肝内胆管囊状肿瘤的声像图特征研究

Study of ultrasonography of intrahepatic duct cystic tumor

目的探讨肝内胆管囊状肿瘤的超声图像特征。方法对12例肝内胆管囊状肿瘤患者的超声图像进行分析,并与手术病理进行对照。其中胆管乳头状腺瘤2例,乳头状腺癌6例,肝内胆管囊腺瘤2例,囊腺癌2例。结果12例肝内胆管囊状肿瘤超声诊断符合率为75%(9/12),10例(83%)患者肝内胆管呈囊状或簇状扩张,7例(58%)胆管壁厚者均为恶性,6例(50%)肿瘤中测及乳头状回声者良恶性皆有,7例(58%)肿瘤内见胶冻状物回声,其中6例堵塞胆总管致胆管扩张。结论局部肝叶或肝段测及胆管不明原因囊状扩张,胆管壁厚,囊内透声差,尤其是胆管内充满大量胶冻状物并见乳头状回声应视为肝内胆管囊状肿瘤的重要诊断依据。提高超声对肝内胆管囊状肿瘤的早期诊断率有重要的临床意义。

Objective To probe the characteristics of the ultrasonography of the intrahepatic duct cystic tumor （IDCT）. Methods The ultrasonography of 12 patients with IDCT was analysed. The results were compared with the operation and pathology. Two of them were intraductal papillary adenomas, six were papillary adenocarcinomas, two were biliary cystadenomas and two were biliary cystadenocarcinomas. Results The ultrasonic diagnostic rate was 75% （9/12）. The bile ducts of 10 cases （83%） were cystically dilated. Seven cases （58%） with thick walls of bile ducts were all malignant. Six tumors （50%） with intraluminal papillate echoes could be malignant or benign. The tremellose echoes were detected in 7 cases （58%） and the common bile ducts of six cases were obstructed by the tremellose substance. Conclusions It is the important diagnostic basis of IDCT that the bile ducts in some liver lobal or segment are dilated without reasons,with the thick bile duct wall and the poor ultrasound penetration,especially when the bile ducts are full of tremellose substance and the papillomas are detected in the ducts. It is of significance in the clinic to raise the early diagnostic rate of IDCT by ultrasound.