胆囊颈部结石超声诊断影像学分析

目的探讨超声在胆囊颈部结石诊断中的应用价值。 方法对我院2011年至2019年彩超诊断为胆囊颈部结石的201例患者的超声声像图特征进行回顾性分析。所有患者均在我院普外科接受保胆取石手术时得以证实。 结果201例胆囊颈部结石中有96例出现胆囊体积增大并积液，占47%；176例出现胆囊壁增厚，占87%；47例出现胆泥团，占23%；35例出现胆囊缩小，占17%；145例出现胆绞痛发作史，占72%。 结论在胆囊颈部结石的诊断中，当超声检查出现以下几点应高度提示胆囊颈部结石的可能性：（1）胆囊体积增大合并积液；（2）胆囊壁明显增厚，胆汁暗区呈云雾状改变；（3）胆囊腔内有多个胆泥团；（4）胆囊缩小，胆囊内仅见极少许胆汁；（5）有反复发作的胆绞痛病史。要重点观察胆囊颈部情况，以提高胆囊颈部结石的检出率，减少漏诊。

Ultrasound diagnosis of gallstones in the neck of gallbladder

ObjectiveTo explore the value of ultrasound in the diagnosis of gallstones in the neck of gallbladder. MethodsThe ultrasonographic characteristics of 201 patients with gallstones in the neck of gallbladder diagnosed by color Doppler ultrasound and confirmed by gallbladder-preserving cholelithotomy from 2011 to 2019 in our hospital were analyzed retrospectively. ResultsIn the 201 cases, 96 cases had gallbladder volume enlargement and effusion, accounting for 47%, 176 cases had thickened gallbladder wall, accounting for 87%, 47 cases had biliary sludge, accounting for 23%, 35 cases had gallbadder contraction, accounting for 17%, and 145 cases had a history of biliary colic, accounting for 72%. ConclusionsIn the diagnosis of gallstones in the neck of the gallbladder, the following points should be highly supported: (1) Gallbladder volume enlargement with effusion. (2) Thickened gallbladder wall, and cloud-shaped bile dark area. (3) Bile sludges in the gallbladder cavity. (4) Gallbladder shrinks with very little bile seen in the gallbladder. (5) Recurrent biliary colic. Gallbladder neck should be observed carefully to improve the detection rate of gallstones in the neck of the gallbladder.