超声对胆管癌术前分期诊断探讨：关于壁浸润程度诊断

由于超声在显示胆管肿瘤的同时，也能显示胆管壁的形态及与邻近脏器组织的关系，因此有望对胆管癌术前分期作出诊断。本文根据肿瘤与胆管壁的关系、胆管壁形态、连续性、尤其外侧缘的形态改变等指标，确定了胆管癌壁浸润的三个程度，即未侵及浆膜下及浆膜层（以下简称浆膜）（S1），侵及浆膜（S2），侵及浆膜外（S3）的超声诊断标准;井报告了经超声显示出肿瘤，并经手术病理确认的61例胆管癌壁浸润程度的超声诊断结果。根据此标准，超声诊断正确率分别为S1达69％;S2达78％;S3达56％;总诊断正确率达67％（41／61）。本文还讨论了胆管壁受侵不同程度的声像图特征及提高诊断率的要点。超声对胆管癌壁浸润程度的判断为胆管癌术前分期诊断提供了重要依据。

Preoperative Staging of cholangiocarcinoma by Ultrasound: The Diagnosis of Wall Infiltration

Three different degrees of infiltratibn to biliary wall by bile duct carcinoma, including serosa not being infiltrated (S1), serosa being infiltrated (S2), and extraserosa being infiltrated (S3), were determined and served as the diagnostic standard,according to the relationship between tumor and bile duct wall, the latter shape and continuity,especially changes of its external edge. Ultrasonographic diagnosis of serosa infiltration of 61 cases with bile duct carcinoma confirmed by operations and pathological findings were made and reported. On the basis of this standard, the accurate rates by ultrasound of S1, S2 and S3 were 69%. 78%, and 56%, respectively. Morphologic characteristics seen sonographically and key points for improving the diagnostic rates were also discussed in this study. The diagnosis of biliary wall infiltration by ultrasound provides important basis for preoperative staging of bile duct carcinoma.