超声检查在十二指肠癌诊断中的应用

The Application of Ultrasonic Examination to the Diagnosis of Duodenum Cancer.

目的 评价超声检查在十二指肠癌诊断中的价值。方法收集我院2000年1月～2005年12月超声检查，并经手术、病理证实的十二指肠癌42例超声图像的特点，及超声对肿瘤诊断漏诊的原因，及与放射．CT、ERCP、镜检等其他检查方法进行回顾性的对比分析。结果42例患者中．超声检查完全符合12例，占28％（12／42）；超声诊断胰头占住7例，壶腹周围占位5例，胆总管末端占位7例，胆总管扩张6例，右肾盂轻度积水1例，无明显阳性改变4例。结论超声在十二指肠癌诊断中，较大的肿物能够明确诊断，并能清晰显示，胆管及胰管有否扩张，及其他脏器、腹腔有无转移，是一种无创伤性，有助于本病的筛选诊断的一种方法，但对十二指肠癌的诊断以超声，钡餐、十二指肠镜检．CT．ERCP等多种检查方法结合可明显提高术前诊断的符合率。

Objective Evaluating the application of ultrasonic examination to the diagnoses of duodenal tumors Methods Collecting all. The cases with the characteristics of 42 ultrasonic images of duodenal tumors, which have been proved by ultrasonic examinations, operations as well as pathology in recent two years in our hospital. The causes of missed diagnoses in examinations, that is, conducting contrastive analyses on these means concerned with irradiation, CT, ERCP and laparoseope. Results Of 42 eases with duodenal tumors, 12 cases （28 %） were perfectly in accord with ultrasonic examinations; 7 patients were found that the tumors were within the pancreatic head; 5 cases were diagnosed with the tumors around ampullae; 7 were found on the end of the bile duet, 6 cases were found to be with dilatation of the bile duet; 1 case was found with light hydronephrosis in the right part; 4 patients were found with no palpable masculine change, which was diagnosed with laparoscope. Conclusion Ultrasonic examinations in the diagnoses of duodenal tumors are able to reveal whether there are the dilatation of bile duct and metastasis among other organs, moreover the application of this means exerts no hurt on patients. The way of examination is also helpful in the diagnosis of this cancer. In the process of identifying duodenal tumors, the application of ultrasonic, barium meal, CT and ERCP to the examination with the above means is able to enhance the exactness of the diagnosis before an operation.