医院收治的49例疑似胆囊结石合并急性胰腺炎患者作为研究对象,所有患者均接受超声检查,对比病理检查结果,分析超声诊断效果.结果:超声诊断灵敏度为93.02%、特异度50.00%、准确率87.76%;单发性结石和多发性...  相似文献   

4.
胆囊癌合并胆囊结石的超声研究   总被引:2,自引:0,他引:2  
目的 探讨易合并胆囊癌的高危胆囊结石声像图特征,为胆囊结石患者选择预防性胆囊切除提供影像学依据。方法 分析37例胆囊癌合并胆囊结石术前超声检查的声像图特点。结果 26例(71%)同时合并慢性胆囊炎。29例(78%)为单发结石且结石大小超过1cm。扫查时27例(73%)结石不移动。胆固醇性和混合性结石共33例(89%)。结论 单发、体积较大且移动性差的胆固醇性或混合性结石更倾向于合并胆囊癌,当超声检查发现上述特点,尤其是同时存在慢性胆囊炎时,提示有较强的预防性胆囊切除指征。  相似文献   

5.
超声显像诊断头孢曲松钠致胆囊假性结石1例分析   总被引:4,自引:1,他引:4  
对超声显像诊断头孢曲松钠致胆囊假性结石1例分析如下。 1病历摘要女,26岁。4d前因尿频、尿急、尿痛在我院行肝、胆、脾、胰、双肾及膀胱等超声检查未见明显异常,经1陆床诊断为急性泌尿系感染后,静点头孢曲松钠4d(3.0g/d),症状明显好转。于第4天静点后,突发右上腹疼痛急来就诊。病来无发热,经超声检查显示:胆囊无增大,壁光滑,胆囊内见密集强回声光点及光团随体位改变浮动,大者后伴弱声影。肝内外胆管无扩张,肝脾未见明显异常。超声提示:胆汁淤积、胆囊结石(图1),考虑药物性结石可能性大,建议1周后复查。患者改用其他抗生素住院观察治疗1周,不适症状消失。复查超声所见:胆囊形态大小正常,壁光滑,囊内胆汁透声良好,未见明显结石影像(图2)。后又经近3个月的2次复查,胆囊超声显像均未见明显异常。  相似文献   

6.
目的:探讨超声检查在胆囊炎胆囊结石腹腔镜胆囊切除术前筛选中的应用效果。方法:选取我院2018年9月-2019年9月收治的46例因胆囊炎胆囊结石而接受腹腔镜胆囊切除术患者作为研究对象,所有患者均在术前接受超声检查和筛选。比较所有患者术前超声筛选结果与术后病理结果之间的符合率。结果:46例患者术后均择期正常完成手术,术后病理证实16例为单纯性胆囊结石、26例为慢性胆囊炎合并胆结石、4例为慢性胆囊炎结石合并胆结石并发胆囊粘连;其中术前利用超声筛查结果适合的33例患者均正常完成手术,筛查结果和手术结局一致率达到100.00%(33/33);超声筛查13例需要抗炎治疗者经对症治疗后由11例正常完成手术,2例中转手术,筛查结果和手术结局一致率为84.62%(11/13)。术前超声检查结果中单纯性胆囊结石均全部检出,诊断符合率达到100.00%,而慢性胆囊炎合并胆结石,以及慢性胆囊炎合并胆结石并发胆囊粘连各出现1例漏诊,检出率分别为96.15%(25/26)和75.00%(1/4);三种超声筛查检出率的比较组间以及组内均未见统计学差异(P>0.05)。结论:超声检查在胆囊炎胆囊结石腹腔镜胆囊切除术前筛选中具有较高的临床应用价值,能够较为准确的为术前诊断提供参考依据,确保手术的顺利开展和完成。  相似文献   

7.
目的:分析对胆囊结石患者实施超声诊断及影像学特征。方法:从2018年1月至2020年1月择取120例疑似胆囊结石患者,所选患者均实施超声诊断,并对照手术病理诊断结果,分析超声诊断结果及影像学特征。结果:从诊断结果来看,手术病理诊断中118例患者确诊为胆囊结石,确诊率为98.33%(118/120),其中典型胆囊结石63例、充满型胆囊结石34例、胆囊颈结石13例、泥沙样型结石8例,超声诊断中114例患者确诊为胆囊结石,其中典型胆囊结石61例、充满型胆囊结石33例、胆囊颈结石12例、泥沙样型结石8例,诊断符合率为96.61%(114/118)。从超声影像学特征来看,典型胆囊结石可见胆壁粗糙,而且毛糙度高,腔内形态稳定,边界清晰,有强回声团,检查期间若移动体位,则后方声影、回声团随之改变。充满型胆囊结石可见胆囊壁增厚,大部分病例胆囊内无明显液性透声腔,胆囊后半部分以及后壁未完全显示,囊壁、结石、声影三合征(即WES症)清晰。胆囊颈结石可见在胆汁衬托下横切面上部分胆囊颈、结石嵌顿明显,结石具体位置无法确定,胆囊肿大,需要改变体位为左前倾位,以更好地暴露结石。泥沙样型结石中,结石大小差异,胆囊结石特征不同,沉积厚、颗粒大的结石声影有移动性,且有沉积状强回声带,颗粒小的结石胆囊后壁粗糙,毛糙感高,相比于前壁、侧壁,后壁回声更强,回声随体位变化出现细小发丝状强回声。结论:对胆囊结石患者实施超声诊断可以对具体疾病状况进行明确,医学影像清晰,临床价值显著。  相似文献   

8.
目的:分析在急性胰腺炎患者的诊断中应用CT联合超声的临床价值。方法:选择2022年9月—2023年9月聊城市第四人民医院收治的疑似急性胰腺炎患者40例,所有患者均接受CT、超声检查,并以手术病理及实验室化验结果为金标准,分析CT、超声单独检查与联合检查的灵敏度、特异度与准确率;分析不同检查方式对疾病分级的检出情况。结果:CT及超声联合诊断的灵敏度、特异度与准确率均高于CT及超声单一检查,其中联合检查的准确率高于超声检查(P <0.05)。26例急性胰腺炎患者中,单纯型9例,坏死Ⅰ型6例,坏死Ⅱ型6例,坏死Ⅲ型5例,CT诊断不同分级的准确率为73.08%(19/26),超声诊断不同分级的准确率为57.69%(15/26),联合诊断不同分级的准确率为88.46%(23/26)。结论:在急性胰腺炎诊断中应用CT联合超声检查可互为补充,提升疾病检出率,有较高的应用价值,对及时为患者提供相应治疗方案有重要意义,值得推广。  相似文献   

9.
目的 评价彩色多普勒超声对肾小结石的诊断价值.方法 对100例肾小结石(直径2~6 mm)患者,135枚小结石,行二维超声和彩色多普勒超声检查.彩色多普勒观察结石后方快闪伪像确定结石的存在,对比分析二维超声和彩色多普勒超声对肾小结石的检出率.通过增加回声差异强化值,观察结石边界情况.结果 135枚小结石,二维超声检出92枚(68.2%,92/135),彩色多普勒通过观察快闪伪像检出128枚 (94.8%,128/135),两者比较差异有统计学意义(P〈0.05).结石直径2~3 mm小结石74枚,二维超声检出39枚(52.3%,39/74),彩色多普勒超声检出72枚(97 3%,72/74),两者比较差异有统计学意义(P〈0.05).135枚小结石通过增加回声差异强化值(△=4~5)观察,边界均清晰显示.结论 ①彩色多普勒超声对肾小结石的检出和诊断有重要价值.②回声差异强化可清晰显示肾小结石边界情况,有助于准确测量结石大小.  相似文献   

10.
目的:探讨MRI结合磁共振胰胆管水成像(MRCP)技术在胆系结石术前诊断中的价值。材料与方法:115例超声诊断为胆结石的患者均行MRI和MRCP检查。结果:115例患者中,单纯性胆囊结石85例,单纯性肝管结石8例,胆囊结石伴胆管结石19例,胆总管囊肿伴结石1例,先天性无胆囊1例,急性单纯性胰腺炎1例。结论:MRI结合MRCP对胆系的先天发育异常是重要适应症,对于胆系结石的有无、大小、形态、数目、梗阻部位和胆管扩张的程度提供了可靠的诊断依据。  相似文献   

11.
Laparoscopic cholecystectomy (LC) is the treatment of choice for uncomplicated symptomatic gallstones. Spillage of stones due to gallbladder rupture has been reported in up to 33% of all LCs, but clinical sequelae caused by dropped gallstones are uncommon. We recently observed two patients with retained stones after LC. Correct diagnosis was made by abdominal ultrasonography (US) in both cases. In the first patient, who presented with fever, malaise, and weight loss 18 months after LC, abdominal US revealed hypoechoic focal lesions containing hyperechoic images with posterior shadowing of the liver and spleen. US-guided aspiration biopsies of these lesions yielded purulent material, and the injection and aspiration of saline solution provoked rolling movements of the hyperechoic images. Laparotomy confirmed the diagnosis of abscess-containing spilled gallstones. In the second patient, multiple hyperechoic images with posterior shadowing were observed in the Morison pouch during a routine US examination. The diagnosis of retained stones was consistent with the history of gallstone spillage during LC performed 2 months previously and was confirmed by computed tomographic findings of hyperdense images in the Morison pouch. The patient was asymptomatic, and treatment was thus deferred. Our experience suggests that US can be very useful in the detection of gallstones spilled during LC.  相似文献   

12.
The role of ultrasound in biliary and pancreatic diseases   总被引:5,自引:0,他引:5  
The possibilities and the limits of transabdominal ultrasonography (US) in the diagnosis of bilio-pancreatic diseases are reviewed here in the light of the last 10 years' research. US remains the method of choice for the diagnosis of gallstones and is generally accepted as an initial imaging technique in gallstone complications, such as acute cholecystitis. Moreover the method can be useful for the detection of the biliary complications after laparoscopic cholecystectomy and after liver transplantation. US is still considered the first diagnostic procedure when stones are suspected in the common bile duct. The use of color Doppler can provide a differential diagnosis of gallbladder cancer with respect to other benign inflammatory or polypoid lesions. Color Doppler US allows to detect vascular complications of acute pancreatitis such as pseudoaneurysms. US is still considered useful for the initial screening of the pancreatic cancer. However, for staging other imaging techniques must be employed. With US useful informations are obtained in the diagnosis of cystic tumors of the pancreas and of pancreatic metastases. US is generally of little use for the diagnosis of endocrine tumors.  相似文献   

13.
目的 探讨双源CT(DSCT)双能量成像分析体内胆囊结石成分的应用价值。方法 对200例胆囊结石患者于胆囊切除术前行DSCT双能量扫描,分析80 kV、140 kV图像对胆囊阴性结石的检出率。以显微红外光谱分析结果为判断结石成分的金标准,比较不同成分结石间80 kV图像CT值、140 kV图像CT值、CT值差值及CT值比值的差异;以ROC曲线评价不同指标鉴别胆固醇与非胆固醇成分胆囊结石的效能。结果 80 kV图像、140 kV图像及联合应用80 kV和140 kV图像对胆囊阴性结石的检出率分别为88.89%(80/90)、76.67%(69/90)和100%(90/90)。胆固醇成分结石的80 kV 图像CT值、140 kV图像 CT值、CT值差值、CT值比值均低于胆红素钙及罕见成分结石(P均<0.05),胆红素钙与罕见成分结石间差异均无统计学意义(P均>0.05)。以80 kV图像 CT值62 HU和CT值差值-2 HU为临界值,诊断胆固醇与非胆固醇成分胆囊结石的敏感度和特异度均为100%。结论 DSCT双能量成像可准确鉴别胆固醇结石与非胆固醇成分胆囊结石。  相似文献   

14.
Currently, most protocols evaluating the efficacy of gallstone lithotripsy require a visualized gallbladder on oral cholecystography (OCG). The primary purpose of the OCG is to establish that the cystic duct is patent. When the gallbladder is visualized on OCG, it can also be used to number and size gallstones accurately. Patients with nonvisualization of the gallbladder on OCG are excluded from consideration for lithotripsy. The purpose of this study was to evaluate retrospectively the ultrasonographic findings (i.e., number and sizes of stones in 32 patients with nonvisualization on the OCG). In 11 patients (34%) ultrasound (US) did not detect any stone, and it is presumed that the gallbladder failed to visualize for other reasons. Six patients (19%) had one or two stones and 15 (47%) patients had more than three stones. This suggests that 20% of patients with nonvisualization of the gallbladder on OCG would otherwise be eligible for lithotripsy provided that patency of the cystic duct can be demonstrated by other means, such as computed tomographic (CT) examination with oral biliary contrast or cholescintigraphy.  相似文献   

15.
PURPOSE: The purpose of this study was to evaluate the diagnostic accuracy of endoscopic sonography (EUS) in the detection of gallbladder wall lesions in patients with and without gallstones. METHODS: We retrospectively reviewed the medical records, sonograms, and sonographic reports of 62 patients who underwent cholecystectomy for gallbladder wall lesions evaluated by EUS. We assessed the accuracy of EUS in diagnosing gallbladder wall lesions in the presence or absence of gallstones and on the basis of the size and number of stones and the size of the gallbladder wall lesions. We also evaluated the effect of acoustic shadowing. The EUS results were compared with the histopathologic results. RESULTS: EUS correctly diagnosed the gallbladder wall lesions in 17 (71%) of 24 patients with gallstones and in 34 (89%) of 38 patients without gallstones. The diagnostic accuracy of EUS was 86% in patients with gallbladder wall lesions smaller than 20 mm and 79% in patients with gallbladder wall lesions 20 mm or larger. The diagnostic accuracy was 75% in patients with gallstones smaller than 5 mm and 67% in patients with stones 5 mm or larger. The accuracy was 67% in patients with 1-5 stones and 83% in patients with 6 or more stones. None of these differences was statistically significant. Acoustic shadowing did not affect the diagnostic accuracy of EUS. CONCLUSIONS: The diagnostic accuracy of EUS for gallbladder wall lesions is not affected by the presence of gallstones. However, better diagnostic criteria must be established based on larger studies, and technical refinements of the equipment are needed to increase the accuracy of EUS in the diagnosis of gallbladder wall lesions.  相似文献   

16.
Biliary calcium is believed to be of great importance in gallstone pathogenesis. These studies were therefore performed to determine if quantitative and/or qualitative differences in calcium are present in gallbladder bile from patients with and without gallstones. Bile was obtained by direct gallbladder aspiration from 68 obese patients undergoing elective gastric bypass surgery. Forty-five patients had no evidence of gallstones or sludge, 18 had cholesterol gallstones, and five had black pigment stones. Gallbladder bile was also obtained from 27 nonobese patients undergoing elective cholecystectomy (19 cholesterol; eight black pigment gallstones). For all patients, total calcium ranged from 1.50 to 16.44 mmol/L (mean: 6.05 +/- 0.31 mmol/L); free Ca++ ion ranged from 0.53 to 2.83 mmol/L (mean: 1.28 +/- 0.05 mmol/L). Considerable overlap was observed between obese and nonobese subjects and between patients with and without gallstones. For all patient groups, calcium, Ca++, and bound calcium increased linearly with increasing concentrations of bile salt. No significant differences in the slopes of these relationships were observed with obesity or gallstones. In contrast, free Ca++ ion was greater in gallbladder bile from gallstone patient groups throughout the entire range of bile salt. We hypothesize that this observed increase in Ca++ resulted from increased Gibbs-Donnan forces and excess gallbladder mucin present within the gallbladder bile of patients with gallstones.  相似文献   

17.
The influence of deoxycholic acid (DCA) on the factors in gallbladder bile responsible for cholesterol gallstone disease has been a controversial subject of discussion. This might be partially due to patient selection or inappropriate methods. Therefore, we investigated the relationship between the percentage of DCA and lithogenic factors in the gallbladder bile of patients with cholesterol gallstones and with normal or moderately impaired gallbladder contractility. Patients with pigment stones served as a control group. The percentage of DCA in the gallbladder bile of 20 patients with cholesterol stones (23.2%+/-6.5%; mean+/-SD) was comparable to the DCA percentage in the gallbladder bile of 11 patients with pigment stones (26.5%+/-8.5%). No correlation was seen between the DCA percentage of total bile acids and the crystal observation time, cholesterol saturation index (CSI), total protein value, mucin level, and amount of cholesterol in vesicles or crystals in the total group of patients or in the subgroups with cholesterol or pigment stones, respectively. The lack of correlation between DCA percentage and CSI was determined in native bile (r = 0.048) as well as in crystal-free bile after ultracentrifugation (r = 0.107). Our findings demonstrate that in patients with gallstones, the percentage of DCA in gallbladder bile is not related to any of the known biliary factors associated with cholesterol gallstone disease. We conclude that in patients with normal or moderately impaired gallbladder function, an elevated DCA level in the gallbladder bile is of minor pathophysiologic significance for the formation of cholesterol gallstones.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号