胃窗声学造影剂在下段胆管梗阻诊断中的临床应用

Clinical Application of Oral Ultrasonic Contrast Agent in Diagnosis of Obstruction of Distal Common Bile Duct

目的探讨口服"胃窗声学造影剂"超声检查在下段胆管梗阻诊断中的应用价值。方法对下段胆管梗阻致梗阻性黄疸患者共40例进行常规超声及采用口服"胃窗声学造影剂"超声检查,并与ERCP(内镜逆行胰胆管造影)或术后病理结果进行比较。结果①常规超声及采用口服"胃窗声学造影剂"超声检查能显示下段胆管梗阻分别为23例(57.5%)和37例(92.5%),后者较前者对下段胆管梗阻的显示率明显提高。②与ERCP或术后病理结果比较,常规超声对病因诊断准确性为52.5%,口服"胃窗声学造影剂"超声检查对病因诊断准确性为85.0%,后者较前者对下段胆管梗阻病因诊断准确性高。结论采用口服"胃窗声学造影剂"超声检查能明显改善对下段胆管梗阻病变的显示率,对梗阻病因的鉴别诊断有重要的临床价值。

Objective To assess the value of oral ultrasonic contrast agent uhrasonography（OUCAU） in the diagnosis of obstruction of distal common bile duct （DCBD）. Methods Forty consecutive patients with obstruction of DCBD were examined with conventional uhrasonography（US） and OUCAU ,respectively. Ultrasonic findings of both methods were compared with the re- suits of endoscopic retrograde cholangiopancreatography （ERCP） or surgical pathology. Results Of the forty patients, 23 （57.5%） were observed by US,and 37（92.5% ） were observed by OUCAU（P =0.009）. OUCAU improved the visualization of DCBD. The diagnostic accuracy of US and OUCAU was 52.5% and 85.0% ,respectively. There was a significant statistical difference in the diagnostic accuracy between US and OUCAU（P = 0. 007）. Conclusion OUCAU can greatly improve the visualization of DCBD, and it is helpful in the differential diagnosis of obstructive jaundice.