超声诊断周围型肝内胆管细胞癌

Gray-Scale Ultrasound Diagnosis of Peripheral Intrahepatic Cholangiocarcinoma

目的:探讨超声检查对周围型肝内胆管细胞癌的诊断价值。方法:对84例经手术及病理证实周围型肝内胆管细胞癌病例用超声检查观察病灶大小、边界、形态、回声,并结合患者的临床表现及实验室检查进行诊断。结果:二维声像图显示病灶最小20 mm×20 mm,最大为130 mm×100 mm,单发78例(92.8%),多发6例(7.2%),共92个病灶;病灶发生在右叶40例,左叶48例,中叶4例,病灶表现为低回声的56个(60.9%),回声不均匀的75个(81.5%),边界模糊的70个(76.1%);肿块呈分叶状的55个(59.8%)。乙型肝炎表面抗原(HBsAg)阳性者15例(17.9%),甲胎蛋白升高者20例(23.8%),糖类抗原19-9(CA19-9)升高者72例(85.7%);有胆道手术史及结石者50例(59.5%)。超声诊断的符合率为85.7%(72/84)。结论:周围型肝内胆管细胞癌的超声表现具有一定的特征,结合临床表现及实验室检查可提高对该病的诊断率。

Objective：To investigate the value of ultrasound in the diagnosis of the peripheral intrahepatic cholangiocarcinoma （ICC）.Methods：The clinical data of eighty-four ICCs confirmed pathologically were retrospectively analyzed.For each lesion, the size,boundary,shape,as well ad echo were evaluated.The clinical manifestation and laboratory examination were also taken into consideration to give a diagnosis.Results;The maximum diameter of the tumors ranged from 20mm to 130 mm.Seventy -eight（92.8%） cases had single lesion,and 6（7.2%） cases had multi lesions.Of all lesions,56（60.9%） tumors showed hypoecho,75（81.5%） showed inhomogenrous echo,70（76.1%） showed indefinite boundaries,55（59.8%） showed irregular shape,hepatitis B surface antigen（HBsAg） was positive in 15（17.9%） cases,Alphafetoprotein（AFP） elevated in 20 （23.8%） cases,and carbohydrate antigen 19-9（CA19-9） elevated in 72（85.7%） cases.Fifty（59.5%） cases had biliary tract surgery.The accuracy rate of the gray-scale ultrasound was 85.7%.Conclusions：The gray-scale ultrasound play an important role in diagnosing the peripheral intrahepatic cholangiocarcinoma.