实时超声显像对肝外胆管结石诊断的应用价值

目的探讨实时超声显像对肝外胆管结石诊断的临床应用价值。方法回顾性分析经手术和病理证实的58例肝外胆管结石患者的超声表现,并探讨其漏诊及误诊原因。结果 39例显示肝外胆管结石;50例肝外胆管扩张,其中48例伴肝内胆管扩张;8例肝外胆管不扩张;伴胆囊结石50例,伴左肝内胆管结石2例,伴右肝内胆管结石2例,伴左右肝内胆管结石1例;5例合并胆管癌,超声诊断3例。结论实时超声显像能直观显示扩张肝外胆管及其程度、结石的部位及大小和数量,对肝外胆管结石的诊断具有重要的临床价值。

Diagnostic value of real-time ultrasound in extrahepatic bile duct stone

Objective To evaluate the value of real-time ultrasound in the diagnosis of extra-hepatic bile duct stone.Methods Ultrasound images of 58 patients with extrahepaticbile duct stones were reviewed.All the patients were confirmed by operation and the pathological results.Results In most cases,pre-operative ultrasound showed signs of extrahepatic bile duct stones.Among them,extrahepatic bile duct stones were directly seen in 39 cases(39/58,67.2%) while indirect signs such as expansion of extra-hepatic or inter-hepatic or both bile ducts were shown in 50 cases(50/58,86%).Pre-operative ultrasound also showed some other accompanying disorders such as gallstone(in 50 cases) and cholangiocarcinoma(3 cases).Conclusions Real-time ultrasound plays an important role in the diagnosis of extra-hepatic bile duct stones.It can not only show the expansion and extent of the expansion of the extra-hepatic bile ducts but also the position,size and number of the stones.