胆囊疾病的超声造影诊断研究

目的探讨超声造影鉴别诊断胆囊良、恶性病变的临床应用价值。方法对56例常规超声诊断为或疑为胆囊癌的病例,采用超声造影（声诺维）和对比脉冲序列成像技术行超声造影检查,分析良、恶性病变的增强特点。结果经手术病理证实胆囊癌26例,良性病变30例。超声造影显示病变早于肝实质增强者胆囊癌为80.8%（21/26）,良性病变为36.7%（11/30）（P〈0.01）。造影开始呈高增强者胆囊癌为80.8%（21/26）,良性病变为46.7%（14/30）（P〈0.01）;表现为增强不均匀者胆囊癌为57.7%（15/26）,良性病变为16.7%（5/30）（P〈0.01）。在注射造影剂60s内病变由高或等增强减退为低增强者胆囊癌为95.8%（23/24）,良性病变为21.4%（6/28）（P〈0.01）。结论胆囊良、恶性病变具有特征的增强表现。超声造影有助于病变性质的鉴别诊断。

Diagnostic study of gallbladder diseases with contrast-enhanced ultrasound

Objective To investigate the clinical value of contrast-enhanced ultrasound in differentiating benign and malignant diseases of gallbladder. Methods Contrast-enhanced ultrasound was performed in fifty-six patients with gallbladder diseases that were diagnosed or suspected of carcinoma by conventional ultrasound.Contrast agent SonoVue and low mechanical index imaging mode of contrast pulse sequencing were applied. The contrast enhancement characteristics of benign and malignant gallbladder diseases were analyzed. Results Twenty-six gallbladder carcinomas and thirty-one benign lesions were confirmed by operation and pathology. Twenty-one (80.8%,21/26) carcinomas and eleven(36.7%,11/30) benign lesions enhanced earlier than liver on contrast-enhanced ultrasound (P<0.01). Twenty-one (80.8%,21/26) carcinomas and fourteen(46.7%,14/30) benign lesions exhibited hyper-enhancement in early phase (P<0.01). Fifteen (57.7%,15/26) carcinomas and five(16.7%,5/30) benign lesions showed inhomogeneous enhancement (P<0.01). Twenty-three (95.8%,23/24) carcinomas and six (21.4%,6/28) benign lesions showed washout from hyper-enhancement or iso-enhancement to hypo-enhancement within 60s after contrast agent administration(P<0.01). Conclusions The contrast-enhanced ultrasound findings of gallbladder diseases are characteristic which may be helpful for their differential diagnosis.