灰阶超声检查胆囊癌误诊16例原因分析

Ultrasonographic Misdiagnosis of Carcinoma of Gallbladder in 16 Cases

讨论灰阶超声对３８例胆囊癌诊断中误诊１６例原因。经手术、病理证实其中１５例为胆囊腺癌，１例为粘液细胞癌。按超声误诊报告分类为（１）胆总管占位性病变；（２）胆总管结石；（３）肝右叶及肝门区病变；（４）上腹腹膜后及胰头肿物；（５）胆囊腺癌；（６）厚壁型胆囊炎。笔者对肿物回声位置、引起误诊原因及特殊回声进行分析，从中找出其规律和鉴别方法。

Thirty eight cases of gallbladder carcinoma were encountered and proven pathologically in our hospital from November 1985 to March 1992.Among these 38 cases misdiagnosis ultrasonographically was made in 16 ofwhich 15 were gallbladder adenocarcinomas and 1 mucinous cell carcinoma,The erroneous ultrasonographical diagnosis given in the 16 cases can be divided into 6 varieties:(1)space-occupying mass of common bile duct,(2)choledocholith,(3)lesions of right liver lobe and hepatic portal region,(4) epigastric retroperitoneal mass and mass of head of pancreas,(5) gallbladder adenoma,(6) thick wall type cholecystitis. The authors suggest that a comprehensive analysis of the patient's history, site and feature of tumor echo image, would help avoiding misdiagnosis.