利用CT三维重建分析肝硬化伴胆囊窝积液对胆囊壁超声成像的影响

目的：探讨肝硬化伴胆囊窝积液病者胆囊壁超声与CT三维重建在影像成像以及胆囊壁厚度测量的方面上对比差异。方法：对比39例患者于空腹状态同时行超声以及多层螺旋CT检查的影像图像， B超和CT测量胆囊厚度情况，绘制散点图，并进行Pearson相关性分析，应用配对样本t检验比较胆囊壁厚度情况。结果：①与CT三维重建图像对比，发现其中31例出现胆囊窝积液超声漏诊情况，并且发现胆囊壁厚度的超声测量值，存在高估情况的16例，低估情况2例。②B超与CT胆囊壁厚度的测量值相关系数为0.648（P<0.000）。③B超测量胆囊壁厚度（（6.2±2.6）mm）较CT测量胆囊壁厚度（（4.5±2.0）mm）平均值更大，测量差异具有统计学意义（t=4.465，P<0.000），变异系数分别为0.42、0.44。结论：局限性胆囊窝积液在CT检查中检出率较超声高, 对肝硬化患者胆囊壁增厚与局限性胆囊窝积液能够更准确地进行鉴别诊断。

The influence of gallbladder fossa fluid accumulation on gallbladder wall thickness in liver cirrhosis on sonographic imaging correlation with multi-slice CT scanning

Objective： To discuss the difference of gallbladder wall thickness in liver cirrhosis with gallbladder fossa fluid accumulation on ultrasound scanning and CT multi-plane reconstruction images. Materials and Methods： Uhrasound scanning and multi-slice CT were performed in 39 patients who had gallbladder fossa fluid accumulation with liver cirrhosis, all cases were under fasting condition. Gallbladder wall thickness was measured both on ultrasonographic and multi-slice CT 3D reconstruction images. The scatter diagram was drawn and Pearson correlation analysis and paired sample t test comparison of gallbladder wall thickness were also carried out. Result： Compared with multi-plane CT reconstruction, （1）Ultrasound missed the diagnosis of gallbladder fossa fluid accumulation in 31 cases, over estimation of gallbladder wall thickness in 16 cases, and under estimation of the thickness in 2 cases. （2）The correlation coefficient of ultrasound detection of gallbladder wall thickness with CT detection was 0.648 （P〈0.000）. （3）Uhrasound detection of gallbladder wall thickness was （6.2±2.6）mm, CT detection of gallbladder wall thickness was （4.5±2.0）mm, there was statistical significance（t=4.465, P〈0.000）. The coefficient of variation was 0.42 and 0.44 respectively. Conclusion： Multi-slice CT scanning is more sensitive in the detection of limited gallbladder fossa fluid accumulation than ultrasound. It can accurately differentiate gallbladder fossa fluid accumulation with gallbladder wall thickening in liver cirrhosis.