16例胆囊内瘘的超声诊断分析

Ultrasonic Diagnosis of 16 cases of Cholecysto-gastrointstinal Fistulae

目的 探讨胆囊内瘘术前超声诊断。方法 对 16例经手术证实为胆囊内瘘的超声资料作回顾性分析。结果 16例胆囊内瘘中 14例 ( 87%)超声提示慢性萎缩性胆囊炎、胆囊结石 ,而术前超声提示胆囊内瘘 7例 ,诊断正确率 44%。胆囊内瘘声像图较为复杂 ,有如下声像学特征 :直接特征 :1 胆囊部位团块状“实变样”强回声 ,后方无声影或有类“靶环征”图像 ;2 胆囊萎缩或显示不清。间接征象 :胆道积气。

Objective To evaluate the preoperative diagnostic value of ultrasound for cholecysto-gastrointestinal fistulae Methods Sixteen patients with cholecysto-gastrointestinal fistulae confirmed by operations were studied by ultrasonic image analysis retrospectively Results Fourteen of 16 cases(87%)were detected as chronic atrophic cholecystitis with cholecystolithiasis by ultrasound Cholecysto-gastrointestinal fistulae were only found 7 in 16 cases preoperatively,and accuracy of ultrasonic finding was 44% Conclusion Ultrasonic images of cholecysto-gastrointestinal fistulae were complicated and could be classfied into two groups:direct and indirect characteristics Direct characterstics included:1 It presented at gallbladder fossae a mass-like solid area,strong echo gram without acoustic shadow or sign similar to bull's eye sign;2 Gallbladder was detected as atrophia or obscurity Indirect sign was pneumobilia When one or two signs of direct characterstics and indirect characterstics appeared,the diagnoses of cholecysto-gastrointstinal fistulae were made sure