原发性胆囊癌的超声诊断及漏误诊分析

Ultrasonic diagnosis of primary gallbladder carcinoma and analysis on reasons for its misdiagnosis

目的分析原发性胆囊癌的超声特点及误诊原因,提高超声对胆囊癌的诊断正确率。方法回顾性分析26例经手术和病理证实的胆囊癌的超声资料,分析胆囊癌超声表现及误诊为胆囊其他疾病的胆囊癌的超声影像学特点。结果26例胆囊癌中超声诊断18例(69.2%),漏误诊8例(30.8%)。胆囊癌的超声影像学表现分成4种类型:①囊壁局部或弥漫性增厚型11例(42.3%);②肿块型6例(23.1%);③乳头结节型8例(30.8%);④胆囊增大型1例(3.8%)。结论原发性胆囊癌超声表现多样化,易诊断为胆囊其他疾病,细致观察胆囊声像图,综合应用二维超声与彩色多普勒超声检查,有助于提高对早期诊断胆囊癌的诊断率。

Objective To analyze the ultrasonic features and causes for misdiagnosis of primary gallbladder carcinoma in order to raise the accurate rate of diagnosis of primary gallbladder carcinoma. Methods The ultrasonic data of 26 patients with primary gallbladder carcinoma diagnosed by pathological examination of operative specimens were retrospectively reviewed and analyzed in order to find out the characteristic ultrasonic features of primary gallbladder carcinoma and the causes for misdiagnosis. Results In 26 cases, 18 cases of primary gallbladder carcinoma were correctly diagnosed by ultrasonography （69.2%） , and 8 cases were misdiagnosed （30.8 % ）. The ultrasononic features of primary gallbladder carcinoma could be divided into 4 types： （1）ocal or total thickening of gallbladder wall（ 11/26 = 42.3 % ） ; （2）solid mass（6/26 = 23.1% ） ;（3）nodular bulge（ 8/26 = 30.8% ） ; （4）big gallbladder（ 1/26 =3.8% ）. Conclusion Although the uhrasonographic features of primary gallbladder carcinoma are diverse, and the aecurate rate of ultrasonographic diagnosis can he raised hy careful observation of the full view of gallbladder with the application of color Doppler imaging technique.