超声检测小儿胆道畸形的临床价值

Value of ultrasound in diagnosing children′s choledochus malformation

目的探讨超声检测小儿胆道畸形的临床价值。方法对16例黄疸患儿进行肝胆脾超声检查,与手术结果进行对比,评价超声检测小儿胆道畸形的临床价值。结果16病例中,12例胆总管囊肿,其中8例超声表现为肝门部胆总管呈囊性迂曲扩张,2例超声检查提示扩张内胆总管合并结石,1例超声表现为胰腺增大,回声增强,3例扩张的胆总管内不清晰,可见点状回声漂浮沉积,术后证实为胆系感染,2例超声仅表现为囊性扩张;另4例胆总管囊肿病例超声仅表现为胆总管呈梭形扩张;2例胆道闭锁患儿病程均超过3个月,超声显示为肝脾大,肝内回声粗糙,肝表面不光滑,胆囊小,于左右肝管走行区呈条索状高回声;2例胆总管隔膜症,于胆总管内见隔膜样回声,隔膜间可见缝隙,胆囊大,继发肝内胆管轻度扩张。结论超声检查能清晰显示胆道的结构及与周围组织的关系,对小儿胆道畸形能作出客观的评价,有很高的临床应用价值。

[ Objective] To explore the clinical value of ultrasound in dignosing children choledochus malformation. [Methods] 16 childish patients were performed by ultrasound. To be compared with operation and to evaluate ultrasound dianosing value. [Results] Among 16 eases, 12 eases were congenital cyst of choledochus. The image of 8 eases of those were dilated and circuitous in chief bile duet in liver ostium. 2 cases of those were informed gall duet stone by ultrasound, 1 case was informed pancreas enlarged and echo intensified. 3 cases were not have the clearness in chief bile duet. Postoperation confirmed infectious in bile duet. 2 cases only had the image of cystic dilation in chief bile duet. Another 4 eases had the images of shuttle dilation in chief bile duet. 2 billiary atresia patients shew enlargement of liver and spleen, unsmoothly in surface, within roughness echo. The volume of gallbladder were very small and unelearness in it, while chief bile duet could not be seen and only high-echo sticky masses along with the left and right liver duet could be seen. 2 eases were choledochus septum. The septem in chief bile duet could be shown ,especially the little gap in septum was clearness. Subsequently gallbladder and bile duct in liver were enlarged and dilated slightly. [Conclusion] Ultrasound can show the structure of bile duct clearly and the relationship with its neighboring tissues. Which can make an odjective evaluation and has the highly significant in children＇s choledochus monstrosity.