超声造影在胆系疾病中的应用价值

目的 评估超声造影(CEUS)应用于胆系疾病诊断的可行性和价值.方法 对57例胆系疾病患者进行CEUS,观察病灶的动态增强特点及形态学特征,与常规二维和彩色多普勒超声图像、手术病理结果做对照,部分病例与增强计算机断层扫描成像(CECT)做对照.结果二维超声结合CEUS的诊断准确率明显高于二维超声结合彩色多普勒超声检查(87.7%比71.9%;x~2=4.41,P<0.05).CEUS可明确显示病变有无血供及血流的动态灌注过程,将胆系肿瘤与结石、胆泥或凝血块相鉴别,而且能清晰显示病变的轮廓,分辨肿瘤的浸润范围和深度,判断肿瘤是否侵及临近脏器、血管和有无转移病灶.但是,仅根据CEUS增强模式所反映的血流灌注情况,对鉴别息肉样病变良、恶性的价值有限.CEUS和CECT的诊断准确率(87.0%比91.3%;x~2=0.45,P>0.05)及所显示病灶大小范围(0.4～6.2 cm比0.4～6.0 cm,P=0.721)差异均无统计学意义.结论 CEUS是对常规胆系疾病超声检查的重要补充,对进一步提高胆系疾病的诊断水平有较大价值.

Application Value of Contrast-enhanced Ultrasonography in the Diagnosis of Biliary Diseases

Objective To evaluate the usefulness of contrast-enhanced ultrasonography(CEUS) in the diagnosis of biliary diseases.Methods CEUS was performed in 57 patients with biliary diseases.The contrast enhancement characteristics and the morphologic features were observed.The ultrasonographic results were compared with those obtained through conventional 2-D ultrasound(2D-US),color Doppler flow ultrasound (CDFI),and clinical,surgical,and laboratory findings.In some cases,the ultrasonographic results were also compa...