二维超声与彩色多普勒血流显像对胆囊隆起性病变的鉴别诊断

Differential diagnosis of gallbladder bulging lesions by gray - scale sonography and color dopper flow imaging

目的 探讨二维超声（BUS）与彩色多普勒血流显像（CDFI）对胆囊隆起性病变（≤2．5cm）的诊断价值。方法 分析76例胆囊隆起性病变（小结节型胆囊癌11例，胆囊息肉51例，腺瘤9例，腺肌增生5例）的二维超声与彩色多普勒血流显像声像图特征，并与手术病理结果对照。结果恶性组的彩色多普勒血流半定量、收缩期最大血流速度（Vmax）、阻力指数（RI）均高于良性组。如果以Vmax≥20cm／s作为判定恶性的指标，其敏感性为81．81％，特异性为98．46％，准确性为96．05％；若以RI≥0．6作为判定恶性的指标，其敏感性为72．72％，特异性为98．46％，准确性为94．74％。结论 联合应用二维超声与彩色多普勒血流显像是鉴别胆囊隆起性病变的有效方法。

Objective To evaluate the value of 2D - uhrasonography and color doppler flow imaging in gallbladder bulging lesions （ ≤2. 5cm）. Methods Features of 2D - us and CDFI with bulging lesions in gallbladder in 76 cases were analysed and compared with pathology,including 11 patients with cancer,51 with polys ,9 with adenomas ,5 with adenomyomatoses. Results The semi - quantityy of CDFI, Vmax, RI in malignant lesions was much higher than that in benign lesions ,when Vmax with in lesions higher than 20cm/s was adopted a diagnostic criteria of gallbladder cancer, the sensitivity, specificity, and accuracy of the ultrasound in diagnosis of gallbladder cancer were 81.8 % ,98.5 % and 96.1% respectively, when RI with in lesions higher than 0.6 was adopted as diagnostic criteria of gallbladder cancer, the sensitivity, specificity and accuracy of the ultrasound in diagnosis of gallbladder cancer were 72.7% ,94% and 94.7% respectively. Conclusion Color doppler flow imaging was useful in the differential diagnosis of gallbladder bulging lesion in combination with 2D - ultrasonography.