胆管灌洗在超声胆管造影中的应用价值

目的 进一步完善超声胆管造影(B-CEUS)的操作步骤,探讨胆管灌洗在超声胆管造影中的应用价值.方法 选取2016年4月至2017年4月于中南大学湘雅医学院附属海口医院超声医学科接受IB-CEUS的21例肝门部梗阻患者,先不经胆道灌洗步骤注入超声造影剂(UCA)进行胆管造影,待UCA效果消退后经引流导管灌洗肝内胆管系统,再行胆管造影.比较患者灌洗前和灌洗后肝内1级和3级胆管(肝段胆管)的即刻显影率.结果 胆管灌洗前,患者1级胆管1例显示不满意,20例显示满意,胆管灌洗后,21例患者1级胆管均显示满意,灌洗前后1级胆管即刻显示率比较,差异无统计学意义(P>0.05);胆管灌洗前,患者3级胆管6例显示不满意,15例显示满意,灌洗后,1例显示不满意,20例显示满意,灌洗前后3级胆管即刻显示率比较,差异有统计学意义(P<0.05).结论 在进行IB-CEUS前加入胆管灌洗这个步骤可以提高IB-CEUS中3级胆管的显示率,从而有望更精确的诊断胆管疾病.

Effects of biliary lavage in intra-biliary contrast-enhanced ultrasound

Objective To further improve and standardize the operation of intra-biliary contrast-enhanced ultra-sound (IB-CEUS) and evaluate the application value of biliary lavage in IB-CEUS. Methods Twenty-one patients of hepatic portal obstruction undergoing IB-CEUS in Central South University Xiangya School of Medicine Affiliated Haik-ou School from April 2016 to April 2017 were enrolled in the study. We first performed IB-CEUS with ultrasound con-trast agent (UCA) without the biliary lavage process, then after the effect of UCA receded, lavage the intrahepatic bile duct system through drainage catheter, and performed IB-CEUS again. The immediate display rates of the intrahepatic stage 1 and 3 bile duct (hepatobiliary duct) were compared before and after the biliary lavage. Results Before the biliary lavage, 20 patients were satisfied for stage 1 bile duct and 1 was unsatisfied, versus 21 were satisfied and 0 was unsatisfied after the biliary lavage (P>0.05). Before the biliary lavage, 15 patients were satisfied for stage 3 bile duct and 6 were unsatis-fied, compared with 20 were satisfied and 1 was unsatisfied after the biliary lavage (P<0.05). Conclusion The addition of the biliary lavage process before IB-CEUS can improve the immediate display rate of stage 3 bile ducts in IB-CEUS, which could lead to more accurate diagnosis of bile duct disease.