超声造影对胆囊胆固醇性息肉的诊断价值

Diagnostic value of contrast-enhanced ultrasonography for gallbladder cholesterol polyps

目的探讨胆囊胆固醇性息肉的超声造影特征。方法对47例胆囊胆固醇性息肉患者行常规超声及超声造影检查,常规超声观察病变大小、形态、数目、内部回声、基底部宽度及彩色血流情况。超声造影观察病变模式、增强强度、病灶的始增时间、达峰时间及减退时间。结果常规超声示24例胆固醇性息肉表现为窄基底,16例表现为宽基底,7例息肉多切面扫查难以确定基底部位置,彩色多普勒测及血流信号者8例。所有息肉行超声造影均可被强化,增强模式呈蜂窝状不均匀增强者29例,均匀增强者18例,高增强40例,低增强7例。本组病例造影始增时间为(17.03±6.51)s,达峰时间为(29.27±9.71)s,减退时间为(54.42±10.37)s。超声造影均能显示病变基底部,与常规超声比较差异有统计学意义(P=0.018)。结论超声造影表现为"蜂窝状"不均匀增强对胆固醇性息肉的诊断有一定参考价值,超声造影可显著提高息肉基底部的显示率。

Objective To investigate the characteristics of gallbladder cholesterol polyps by contrast-enhanced ultrasonography（CEUS）. Methods Forty-seven patients with gallbladder cholesterol polyps were examined by conventional ultrasonography and CEUS. Polyp size,shape,number,internal echo,bottom and presence of blood flow were observed by conventional ultrasonography. Enhancement pattern,enhanced intensity,wash-in time,time to peak and wash-out time were evaluated by CEUS. Results Conventional ultrasonography showed 24 polyps were pedunculated,16 were sessile,and the bottoms of the remaining 7 cases could not be identified with multiple section. Blood flow was detected in 8 cases by color Dopplor. All the polyps could be enhanced by CEUS. Twenty-nine cases showed heterogeneous enhancement pattern,while 18 cases were enhanced homogeneously. Forty cases showed hyper-enhancement,7 showed mild enhancement. The wash-in time,time to peak and washout time of the cholesterol polyps were（17.03±6.51）s,（29.27±9.71）s and（54.42 ±10.37）s,respectively. The bottoms of all the polyps could be observed by CEUS,the detection rate of bottoms was significantly higher by CEUS than that by conventional ultrasonography（P=0.018）. Conclusion The heterogeneous and mild enhancement patterns were useful variables in the diagnosis of cholesterol polyps. CEUS could markedly improve the detection rate of blood flow and bottoms of cholesterol polyps.