双重对比超声造影在壶腹周围病变检出中的临床应用

摘 要:【目的】与常规超声和胃肠水对比超声互相作比较,探讨双重对比超声造影对壶腹周围病变的检出诊断能力?【方法】回顾性分析在我院均行常规超声?GI-US和D-CEUS检查的67例壶腹周围病灶患者共69个病灶的临床资料,所有患者均签署知情同意书,符合医学伦理学规定?其中40 个为恶性病灶,包括十二指肠乳头癌19 个,胆总管下段癌9 个,胰头钩突癌6 个,壶腹癌6 个;29个为良性病灶,包括28个胆总管下段结石和1个十二指肠绒毛管状腺瘤?所有病灶均经手术病理活检或胆道镜直视证实?比较以上3种超声检查方法对壶腹周围病灶的检出率和病灶清晰显示率?【结果】 常规超声?胃肠水对比超声和双重对比超声造影的检出率分别为59.42%?95.65%?98.55%,清晰显示率分别为17.39%?60.87%和84.06%?双重对比超声造影在病灶检出率和清晰显示率均优于常规超声(P < 0.001),双重对比超声造影与胃肠水对比超声相比较,检出病灶能力相当(P = 0.619),但病灶清晰显示率则前者优于后者(P = 0.006)?【结论】 双重对比超声造影可提高壶腹周围病变的检出诊断能力及清晰显示病灶的边界,可作为壶腹周围梗阻性病变的重要影像学检查方法?

Value of Double Contrast Enhanced Ultrasound in Detection of Lesions in Periampullary Region

Abstract:【Objective】 To evaluate the detected diagnostic value of double-contrast enhanced ultrasound (D-CEUS) in periampullary region lesions and compare with that of conventional ultrasound (US) and hydrosonography of gastrointestinal tract (GI-US). 【Methods】 Clinical data of 67 patients with periampullary lesions who received examinations of US, GI-US, and D-CEUS both in The Third Affiliated Hospital of Sun Yat-sen University were analyzed retrospectively. The informed consents of all patients were obstained and the ethical committee approval was received. There were totally 67 lesions in 69 patients, including 40 malignant lesions (19 duodenal papillary carcinoma, 9 distal common bile duct carcinoma, 6 pancreatic uncinate process carcinoma, 6 ampullary carcinoma) and 29 benign lesions (28 distal common bile duct stones and 1 villus-tubiform adenoma). All the lesions were confirmed by surgical pathological biopsy or choledochoscopy. Three ultrasound modalities were made comparison between each other in the detection rate, clarity degree and definite diagnosis rate of the above periampullary region lesions. 【Results】 The detection rate of US, GI-US, and D-CEUS were 59.42%, 95.65%, and 98.55% and the clarity degree of each modality were 17.39%, 60.87%, and 84.06%, respectively. D-CEUS can highly raise the display capacity compared with US (P < 0.001). Although D-CEUS appeared with no statistical differences (P = 0.619) compared with GI-US, it has significant differences in clarity degree of images (P = 0.006). 【Conclusions】 D-CEUS can improve the detected diagnostic capacity of periampullary lesions as an important imaging modality for periampullary obstructive diseases.