肝内胆管结石并肝内胆管癌的超声诊断及其临床价值研究

目的 探讨肝内胆管结石合并肝内胆管癌的声像图特征，以便提高其超声诊断率。方法 肝内胆管结石合并肝内胆管癌患者22例，均为长期肝内结石患者。全部患者均经手术病理证实。结果 22例肝内胆管结石合并肝内胆管癌患者超声诊断率为63．6％（14／22），左肝与右肝内胆管结石合并胆管癌患者分别为86．4％（19／22）与13．6％（3／22），手术行肝叶切除术达54．5％（12／22）。肝内胆管结石合并肝内胆管癌的特征性声像表现为肿瘤境界不清，结石位于肿物中，肿物旁小胆管扩张，肿物所在处门静脉分支显像不清等。结论 加强对肝内胆管结石合并肝内胆管癌声像图的识别能力，提高超声早期诊断率对进一步提高其手术切除率与患者的生存率有重要的临床价值。

Study of clinical value of ultrasonic diagnosis of hepatolithiasis associated with cholangiocarcinoma

Objective To explore the ultrasonographic characteristics of the hepatolithiasis associated with cholangiocarcinoma (HC),to raise the diagnostic rate of HC.Methods Twenty two cases with HC were patients who had all suffered from the hepatolithiasis for a long period of time and confirmed by the operation and pathology.Results The ultrasonic diagnostic rate of the 22 cases was 63.6% (14/22).The HC in the left lobe and the right lobe was 86.4% (19/22)and 13.6% (3/22)respectively.The ultrasonographic characteristics of the HC were uncertain boundary,the echoes of the stones in the tumor,the dilatation of the small bile ducts adjacent to the tumor,no clear ultrasonograms of the branches of the porter vein and so on.Conclusions It is of clinical significance to improve the discernment of the ultrasonography of the HC and raise the early ultrasonic diagnostic rate so as to raise the tumor resection rate as well as the survival rate.