胆囊张力与囊壁厚度在早期急性胆囊炎中的超声诊断价值

目的探讨和完善急性胆囊炎的超声表现特点,明确早期急性胆囊炎胆囊张力与胆囊壁厚度在超声诊断中的价值。方法对于疼痛发作后48h之内并经临床保守或手术治疗确诊为急性胆囊炎的视为早期急性胆囊炎,将该组超声所测胆囊张力(短轴值/长轴值)及胆囊壁厚度与正常组胆囊所测值对照比较,并对胆囊炎组胆囊张力变化与囊壁厚薄进行相关分析。结果早期急性胆囊炎声像图表现为:①以短轴值增加即张力增高(短/长轴之比≥0.4248)为主的胆囊体积增大;②以长、短轴同时增加而张力增高不明显(短/长轴之比<0.4248)的胆囊体积增大。前者囊壁厚度≤2mm约占80.0%,胆囊张力变化与囊壁厚度有一定的相关性,r=0.78(P<0.05)。结论胆囊体积增大、张力增高、壁薄(≤2mm)是超声诊断早期急性胆囊炎的重要指标。

Gallbladder tension and wall thickness in early acute cholecystitis and their diagnostic value to ultrasonic examination

Objective To evaluate the ultrasonic manifestation of the gallbladder tension and bladder wall thickness in diagnosis of acute cholecystitis.Methods Acute cholecystitis that had had a definite diagnosis during 48 hours after pain attack and was given a conservative or surgical treatment,was regarded as an early one.The gallbladder tension and wall thickness of acute cholecystitis were detected and compared with those of normal gallbladder,also making a correlation analysis on the gallbladder tension and wall thickness changes among the cholecystitis cases.Results The ultrasonography showed:①Mainly with the increased minor axis the cyst volume enlarged with a higher tension(≥0.4248);②With concurrently increased long axis and minor axis the cyst volume enlarged but without marked tension increase(<0.4248).The former with the wall thickness not more than 2 mm accounted for 80.0%.The bladder tension correlated with wall thickness to some degree(r=0.78,P<0.05).Conclusion Gallbladder enlargement,tension increasing,wall remaining thin(not more than 2 mm)are important criteria for diagnosing early acute cholecystitis.