摘要
目的：探讨超声造影对胆囊胆固醇性息肉的诊断及临床应用价值。材料与方法：对照手术病理结果,回顾性分析总结38例46枚胆囊胆固醇性息肉的超声影像资料。常规超声观察息肉的大小、形态、回声、彩色多普勒血流以及胆囊壁是否光滑完整,超声造影以同深度的肝脏增强方式作为参考,实时观察胆囊壁及息肉的增强时相及增强模式。结果：常规超声表现38例46枚胆囊胆固醇性息肉中,直径4~25 mm,平均9.5 mm,〈10 mm 33枚,≥10 mm 13枚;单发9例,多发29例,多发时选取最大一枚进行观察,或在同一切面上观察多枚病灶;菜花形21枚,长椭圆形10枚,乳头状15枚。彩色多普勒显示10枚胆囊息肉内测及血流信号（10/46）,其中〈10 mm 4枚,≥10 mm 6枚。实时超声造影显示：增强方式上,46枚病灶均有增强,胆囊壁光滑整齐与病灶界限清晰,其中：高增强39枚（39/46）,等增强7枚（7/46）;病灶动脉期增强快于肝实质38枚（38/46）,与肝实质同步8枚（8/46）;蜂窝样增强31枚（31/46）,整体增强15枚（15/46）;在减退方式上,慢于肝实质减退36枚（36/46）,与肝实质同步减退10枚（10/46）;29枚病灶可见明显的蒂。结论：超声造影可提高胆囊胆固醇性息肉的血流显示率;蜂窝样增强,基底较窄,可见蒂,慢于或同步于肝实质减退是诊断胆囊胆固醇性息肉的主要超声表现;超声造影为临床选择治疗方式提供依据,具有重要的参考价值。
Purpose： To investigate the clinical application value of contrast-enhanced ultrasonography（ CEUS） in the diagnosis of cholesterol polyps of gallbladder. Materials and Methods： We retrospectively analyzed the data of 46 Cholesterol polyps of gallbladder from 38 patients by comparison with the results of pathological examination after surgery. The size,shape,inner echo and color Doppler flow of polyps together with the smooth and integral of gallbladder wall were observed via conventional ultrasonography. The enhancement phases and enhancement model of the gallbladder wall and polyps were real-timely observed. Moreover,CEUS referred to the same depth of enhancement pattern of the liver. Results： By conventional ultrasonography we found that in the 46 Cholesterol polyps of gallbladder from 38 patients,the diameter is 4 - 25 mm and the average is 9. 5mm,33 polyps 〈10 mm,13 polyps ≥10mm; 9 patients with solitary polyps and 29 with multiple polyps.The largest polyp was chose to observe when there are multiple polyps or multiple polyps were observed within the same section and there were 21 cauliflower shape polyps,10 oblong polyps and 15 papillary polyps. Color Doppler showed that 10 polyps had blood flow signals（ 10 /46） and among them 4 polyps 〈10 mm and 6 polyps ≥10mm. Real-time CEUS demonstrated that46 lesions had enhancement in enhancement model with smooth and orderly wall of gallbladder and had distinct boundary with lesions,including 39 hyper-enhancement polyps（ 39 /46）,7 iso-enhancement polyps（ 7 /46）. 38 lesions（ 38 /46） presented faster arterial phase enhancement than liver parenchyma and 8 lesions（ 8 /46） synchronize with liver parenchyma. 31 polyps（ 31/46） had honeycomb-like enhancement and15 polyps showed（ 15/46） integral enhancement. Within the decrease model,36 polyps（ 36 /46） decreased slower than liver parenchyma,10 polyps（ 10 /46） synchronize with it and distinguished pedicleswere observed in 29 lesions. Conclusion： CEUS could improve the flow signals displaying rate of gallbladder cholesterol polyps. The main ultrasonography manifestations in the diagnosis of gallbladder cholesterol polyps were the honeycomb-like enhancement,the narrower base,the visible pedicle and slower than or synchronize with the decreased patterns of adjacent liver parenchyma. Furthermore,CEUS could provide foundation for the choice of treatment methods in clinical practice and have crucial reference value.
出处
《现代医用影像学》
2014年第3期207-211,共5页
Modern Medical Imageology
关键词
超声检查
超声造影
胆囊胆固醇性息肉
增强方式
Ultrasonography Contrast-enhanced ultrasonography（CEUS） Cholesterol polyps of gallbladder
Enhancement model
