B超对腹水病人胆囊壁变化的探讨——附175例分析

ULTRASONIC CHANGES OF THE GALLBLADDER WALL IN PATIENT WITH ASCITES: AN ANALYSIS OF 175 CASES

本文对175例腹水病人胆囊壁声象图变化作对照分析。其中癌性腹膜炎50例,胆囊壁表现为单一的强回声(单层型),胆囊壁厚均在6mm以下,有30例胆囊壁厚度小于3mm。肝硬化100例,肝癌合并肝硬化20例,肾病综合征4例,Budd-chiari综合征1例,胆囊壁内有弱回声带出现(双层型),胆囊壁厚在7mm以上。文中描述了腹水时胆囊壁典型声象图特征,对胆囊壁变化的原因进行了分析,并讨论了其对腹水病因的诊断价值。与手术和病理对照分析结果显示其对癌性腹膜炎的确诊率为88%。

In this control study, the ultrasonic changes of the gallbladder wall in 175 cases of ascites were analysed. Of these cases, 50 had cancerous peritonitis, whose gallbladder walls manifested as high level echoes, and the thickness of whose gallbladder walls was not more than 6mm (called single wall). The rest were associated with liver cirrhosis (100), hepatic carcinoma complicated by cirrhosis of the liver (20), nephrotic syndrome (4) and Budd-Chiari syndrome (1). A thin weak echo layer within the echogenic gallbladder wall was observed (called double wall); the thickness of the wall was more than 7mm. In this paper, the characteristics of the typical ultrasound changes of the gallbladder wall in various ascitic cases were described, their causes were analysed, and their diagnostic value for the etiology of ascites was discussed. The results correlated with pathobiology and operating findings suggested that the sensitivity and specificity for diagnosis of cancerous peritonitis were 88%.