M值测定对胆囊息肉样病变的诊断及手术指征评估

目的通过测定超声下胆囊息肉样病变的M值协助临床诊断及制订治疗方案。方法选取2009年4月至2013年4月收治的胆囊息肉样病变患者280例，所有患者均行B超检查，观察并记录超声下息肉样病变部位、数目、大小、形态及胆囊壁厚度等指标，运用胆囊息肉M值进行测定并对所得数据及术后病理类型进行统计学分析。结果所有患者非肿瘤性息肉250例，肿瘤性息肉30例，M〈0者212例均为良性病变，0≤M〈2．5者43例，恶性病变11例，良性病变32例；M≥2．5者25例，恶性病变19例，良性病变6例。胆囊息肉样病变不同病理类型的发病率与M值评分呈正相关关系，M值越高其发病率越高（r=1．224，P〈O．01）。结论超声下M值测定对胆囊息肉样病变的诊断及治疗具有指导意义，有助于尽早识别胆囊癌及有恶变可能性的息肉，具有广阔的临床应用价值。

M value determination for diagnosing gallbladder polypoid lesion and evaluating operation indications~

Objective To determine the M value of gallbladder polypoid lesion by ultrasound for assisting clin- ical diagnosis and formulating the therapy scheme. Methods 280 cases of gallbladder polypoid lesion in our hospital from April 2009 to April 2013 were selected and underwent B-type ultrasonography examination. The sites,number, size, shape and gallbladder wall thickness of gallbladder polypoid lesions were observed and recorded. The M value of gallbladder polypoid lesion was determined and the detected results and postoperative pathological types were per- formed the statistical analysis. Results Among all cases,250 cases were non-neoplastic polyp and 30 cases were tu- morous polyps212 cases with M〈0 were benign lesions;among 43 cases with 0≤M 〈2.5,11 cases were malignant lesions and 32 cases were benign lesions;among 25 cases with M≥2.5,19 cases were malignant lesions and 6 cases were benign lesions. The pathologic types of gallbladder polypoid lesions showed that its incidence rate was positively correlated with the M value score, the higher the M value, the higher the incidence rate（r= 1. 224, P〈0.01）. Conclu- sion The M value determination by ultrasound has the guidance significance to the diagnosis and treatment of gall- bladder polypoid lesions and is conducive to identify gallbladder carcinoma and polyp with malignant change possibili- ty, which has wide clinical application value.