超声胃镜在胆囊病变诊断中的意义

本文回顾分析103例非结石性胆囊病变超声内镜（EUS）检查结果，并与体表超声及手术后病理进行比较，以分析EUS在胆囊病变诊断中的意义。103例胆囊病变中，EUS诊断胆囊炎1例，胆囊息肉82例，胆囊腺肌瘤6例，胆囊癌10例，胆囊腺瘤4例；体表超声诊断胆囊息肉74例，其余2例误诊，6例漏诊，诊断胆囊癌6例，其余4例误诊，6例胆囊腺肌瘤体表超声均未做出诊断。12例胆囊疾病患者行手术治疗，与术后病理比较，EUS诊断正确率为75％，体表超声为41．6％。EUS对胆囊息肉、胆囊癌及胆囊腺肌瘤诊断符合率为100％，体表超声为55．6％。3例EUS误诊病例，2例为胆囊壁纤维化伴泥沙样结石，1例为化脓性胆囊炎，均误诊为胆囊占位性病变。结论。我们认为EUS对胆囊病变具有较高的诊断价值。

The Value of Endoscopic Ultrasonography in Diagnosis of Gallbladder Diseases

To evaluate endoscopic ultrasonography (EUS) in the diagnosis of gallbladder diseases, 103 non-gallbladder stone patients were retrospectively investigated. Abdominal ultrasonography and postoperative histological examination were compared. Among these cases, EUS diagnosed cholecystitis in 1 case, gallbladder polypus in 82 cases, gallbladder adenomyoma in 6 cases,gallbladder carcinoma in 10 cases and gallbladder adenoma in 4 cases. On the other hand, abdominal ultrasonography diagnosed gallbladder polypus in 74 cases, 2 cases misdiagnosed and 6 negative cases, gallbladder carcinorna in 6 cases,4 cases misdiagnosed, all the 6 gallbladder adenomyoma cases were miss-diagnosed. 12 operated patients were compared with the histological examination, the diagnostic accuracy of EUS was 75%, while that of ultrasonography was 41. 6%. The diagnostic accuracy of EUS for gallbladder polypus, gallbladder carcinoma and gallbladder adenomyoma was 100%, while that of ultrasonography was 55. 6%. EUS misdiagnosed 2 cases with gallbladder fibrosis and sludge and 1 case with cholecystitis as gallbladder occupation lesions. Conclusion:EUS had great value in the diagnosis of gallbladder diseases.