先天性胆管扩张症45例影像学诊断分析

Imageological diagnostic analysis of congenital biliary dilatationg in 45 cases

目的通过与磁共振胆胰管成像(MRCP)对照分析45例先天性胆管扩张症的超声声像图特征及漏诊原因。方法对45例先天性胆管扩张症的超声(US)与MRCP检查结果进行对照分析。结果本组病例超声检查正确诊断率为91.1%。先天性胆管扩张症的超声声像图表现根据胆管扩张形态、累及范围分为:胆总管囊性扩张型(Ⅰ型)(84.4%),肝内、外胆管扩张型(Ⅳ型)(13.3%),肝内胆管囊性扩张型(Ⅴ型)(2.2%)。结论Ⅰ型先天性胆管扩张症因表现为典型超声声像图特征,故其诊断符合率较高(97.4%);Ⅳ型肝内、外胆管轻度不规则扩张及Ⅴ型肝内胆管多发囊性扩张,超声诊断易漏、误诊为肝内、外扩张及肝多发囊肿。

Objective To compared utlrasonographic characteristics and reasons for misdiagnosis of utlrasonographic diagnose results of 45 cases of CBD with MRCP.Methods To analyze comparatively the examination results of US and MRCP to the 45 cases of CBD.Results The correct rate of diagnosis in 45 cases which examinationed by US was 91.1%;The CBD＇s US sonogram by the basic of the bile ducts expangsion and the scope can be divided into cystic dilated common bile duct（Ⅰ type）（84.4%）;Both inside and outside the liver bile duct cystic expansion（Ⅳ type）（13.3%）;Cystic expansion of intrahepatic bile duct（Ⅴ type）（2.2%）.Conclusion The CBD of Ⅰ type＇s correct diagnose is higher because of its typical US sonogram characteristics（97.4%）.The CBD of Ⅳ type because of the inside and outside the liver bile ducts irregular expansion and the CBD of Ⅴ type whose inside liver bile ducts multiple cystic expansion,be easily misdiagnosis as the liver multiple cyst.